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Cover page of the Journal of Health Sciences


 
 Table of Contents  
LETTER TO EDITOR
Year : 2020  |  Volume : 13  |  Issue : 2  |  Page : 171-174

The immunity boosting circus


Nutrition Coach and Trainer, ExploRunner, Mumbai, Maharashtra, India

Date of Submission11-Apr-2020
Date of Acceptance20-May-2020
Date of Web Publication23-Jun-2020

Correspondence Address:
Ms. Jessica Philip
Nutrition Coach and Trainer, ExploRunner, Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kleuhsj.kleuhsj_106_20

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How to cite this article:
Philip J. The immunity boosting circus. Indian J Health Sci Biomed Res 2020;13:171-4

How to cite this URL:
Philip J. The immunity boosting circus. Indian J Health Sci Biomed Res [serial online] 2020 [cited 2020 Aug 3];13:171-4. Available from: http://www.ijournalhs.org/text.asp?2020/13/2/171/287383



Dear Editor,



Things media won't tell you about immunity but your healthcare professional would

(Image credit: George Crux@ freeimages.com)

The COVID-19 pandemic has unleashed a barrage of experiences upon us. One of which is your daily dose of social media messaging on how to “boost” immunity. While the intentions are noble which is to give your body a fighting chance against an infection, some of these messages perpetuate “beliefs” rather than science.

All of you reading this may have even received those marketing messages on the immunity boosting supplements, notably among them Vitamin C supplements.[1] Let me throw my two cents worth of information here.

Let me explain with the help of an analogy. Let's say there are two beautiful neighboring kingdoms each ruled by their own Kings. Kingdom 1 believes that they must build a fortress to protect against any unforeseen circumstances and they must dedicate resources from the very beginning in building and maintaining the fortress. They are the “precautionary” group. Hence they build and maintain it over years. Kingdom 2 believes that itis an unnecessary economic burden to build and maintain a fortress for an event whose likelihood of occurrence is not known. They vote for being the “reactionary” group and will pool resources only when necessary. Now, let's say the unfortunate event does occur and an enemy challenges both Kings to besiege the Kingdoms within days. Obviously, Kingdom 2 will now spring to action and attempt to build a fortress. Kingdom 2 would hurry and summon the best of their skills. However, time is the enemy here. How quickly can you build something despite the best of resources?

Now, could you guess which Kingdom would be easier to attack? Kingdom 1 or 2? And you would understand the intention of writing this blog. Rome was not built in a day and so was your immunity.[2]

You were blessed with Immunity right from the time you exited your mother's womb.[3] Whether you developed and maintained it over the years to fight any impending event is a question you need to ask yourself.[4],[5],[6] Believe it or not, looking after your immunity is not difficult; it just takes effort on your end. What are those components of the effort?


  Movement Top


This would in involve moderate intensity exercise for 30 min totaling 150 min over a week or 75 min of vigorous intensity exercise over a week. This is a universal guideline. Movement, as the word suggests, helps move the vast array of your own immune cells to every nook and cranny of your body. Note that vigorous intensity exercise leads to a transient drop in immunity.[7],[8],[9] Hence, running a marathon (a vigorous intensity activity) in your balcony in COVID-19 hotspot is not a good idea simply because you are more vulnerable to an infection. While the World may cheer at the bravery of an attempt like this, it is outright silly and there would be better, safer times to attempt this. People who are habitual smart exercisers (and by smart I mean not those attempting a silly bravado), and those who do just enough not too much not too less, are the ones better equipped to fight an infection.


  Sleep Top


Your immune system is constantly on lookout for attackers, i.e., pathogens. Pathogens would need to cross many layers of your body's defense system (which includes your immune response) to be successful at attacking you. While your innate immunity cells (your first immunity line of defense in an attack) do its job of destroying and spitting out remains of pathogens, the repair process is always on and this is facilitated even more done during sleep. While most people are working from home gorging those Vitamin c supplements, are they getting their 7–8 h worth of daily sleep?[10]


