-
1.
The Role of Lung and Gut Microbiota in the Pathology of Asthma.
Barcik, W, Boutin, RCT, Sokolowska, M, Finlay, BB
Immunity. 2020;52(2):241-255
-
-
-
Free full text
-
Plain language summary
Over 300 million people suffer with asthma worldwide and it has emerged that microbiome analysis of the lung and gut bacteria, fungi, viruses, and archaea may help with disease management. This microbiome plays an important role in immune response. Disturbances to these microbes, known as dysbiosis, may influence onset of disease and the body’s ability to respond naturally, and/or to pharmaceutical treatments. Asthma is not a singular disease and there are great variations in symptom severity and underlying immune mechanisms. Patients are typically classified as type 2 or non-type 2. Type 2 patients tend to be allergic to common air-born allergens which can trigger an attack. Treatment usually consists of glucocorticosteroids or novel biologicals. Non type-2 asthma is associated with obesity-related asthma and typically responds poorly to steroid treatment. For a long time, researchers believed the human lungs to be sterile, so they were initially not included in the 2007 Human Microbiome Project. It has since been shown that, like the gut, the lungs and respiratory tract also host various microbes, and this healthy-airway microbiota influence innate and adaptive immune processes. The Gut-Lung axis also confers additional microbial benefits from the intestines. In asthma patients, there is often an over-dominance of pathogenic bacteria. Fungal dysbiosis is associated with high-risk asthma phenotypes in childhood. Viral infections have been shown as a primary cause of asthmatic episodes. Future diagnosis and treatment of patients with asthma should be assisted by analysis of the composition and metabolic activity of an individual’s microbiome.
Abstract
Asthma is a common chronic respiratory disease affecting more than 300 million people worldwide. Clinical features of asthma and its immunological and molecular etiology vary significantly among patients. An understanding of the complexities of asthma has evolved to the point where precision medicine approaches, including microbiome analysis, are being increasingly recognized as an important part of disease management. Lung and gut microbiota play several important roles in the development, regulation, and maintenance of healthy immune responses. Dysbiosis and subsequent dysregulation of microbiota-related immunological processes affect the onset of the disease, its clinical characteristics, and responses to treatment. Bacteria and viruses are the most extensively studied microorganisms relating to asthma pathogenesis, but other microbes, including fungi and even archaea, can potently influence airway inflammation. This review focuses on recently discovered connections between lung and gut microbiota, including bacteria, fungi, viruses, and archaea, and their influence on asthma.
-
2.
Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections.
Calder, PC, Carr, AC, Gombart, AF, Eggersdorfer, M
Nutrients. 2020;12(4)
-
-
-
Free full text
Plain language summary
Acute respiratory tract infections are a major cause of morbidity and mortality across the globe with seasonal influenza epidemics and outbreaks of viruses, such as Covid-19. The authors support public hygiene practices and the development of vaccinations however call for further strategies in order to reduce the impact that these infections have on societies. The role nutrition plays in supporting the immune system is well established. This review article and opinion piece presents the evidence for Vitamins A, B6, B12, C, D, E and folate; trace elements including zinc, selenium, magnesium and copper; and omega-3 fatty acids in supporting the immune system. The authors call for the consumption of a well-balanced diet, with additional supplementation of key immune supportive nutrients. Well referenced and with a helpful table of the rationale and recommended nutrient intake levels, Nutrition Practitioners will find this article useful when working to support client immune health.
Abstract
Public health practices including handwashing and vaccinations help reduce the spread and impact of infections. Nevertheless, the global burden of infection is high, and additional measures are necessary. Acute respiratory tract infections, for example, were responsible for approximately 2.38 million deaths worldwide in 2016. The role nutrition plays in supporting the immune system is well-established. A wealth of mechanistic and clinical data show that vitamins, including vitamins A, B6, B12, C, D, E, and folate; trace elements, including zinc, iron, selenium, magnesium, and copper; and the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid play important and complementary roles in supporting the immune system. Inadequate intake and status of these nutrients are widespread, leading to a decrease in resistance to infections and as a consequence an increase in disease burden. Against this background the following conclusions are made: (1) supplementation with the above micronutrients and omega-3 fatty acids is a safe, effective, and low-cost strategy to help support optimal immune function; (2) supplementation above the Recommended Dietary Allowance (RDA), but within recommended upper safety limits, for specific nutrients such as vitamins C and D is warranted; and (3) public health officials are encouraged to include nutritional strategies in their recommendations to improve public health.
