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Individual risk management strategy and potential therapeutic options for the COVID-19 pandemic.
Gasmi, A, Noor, S, Tippairote, T, Dadar, M, Menzel, A, Bjørklund, G
Clinical immunology (Orlando, Fla.). 2020;215:108409
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With the continuing spread of COVID-19 and lack of any approved treatments, this paper examines possible strategies for prevention. The data emerging so far highlights that individual health status plays a critical role in determining clinical severity of COVID-19 symptoms ranging from asymptomatic, mild, moderate, to death. Metabolic status, as determined by a patient’s diet, nutrition, age, sex, medical conditions, lifestyle, and environmental factors can therefore be considered preventative strategies to improve the severity of COVID-19 outcomes. Social distancing and personal hygiene are stated as the most effective strategies to prevent or slow spread of the disease. However individual health status, age and the presence of pre-existing comorbidities influences outcomes, as shown by global data highlighting a prevalence in older, males with metabolic conditions; hypertension in 23.7% patients and diabetes in 16.2% of patients. Older males appear more prone to infectious diseases with high pro-inflammatory immune responses and low adaptive immune responses than an older woman. Diet and healthy intestinal and respiratory tract microbiota may also influence immune system competence. Numerous micronutrients are essential for immunocompetence, particularly vitamin A, C, D, E, Bs, iron, selenium, and zinc. A balanced diet, high in colourful fruits and vegetables with a variation of prebiotic fibres, probiotics, and plant polyphenols and phytonutrients, help promote a healthy, diverse microbiota. Oral probiotics may also be beneficial to vulnerable individuals. Vitamin D supplementation is also proving helpful in prevention of acute respiratory tract infections. Other lifestyle factors such as smoking and exposure to environmental toxins should also be considered. Together these preventative measures may reduce personal risk of getting the disease.
Abstract
It is an ugly fact that a significant amount of the world's population will contract SARS-CoV-II infection with the current spreading. While a specific treatment is not yet coming soon, individual risk assessment and management strategies are crucial. The individual preventive and protective measures drive the personal risk of getting the disease. Among the virus-contracted hosts, their different metabolic status, as determined by their diet, nutrition, age, sex, medical conditions, lifestyle, and environmental factors, govern the personal fate toward different clinical severity of COVID-19, from asymptomatic, mild, moderate, to death. The careful individual assessment for the possible dietary, nutritional, medical, lifestyle, and environmental risks, together with the proper relevant risk management strategies, is the sensible way to deal with the pandemic of SARS-CoV-II.
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Multivitamin and Mineral Supplementation Containing Phytonutrients Scavenges Reactive Oxygen Species in Healthy Subjects: A Randomized, Double-Blinded, Placebo-Controlled Trial.
Kang, S, Lim, Y, Kim, YJ, Jung, ES, Suh, DH, Lee, CH, Park, E, Hong, J, Velliquette, RA, Kwon, O, et al
Nutrients. 2019;11(1)
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Plant-based multivitamin/mineral and phytonutrient (PMP) supplementation has been reported to reduce oxidative stress, thus alleviating many chronic diseases, though inconsistent results have been published. The aim of this randomised, double-blind, parallel-arm, placebo-controlled trial was to determine the antioxidant and protective capacity of a PMP supplementation in 96 healthy adults with habitually low fruit and vegetable intake. After a two-week run in period, participants were randomised to consume either a PMP supplement or colour-matched control for eight weeks. The PMP supplement contained 14 vitamins, 10 minerals and 22 phytonutrient extracts. Blood was taken at baseline and conclusion of the intervention period. This study found that after an eight-week PMP supplementation, several plasma vitamins and phytonutrients were associated with reduced markers of oxidation and DNA damage compared to the control group. Based on these results, the authors conclude PMP supplement may support the body's ability to handle oxidative stress and suggest further research be conducted to better understand the role mechanisms action of phytonutrients.
Abstract
Phytonutrients and vitamin and mineral supplementation have been reported to provide increased antioxidant capacity in humans; however, there is still controversy. In the current clinical trial, we examined the antioxidant and DNA protection capacity of a plant-based, multi-vitamin/mineral, and phytonutrient (PMP) supplementation in healthy adults who were habitually low in the consumption of fruits and vegetables. This study was an eight-week, double-blind, randomized, parallel-arm, and placebo-controlled trial. PMP supplementation for eight weeks reduced reactive oxygen species (ROS) and prevented DNA damage without altering endogenous antioxidant system. Plasma vitamins and phytonutrients were significantly correlated with ROS scavenging and DNA damage. In addition, gene expression analysis in PBMC showed subtle changes in superoxide metabolic processes. In this study, we showed that supplementation with a PMP significantly improved ROS scavenging activity and prevented DNA damage. However, additional research is still needed to further identify mechanisms of actions and the role of circulating phytonutrient metabolites.
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Cardiovascular Health Benefits of Specific Vegetable Types: A Narrative Review.