  Your “Nutriture” Top


In simpler words, your nutritional status. This, like the two kingdoms example, is something that is built up with a fortress called habits- a habit of eating simpler unprocessed foods as per the body's needs such as a variety of fruits, vegetables, legumes, grains, nuts, and seeds. Some may even include probiotics in this equation.[11] This is more than enough! Do you know that your body requires just 60–80 mg on an average of Vitamin C for a healthy sustenance (this changes during an injury or an actual infection), but this much is enough to maintain health. Have you ever checked the dose of Vitamin C on your supplement? Quite often, it would be 10 times or more than the recommended dietary allowance (RDA). Just because a little is good, more does not mean better. Some may even argue that Vitamin C is water soluble, yeah it is; however, imagine the burden you are imposing on your system in getting it cleared. As it is commonly known in nutrition circles – it just creates expensive pee. How about keeping your mouth moist and drinking water to “flush” down the virus into your stomach to meet its nemesis – hydrochloric acid. That was another popular one floating around on the web. Well for one, we do not know for sure whether the virus could survive the acid; there are some bacteria that actually do and land up in your gut. There are even some studies on the “viability” of coronavirus being present in “feces/stools,”[12] hinting at that possible survival of the virus in the gastrointestinal tract, and subsequent alternate mode of transmission as well.


  Stress Top


Cortisol – that hormone we have all heard of – has an impact on immunity, especially the low-grade, continuous stress that most of us harbor. While stress for a short period is what helps pump adrenaline and enable the fight-or-flight response, a continuous prolonged stress will simply and surely dampen your immune response.[13]

Your immunity does not need a boost all of a sudden, it requires your daily assistance to “tolerate” possibly even endure pathogens if not necessarily destroy them.[14] There are lots of vitamins and minerals not just one that help the immune system do its job. Perhaps, the most ignored of them all is Vitamin D. This vitamin has the ability to modulate both our innate (default defenses after our physical barriers of immunity are breached) and adaptive (acquired) immunity.[15],[16] If your coaches kept telling you to get your Vitamin D in check and you kept ignoring it, now you know why they were concerned. Fruits and vegetables have fiber that is best for keeping your microbiome healthy. They facilitate communication between your gut and the brain. Phytonutrients found in the plants only have both antioxidant and anti-inflammatory properties.[17] These are fundamentals! Morevoer, fundamentals are enough to build and maintain the kingdom called your body. Do not expect to build a fortress all of a sudden with supplements and expect a better chance of surviving an attack. Supplements are meant to plug gaps, not replace real food. Any fortress needs to have a strong base with fundamentals not shaky supplements. Your immunity is supported by lifestyle habits.[18] “Every” vitamin and mineral whether essential or nonessential, every fatty acid whether essential or nonessential, every amino acid whether essential or nonessential, all come together to help your immune system function. It would be difficult for any supplement to pack all of it in a couple of pills even.

Although this is not a 100% correct approach from a statistical analysis perspective, here, an experiment you can try since it would give you a rough idea. Referring to the analysis of authors in paper,[19] a quick search on the published research on PubMed as on March 26, 2020, with the keyword “IMMUNITY” yields 51,9812 results. Search with the keywords “Immunity + Vitamin C” yields 10,037 results.

  • Immunity + Vitamin D - 12193 (more than that on Vitamin C)
  • Immunity + Vitamin E - 6559
  • Immunity + selenium - 5744
  • Immunity + zinc - 36,872
  • Immunity + quercetin - 4232
  • Immunity+ carbohydrates - 50,709
  • Immunity + fat - 54,982
  • Immunity + vaccination - 98,994
  • Immunity + vaccine - 144,205.


A quick glance and you would see basic macronutrients such as carbohydrates and fat were far more studied for its association with immunity than Vitamin C.[20],[21] Note there were more studies dedicated to Vitamin D too as compared to Vitamin C. What is partially proven and documented in the medical fraternity regarding a true “boost” to the immune system is vaccination. The reason we state that this is partially proven (and so are any other so-called immunity boosters) is because immune systems are highly individualized, some of them are so different that they generate less than adequate response, e.g., most childhood vaccines have an effectiveness of 85%–95%.[22] Furthermore, the length of time immunity is acquired differs from vaccine to vaccine, some offering lifelong immunity with just a single dose versus others that require multiple “booster” shots to maintain immunity. To say that A is a booster to B would mean to get B above its baseline normal levels. Just providing a supplement often corrects a deficiency rather than “boosting” its levels, if it is water soluble like Vitamin C, it would not even stay in your body but be flushed out if over and above what's required is present in the body.