-
3.
The impact of nutrition on COVID-19 susceptibility and long-term consequences.
Butler, MJ, Barrientos, RM
Brain, behavior, and immunity. 2020;87:53-54
-
-
-
Free full text
-
Plain language summary
The impacts of Covid-19 are being felt across the world, affecting health, healthcare and economies. Statistics from across the world are showing that the elderly, those with underlying medical conditions and under-represented minority groups are particularly vulnerable to severe complications and have a higher risk of dying of Covid-19. This opinion piece presents arguments for the importance of focusing on diet to support health resilience in general and the immune system in particular, to minimise the impact of this and future viruses. Research is presented on excessive intake of saturated fat leading to chronic activation of the innate immune system (first line, rapid defence against infection), resulting in inflammation, and associated heightened susceptibility to complications of viral infection. The standard western diet (high saturated fat, refined carbohydrates and sugars, low levels of fibre, unsaturated fat and antioxidants) has also been shown to affect the adaptive immune system (second line, delayed defence against infection), depressing its action against infection. The piece also discusses possible long-term, future impacts of those recovered from Covid-19 infection, particularly in relation to neurodegenerative diseases such as Alzheimer’s. The authors call for fresh, healthy wholefoods to be readily available and affordable to everyone in society.
Abstract
While all groups are affected by the COVID-19 pandemic, the elderly, underrepresented minorities, and those with underlying medical conditions are at the greatest risk. The high rate of consumption of diets high in saturated fats, sugars, and refined carbohydrates (collectively called Western diet, WD) worldwide, contribute to the prevalence of obesity and type 2 diabetes, and could place these populations at an increased risk for severe COVID-19 pathology and mortality. WD consumption activates the innate immune system and impairs adaptive immunity, leading to chronic inflammation and impaired host defense against viruses. Furthermore, peripheral inflammation caused by COVID-19 may have long-term consequences in those that recover, leading to chronic medical conditions such as dementia and neurodegenerative disease, likely through neuroinflammatory mechanisms that can be compounded by an unhealthy diet. Thus, now more than ever, wider access to healthy foods should be a top priority and individuals should be mindful of healthy eating habits to reduce susceptibility to and long-term complications from COVID-19.
-
4.
COVID-19: The Inflammation Link and the Role of Nutrition in Potential Mitigation.
Zabetakis, I, Lordan, R, Norton, C, Tsoupras, A
Nutrients. 2020;12(5)
-
-
-
Free full text
Plain language summary
By May 2020, the novel coronoavirus COVID-19 had infected over 4 million people worldwide. Spread through droplet, it gains entry to body cells through ACE2 cell receptors, causing viral infection-related inflammation, and predominantly infects the lower respiratory tract. Those with non-communicable diseases with COVID-19 experience increased inflammation and have a higher risk of adverse outcomes and mortality. This review article gives details of the mechanisms involved in a cytokine storm (an uncontrolled inflammatory response) and current treatment options, before discussing the immune-balancing and anti-inflammatory potential of healthy nutrition in reducing susceptibility to developing infections. Nutrition Practitioners looking to support the immunity and inflammation of their clients will find the summary research presented in relation to dietary strategies, different food groups and nutrients a useful basis for further study.