Blekkenhorst, LC, Sim, M, Bondonno, CP, Bondonno, NP, Ward, NC, Prince, RL, Devine, A, Lewis, JR, Hodgson, JM
Nutrients. 2018;10(5)
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Diets high in vegetables are linked with a lower incidence of chronic disease. Some vegetables may have much larger health benefits in comparison to others, and therefore dietary guidelines could be developed to include targeted advice on consuming specific types of vegetables with the greatest health benefits. This review of observational studies focused on the cardiovascular health benefits of specific vegetable types. Vegetables discussed in this review were grouped into the following types: leafy green, cruciferous, alliums, yellow-orange-red and legumes. These vegetables contain many nutrients and phytochemicals that have been proposed to have benefits for cardiovascular health. The authors looked at the results from nearly 100 observational studies. Most of the studies were carried out on older adults; some were focussed on a single gender (male or female), and some were mixed. Follow up periods in the studies ranged from 3 years to 28 years. Most of the studies relied on food frequency questionnaires (FFQs) to estimate vegetable consumption, and many did not define the size of a vegetable portion in grams. The percentage of studies demonstrating significant benefits of vegetable consumption on CVD ranged from 25% for legumes to 43% for leafy greens. The strongest beneficial effects on CVD risk were seen for leafy green and cruciferous vegetables. The authors concluded that the evidence in this review suggests intake of leafy green and cruciferous vegetables may confer strong cardiovascular health benefits. Increasing vegetable intake, with a focus on leafy green and cruciferous vegetables may provide the greatest benefits.
Expert Review
Conflicts of interest:
Educator for various organizations, such as Institute for Functional Medicine, American Academy for Anti-Aging Medicine
Take Home Message:
- Green leafy vegetables and cruciferous vegetables were found to most impactful for cardiovascular health.
Evidence Category:
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A: Meta-analyses, position-stands, randomized-controlled trials (RCTs)
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B: Systematic reviews including RCTs of limited number
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C: Non-randomized trials, observational studies, narrative reviews
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D: Case-reports, evidence-based clinical findings
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E: Opinion piece, other
Summary Review:
This review highlights the role of specific types of vegetables based on color and nutrients for cardiovascular health benefit.
Clinical practice applications:
The authors investigated whether some vegetable types were more relevant for cardiovascular-related issues than others. Based on their review of the scientific literature, green, leafy vegetables and cruciferous vegetables were found to be most impactful.
Considerations for future research:
This review suggests that more research is needed to understand how certain plant foods, vegetables, and phytochemicals may be functionally important for certain organ systems.
Abstract
Adequate vegetable consumption is one of the cornerstones of a healthy diet. The recommendation to increase vegetable intake is part of most dietary guidelines. Despite widespread and long-running public health messages to increase vegetable intake, similar to other countries worldwide, less than 1 in 10 adult Australians manage to meet target advice. Dietary guidelines are predominantly based on studies linking diets high in vegetables with lower risk of chronic diseases. Identifying vegetables with the strongest health benefits and incorporating these into dietary recommendations may enhance public health initiatives around vegetable intake. These enhanced public health initiatives would be targeted at reducing the risk of chronic diseases, such as cardiovascular diseases (CVD). Specific vegetable types contain high levels of particular nutrients and phytochemicals linked with cardiovascular health benefits. However, it is not clear if increasing intake of these specific vegetable types will result in larger benefits on risk of chronic diseases. This review presents an overview of the evidence for the relationships of specific types of vegetables, including leafy green, cruciferous, allium, yellow-orange-red and legumes, with subclinical and clinical CVD outcomes in observational epidemiological studies.
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Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial.
Tiralongo, E, Wee, SS, Lea, RA
Nutrients. 2016;8(4):182
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Long-haul air travel increases the occurrence of respiratory illnesses such as the common cold. Elderberries have anti-bacterial and anti-viral properties and previous studies have shown that an elderberry extract can reduce the duration and severity of cold and flu symptoms. This randomised controlled trial aimed to identify whether capsules containing a standardised elderberry extract are effective in preventing respiratory symptoms in travellers on long-haul flights. 325 healthy adults volunteered for the study. Participants were split into two groups: one group was given capsules each containing 300mg of Elderberry extract, and the other group was given placebo capsules. For both groups, participants were given 2 capsules a day for 10 days leading up to travelling, and 3 capsules a day during travel and for four to five days after reaching their destination. Participants completed health surveys 10 days and two days before travelling, and then again five days after. They also kept a daily diary of cold symptoms. Participants in both the placebo and elderberry group tended to experience an increase in respiratory symptoms after travelling. The elderberry group experienced less colds than the placebo group, although the difference was not statistically significant. Elderberry supplementation did however result in a reduction in symptoms, and shortened the cold duration by approximately two days compared to the placebo. The authors recommend that more clinical research with high quality elderberry preparations is carried out to better understand the health benefits of this traditional medicine.
Abstract
Intercontinental air travel can be stressful, especially for respiratory health. Elderberries have been used traditionally, and in some observational and clinical studies, as supportive agents against the common cold and influenza. This randomized, double-blind placebo-controlled clinical trial of 312 economy class passengers travelling from Australia to an overseas destination aimed to investigate if a standardised membrane filtered elderberry (Sambucus nigra L.) extract has beneficial effects on physical, especially respiratory, and mental health. Cold episodes, cold duration and symptoms were noted in a daily diary and assessed using the Jackson score. Participants also completed three surveys containing questions regarding upper respiratory symptoms (WURSS-21) and quality of life (SF-12) at baseline, just before travel and at 4-days after travel. Most cold episodes occurred in the placebo group (17 vs. 12), however the difference was not significant (p = 0.4). Placebo group participants had a significantly longer duration of cold episode days (117 vs. 57, p = 0.02) and the average symptom score over these days was also significantly higher (583 vs. 247, p = 0.05). These data suggest a significant reduction of cold duration and severity in air travelers. More research is warranted to confirm this effect and to evaluate elderberry's physical and mental health benefits.