The difficulty with supplements is that they are not regulated like the counterpart pharmaceutical medicines are and manufacturers are even allowed to make claims such as “Vitamin C supports a healthy immune system.” They are not allowed to make claims w.r.t any disease though. For example, it is outright illegal to make a claim that “product X can prevent or cure disease Y” without the Food and Safety Standards Act (FSSA)/D and C act regulation vetting it (FSSA regulation would apply if the ingredients of a supplement are less than 1 (RDA) Recommended Dietary Allowance, whereas D and C act would apply if the RDA has been exceeded). Hence, its up to you, the final reader and decider, to whom all the marketing messages are targeted, to make an informed choice. Only your trusted healthcare professionals are the best to help you here. These particularly include people who study nutrition/healthcare rather than people who blindly forward messages that lack a scientific merit. As of now, there are no supplements that can prevent or cure COVID-19. Be wary of any marketing statements that even hint otherwise.

If you really are a fan of supplements despite all this advice, or your nutritionist recommends it for a deficiency that cannot be met through food, at least find out whether your product truly contains what it “claims.” Most don't. Write an email to the company, demand for answers, proofs. It is your right. Stop sharing silly cookie-cutter or quarantine diet plans on WhatsApp no matter how famed the nutritionist is. Each person is so unique and so are his/her nutritional needs.

Did it ever strike you that the best foods do not market themselves? Have you ever seen an orange scream to you for attention on how much Vitamin C it can offer you? Did you know that gram for gram a Bitter gourd (also known as “Karela” in Hindi) has more Vitamin C than an orange? Did you ever hear the sunlight begging you to come out and play with its ultraviolet that will eventually turn to Vitamin D in your body? Or that purple brinjal sitting quietly yet enticing you with all its phytonutrients a.k.a anthocyanins teeming under its skin? Nutritious food is never complicated and does not need marketing. Those are the ones we should be after. As long as we eat “well-balanced” meals that match our metabolic demands, i.e., closely match energy intake with its expenditure, we should be sorted at least from the nutritional standpoint, not forgetting that other factors, such as those mentioned above also, have a very big role to play in “maintaining” an athlete's immune army.[23] Eat a variety of foods and you would have equipped yourself with all the macronutrients, vitamins, minerals and phytonutrients to build your fortress.

I would like to end this article with a Latin quote by late Paracelsus known for his breakthrough ideas in medicine and toxicology (and whom the word “Zinc,” one of the most widely studied minerals in relation to immunity, is attributed to).


  “Sola Dosis Facit Venenum” Top


This translates to “The dose makes the poison.” Hence, even good things in excess become poison, even the so-called Vitamin c and zinc and what not. It is just the dose which differentiates.

There is a reason our immunity is called a “System!” Merriam-Webster dictionary defines a system as “a regularly interacting or interdependent group of items forming a unified whole.”[24] Hence, there is no single item that forms the line of defense but multiple, e.g., both the innate and acquired, components of the immune system work together in fighting off invaders; similarly, there is no one single source of an immunity enhancers, but multiple factors come together to determine your immune response – To summarize, some of the key determinants mentioned in this article are Movement, Sleep, Nutriture, and Stress. This is not to undermine the value of micronutrients such as Vitamins A, C, and E and minerals such as zinc and selenium in “helping” the immune system does its job, but a well-balanced diet will cover these without the need of supplements in an otherwise healthy population group. To indicate to the wider nonclinical population (which includes those who eat well-balanced meals) that such supplements will “boost” their immune responses lacks scientific basis and this is where such advertising crosses the boundary and becomes a misleading marketing circus.[25]

Your body loves natural food. It understands it best versus a manufactured cocktail. Supplements are only advised for filling gaps not as an excuse for not eating balances meals. Your body loves movement, it loves recovery. These are the simple things that often get ignored and are simply not marketable. Because they don't need it.