Abstract
The novel coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has engulfed the world, affecting more than 180 countries. As a result, there has been considerable economic distress globally and a significant loss of life. Sadly, the vulnerable and immunocompromised in our societies seem to be more susceptible to severe COVID-19 complications. Global public health bodies and governments have ignited strategies and issued advisories on various handwashing and hygiene guidelines, social distancing strategies, and, in the most extreme cases, some countries have adopted "stay in place" or lockdown protocols to prevent COVID-19 spread. Notably, there are several significant risk factors for severe COVID-19 infection. These include the presence of poor nutritional status and pre-existing noncommunicable diseases (NCDs) such as diabetes mellitus, chronic lung diseases, cardiovascular diseases (CVD), obesity, and various other diseases that render the patient immunocompromised. These diseases are characterized by systemic inflammation, which may be a common feature of these NCDs, affecting patient outcomes against COVID-19. In this review, we discuss some of the anti-inflammatory therapies that are currently under investigation intended to dampen the cytokine storm of severe COVID-19 infections. Furthermore, nutritional status and the role of diet and lifestyle is considered, as it is known to affect patient outcomes in other severe infections and may play a role in COVID-19 infection. This review speculates the importance of nutrition as a mitigation strategy to support immune function amid the COVID-19 pandemic, identifying food groups and key nutrients of importance that may affect the outcomes of respiratory infections.
-
5.
COVID-19 and diabetes: The why, the what and the how.
Cuschieri, S, Grech, S
Journal of diabetes and its complications. 2020;34(9):107637
-
-
-
Free full text
-
Plain language summary
Early reports have shown that individuals with diabetes who contract Covid-19 have higher hospital admissions and mortality rates, classing them as a vulnerable group. This review paper aimed to explain why this group of people are vulnerable and what measures could be recommended. The paper outlined that individuals with diabetes have a compromised immune system due to uncontrolled blood sugar levels. In addition to this, individuals with diabetes and Covid-19 may have a higher risk of organ damage due to the effects of the body's immune response combined with the disordered biological processes associated with their pre-existing condition. Conversely, it was discussed that Covid-19 could exacerbate diabetes progression if the Covid-19 virus entered the cells of the pancreas, causing a blood sugar imbalance. As a result, the importance of optimal blood sugar control was outlined. Several medications were addressed and their benefits/disadvantages discussed. Amongst those reviewed were medications such as GLP-1 agonists, which may help with controlling blood sugar levels and may prevent Covid-19 entering the body's own cells, and metformin, which was initially developed as an anti-influenza drug. Finally the paper discussed diabetes specific precautions to avoid contracting Covid-19. Vitamin D supplementation, regular blood sugar checks, lifestyle measures such as exercise and dietary requirements and allowing individuals with diabetes to have large supplies of their medications to avoid leaving the house were discussed. It was concluded that during the Covid-19 pandemic, individuals with diabetes require particular care in order to avoid additional burden on healthcare systems. For those individuals with diabetes who haven’t contracted Covid-19, this paper could be used to recommend any extra precautions to take to avoid contracting this virus.
Abstract
BACKGROUND The novel coronavirus SARS-CoV-2 has taken the world by storm. Alongside COVID-19, diabetes is a long-standing global epidemic. The diabetes population has been reported to suffer adverse outcomes if infected by COVID-19. The aim was to summarise information and resources available on diabetes and COVID-19, highlighting special measures that individuals with diabetes need to follow. METHODS A search using keywords "COVID-19" and "Diabetes" was performed using different sources, including PubMed and World Health Organization. RESULTS COVID-19 may enhance complications in individuals with diabetes through an imbalance in angiotension-converting enzyme 2 (ACE2) activation pathways leading to an inflammatory response. ACE2 imbalance in the pancreas causes acute β-cell dysfunction and a resultant hyperglycemic state. These individuals may be prone to worsened COVID-19 complications including vasculopathy, coagulopathy as well as psychological stress. Apart from general preventive measures, remaining hydrated, monitoring blood glucose regularly and monitoring ketone bodies in urine if on insulin is essential. All this while concurrently maintaining physical activity and a healthy diet. Different supporting entities are being set up to help this population. CONCLUSION COVID-19 is a top priority. It is important to remember that a substantial proportion of the world's population is affected by other co-morbidities such as diabetes. These require special attention during this pandemic to avoid adding on to the burden of countries' healthcare systems.
-
6.
Antiviral Functional Foods and Exercise Lifestyle Prevention of Coronavirus.
Alkhatib, A
Nutrients. 2020;12(9)
-
-
-
Free full text
Plain language summary
In lieu of a vaccine, complementary therapies have a major role to play in the Covid-19 pandemic. This review paper aimed to highlight how lifestyle approaches such as consumption of functional foods and increased physical activity could optimise the immune system in response to viral infections such as respiratory tract infections and Covid-19, and act as a possible adjuvant to vaccination. The paper outlined the role of exercise as being controversial. Although exercise has been shown to activate white blood cells, intense exercise in elite athletes has been linked to higher upper respiratory tract infection rates. It appears that varying intensity and type of exercise may optimise the immune system and have an additive effect to immunisation against viruses like influenza. The authors also stated that having a sedentary lifestyle may impair the immune system and diseases such as obesity and diabetes may increase susceptibility to infections such as Covid-19. The antiviral effect of functional foods was discussed. The paper paid particular attention to olive oil, vitamin D, traditional herbs and roots, coffee and caffeine. The reviewed mechanisms included enhanced gut bacteria profiles and promotion of anti-oxidants and anti-inflammatories. The authors also stated that supplementation as well as adequate dietary intake might be of importance against Covid-19, especially in deficient individuals. It was concluded that moderate intensity exercise alongside dietary intake of functional foods, may prevent communicable diseases, such as Covid-19. Clinicians could use this paper to recommend specific functional foods plus moderate exercise, to help prevent viral infections like Covid-19.
Abstract
Novel coronavirus (COVID-19) is causing global mortality and lockdown burdens. A compromised immune system is a known risk factor for all viral influenza infections. Functional foods optimize the immune system capacity to prevent and control pathogenic viral infections, while physical activity augments such protective benefits. Exercise enhances innate and adaptive immune systems through acute, transient, and long-term adaptations to physical activity in a dose-response relationship. Functional foods prevention of non-communicable disease can be translated into protecting against respiratory viral infections and COVID-19. Functional foods and nutraceuticals within popular diets contain immune-boosting nutraceuticals, polyphenols, terpenoids, flavonoids, alkaloids, sterols, pigments, unsaturated fatty-acids, micronutrient vitamins and minerals, including vitamin A, B6, B12, C, D, E, and folate, and trace elements, including zinc, iron, selenium, magnesium, and copper. Foods with antiviral properties include fruits, vegetables, fermented foods and probiotics, olive oil, fish, nuts and seeds, herbs, roots, fungi, amino acids, peptides, and cyclotides. Regular moderate exercise may contribute to reduce viral risk and enhance sleep quality during quarantine, in combination with appropriate dietary habits and functional foods. Lifestyle and appropriate nutrition with functional compounds may offer further antiviral approaches for public health.
-
7.
Coronavirus disease 2019 (COVID-19) and obesity. Impact of obesity and its main comorbidities in the evolution of the disease.
Cornejo-Pareja, IM, Gómez-Pérez, AM, Fernández-García, JC, Barahona San Millan, R, Aguilera Luque, A, de Hollanda, A, Jiménez, A, Jimenez-Murcia, S, Munguia, L, Ortega, E, et al
European eating disorders review : the journal of the Eating Disorders Association. 2020;28(6):799-815
-
-
-
Plain language summary
The Covid-19 pandemic has caused thousands of deaths worldwide. Being obese is associated with worse outcomes following infection with Covid-19. This review aimed to summarise the data available on the relationship between Covid-19 and obesity, and explored some of the possible reasons for this relationship. The researchers found that obesity is an independent and strong risk factor for severe infection, Intensive Care Unit (ICU) admission and death. The impact of obesity might be of particular relevance in males and in younger individuals. Long‐term complications of Covid‐19 could also be more frequent and severe in obese subjects. There are many potential mechanisms that could explain this relationship. These include the effects of obesity and related diseases such as diabetes, high blood pressure and heart disease on the immune system, lung function, vitamin D deficiency and male hormones. The researchers also discussed the possibility of fat cells acting as a possible reservoir for Covid-19 infection. Research into Covid-19 is still at a very early stage and more studies are needed.
Abstract
The COVID-19 pandemic is posing a great challenge worldwide. Its rapid progression has caused thousands of deaths worldwide. Although multiple aspects remain to be clarified, some risk factors associated with a worse prognosis have been identified. These include obesity and some of its main complications, such as diabetes and high blood pressure. Furthermore, although the possible long-term complications and psychological effects that may appear in survivors of COVID-19 are not well known yet, there is a concern that those complications may be greater in obese patients. In this manuscript, we review some of the data published so far and the main points that remain to be elucidated are emphasized.
-
8.
Vitamin C-An Adjunctive Therapy for Respiratory Infection, Sepsis and COVID-19.
Holford, P, Carr, AC, Jovic, TH, Ali, SR, Whitaker, IS, Marik, PE, Smith, AD
Nutrients. 2020;12(12)
-
-
-
Free full text
Plain language summary
High levels of vitamin C are likely required during viral infections due to its ability to decrease inflammation and control the immune system. This large review looked at 119 studies surrounding this. Evidence supporting vitamin C deficiency during several viral infections was reviewed, however studies in Covid-19 are lacking. At the time of writing, 45 trials of vitamin C and Covid-19 were in progress. It was stated that deficiency could be due to increased use during infection. The authors reviewed clinical research of vitamin C in colds, pneumonia, sepsis and Covid-19. The general trend was that severity of symptoms and duration of illness decreased with vitamin C. Vitamin C supplementation was generally considered safe, although those with history of kidney stones or kidney dysfunction should be cautious. It was concluded that the potential of vitamin C to reduce inflammation and influence the immune system alongside its safety profile and low cost, makes it a possible therapy for those with Covid-19. This paper could be used by healthcare professionals to help understand the overall role of vitamin C in viral infections with a view to recommendation to individuals with viral infections.
Abstract
There are limited proven therapies for COVID-19. Vitamin C's antioxidant, anti-inflammatory and immunomodulating effects make it a potential therapeutic candidate, both for the prevention and amelioration of COVID-19 infection, and as an adjunctive therapy in the critical care of COVID-19. This literature review focuses on vitamin C deficiency in respiratory infections, including COVID-19, and the mechanisms of action in infectious disease, including support of the stress response, its role in preventing and treating colds and pneumonia, and its role in treating sepsis and COVID-19. The evidence to date indicates that oral vitamin C (2-8 g/day) may reduce the incidence and duration of respiratory infections and intravenous vitamin C (6-24 g/day) has been shown to reduce mortality, intensive care unit (ICU) and hospital stays, and time on mechanical ventilation for severe respiratory infections. Further trials are urgently warranted. Given the favourable safety profile and low cost of vitamin C, and the frequency of vitamin C deficiency in respiratory infections, it may be worthwhile testing patients' vitamin C status and treating them accordingly with intravenous administration within ICUs and oral administration in hospitalised persons with COVID-19.
-
9.
Nutrition, Health, and Disease: Role of Selected Marine and Vegetal Nutraceuticals.
Corzo, L, Fernández-Novoa, L, Carrera, I, Martínez, O, Rodríguez, S, Alejo, R, Cacabelos, R
Nutrients. 2020;12(3)
-
-
-
Free full text
Plain language summary
Eating habits not only affect current health but may determine the development of future diseases in later stages of life. The appearance of genomics has presented an opportunity to explore the inter-individual differences in the metabolism of and response to nutrients. Nutraceuticals are biological substances extracted from natural sources by non-denaturing processes to preserve their original properties without any chemical manipulation. Thus, non-denaturation conditions and the use of the original matrix of the species allow all health-beneficial properties to remain intact. This review outlines that: - fish occupies the highest position in marine animal consumption. Literature shows strong links between fish and seafood consumption and positive health effects, particularly in a decreased risk of coronary heart and cardiovascular diseases, a decrease in inflammatory diseases such as arthritis, and the prevention of cancer. - the consumption of complex marine extracts provides numerous health benefits concerning the immune system, hypertension, atherosclerosis, arthritis, and menopause-related dysfunctions, and might reduce the risk of cardiovascular problems, osteoporosis, or senile muscle weakness. - based on nutrigenomic and epigenomic principles, nutritional advice can benefit the relationship between genes and the nutritional habit-related consequences. Authors conclude that the use of each person’s genetic profile for the prescription of nutraceuticals is a major goal to be striven for in order to improve their effectiveness in the prevention and natural treatment of prevalent diseases.
Abstract
The investigation of new alternatives for disease prevention through the application of findings from dietary and food biotechnology is an ongoing challenge for the scientific community. New nutritional trends and the need to meet social and health demands have inspired the concept of functional foods and nutraceuticals which, in addition to their overall nutritional value, present certain properties for the maintenance of health. However, these effects are not universal. Nutrigenetics describes how the genetic profile has an impact on the response of the body to bioactive food components by influencing their absorption, metabolism, and site of action. The EbioSea Program, for biomarine prospection, and the Blue Butterfly Program, for the screening of vegetable-derived bioproducts, have identified a new series of nutraceuticals, devoid of side effects at conventional doses, with genotype-dependent preventive and therapeutic activity. Nutrigenomics and nutrigenetics provide the opportunity to explore the inter-individual differences in the metabolism of and response to nutrients, achieving optimal results. This fact leads to the concept of personalized nutrition as opposed to public health nutrition. Consequently, the development and prescription of nutraceuticals according to the individual genetic profile is essential to improve their effectiveness in the prevention and natural treatment of prevalent diseases.
-
10.
Obesity, Cardiovascular Disease, and Influenza: How Are They Connected?
Gutiérrez-Spillari, L, Palma M, G, Aceituno-Melgar, J
Current tropical medicine reports. 2020;7(3):92-97
-
-
-
Free full text
Plain language summary
Retrospective studies demonstrate that during the 2009 H1N1 pandemic, obesity was identified as a risk factor for hospitalization, mechanical ventilation, and mortality upon infection. This study is a review which focuses on how obesity and cardiovascular disease impact influenza response. A higher body mass index and metabolic syndrome in patients with influenza have shown an increased risk and length of hospitalization, increased disease severity, morbidity, and mortality during lower respiratory tract infections. Obesity causes a chronic state of inflammation in a generalized and constant way with negative effects on immunity. In fact, obese people have delayed immune responses to influenza virus infection and experience slower recovery from the disease. Thus, recent recommendation advocates the priority of vaccination against influenza in obese patients. Furthermore, cardiovascular diseases, such as ischemic heart disease and heart failure combined with influenza A infection, can trigger acute heart failure exacerbations that increase the overall mortality in a hospitalized setting. The cardioprotective mechanism of influenza vaccination may not function effectively in obese cohorts, thus authors conclude that in order to prevent these complications and in the absence of special consideration treatments for this population, a weight-loss approach is highly recommended.
Abstract
PURPOSE OF REVIEW To better understand the impact of obesity and cardiovascular diseases on influenza A infection. RECENT FINDINGS This infection could have detrimental outcomes in obese patients with cardiovascular diseases, such as an increased risk, length of hospitalization, disease severity, morbidity, and mortality. Nevertheless, there also might be some cardioprotective benefits associated with influenza vaccination, such as a reduced mortality, hospitalization, and acute coronary syndromes, in patients with coronary heart disease and/or heart failure. SUMMARY Obesity negatively impacts immune function and host defense. Recent studies report obesity to be an independent risk factor for increased morbidity and mortality following infection. Obese patients might need special considerations in the treatment; however, there is not enough evidence to fully comprehend the mechanisms behind the reduced immunocompetence when influenza A infection occurs. Future studies should focus on special consideration treatments when the patients have not been vaccinated and have cardiovascular diseases.