-Jessica Philip

ACSM Certified Personal Trainer | NASM Corrective Exercise Specialist | ACE Fitness Nutrition Specialist + Weight Management Specialist | NESTA Sports Nutrition Specialist | ACSM approved Clinical Nutrition specialisation | Nutrition coach for ExploRunner



Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Hemilä H, Chalker, E.. Vitamin C for preventing and treating the common cold. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23440782/. (2013, January 31)  Back to cited text no. 1
    
2.
Maggini S, Pierre A, Calder PC. Immune function and micronutrient requirements change over the life course. Nutrients 2018;10:1531.  Back to cited text no. 2
    
3.
Hanson LA, Korotkova M, Lundin S, Håversen L, Silfverdal SA, Mattsby-Baltzer I, et al. The transfer of immunity from mother to child. Ann N Y Acad Sci 2003;987:199-206.  Back to cited text no. 3
    
4.
Afshar M, Richards S, Mann D, Cross A, Smith GB, Netzer G, et al. Acute immunomodulatory effects of binge alcohol ingestion. Alcohol 2015;49:57-64.  Back to cited text no. 4
    
5.
Sarkar D, Jung MK, Wang HJ. Alcohol and the immune system. Alcohol Res 2015;37:153-5.  Back to cited text no. 5
    
6.
Qiu F, Liang CL, Liu H, Zeng YQ, Hou S, Huang S, et al. Impacts of cigarette smoking on immune responsiveness: Up and down or upside down? Oncotarget 2017;8:268-84.  Back to cited text no. 6
    
7.
Cavalcante PA, Gregnani MF, Henrique JS, Ornellas FH, Araújo RC. Aerobic but not resistance exercise can induce inflammatory pathways via toll-like 2 and 4: A systematic review. Sports Med Open 2017;3:42.  Back to cited text no. 7
    
8.
Hackney AC. Clinical management of immuno-suppression in athletes associated with exercise training: Sports medicine considerations. Acta med Iran 2013;51:751-6.  Back to cited text no. 8
    
9.
Nieman DC, Wentz LM. The compelling link between physical activity and the body's defense system. J Sport Health Sci 2019;8:201-17.  Back to cited text no. 9
    
10.
Besedovsky L, Lange T, Born J. Sleep and immune function. Pflugers Arch 2012;463:121-37.  Back to cited text no. 10
    
11.
Tilg H, Moschen AR. Food, immunity, and the microbiome. Gastroenterology 2015;148:1107-19.  Back to cited text no. 11
    
12.
Swift D. Study: COVID-19 is Also Spread by Fecal-Oral Route. Available from: https://www.medpagetoday.com/infect iousdisease/covid19 / 85315. [Last accessed on 2020 May 18].  Back to cited text no. 12
    
13.
Segerstrom SC, Miller GE. Psychological stress and the human immune system: A meta-analytic study of 30 years of inquiry. Psychol Bull 2004;130:601-30.  Back to cited text no. 13
    
14.
Walsh NP. Nutrition and athlete immune health: New perspectives on an old paradigm. Sports Med 2019;49:153-68.  Back to cited text no. 14
    
15.
Di Rosa M, Malaguarnera M, Nicoletti F, Malaguarnera L. Vitamin D3: A helpful immuno-modulator. Immunology 2011;134:123-39.  Back to cited text no. 15
    
16.
Bivona G, Agnello L, Ciaccio M. The immunological implication of the new vitamin D metabolism. Cent Eur J Immunol 2018;43:331-4.  Back to cited text no. 16
    
17.
Nantz MP, Rowe CA, Nieves C Jr., Percival SS. Immunity and antioxidant capacity in humans is enhanced by consumption of a dried, encapsulated fruit and vegetable juice concentrate. J Nutr 2006;136:2606-10.  Back to cited text no. 17
    
18.
Can lifestyle Modifications Boost Your Immune System? Available from: https://www.mdlinx.com/internal-medicine/article/3577. [Last accessed on 2020 May 18].  Back to cited text no. 18
    
19.
Macedo AC, de Faria AO, Ghezzi P. Boosting the immune system, from science to myth: Analysis the infosphere with google. Front Med (Lausanne) 2019;6:165.  Back to cited text no. 19
    
20.
Cobb BA, Kasper DL. The amino acid sequence of neurospora NADP-specific glutamate dehydrogenase. Peptic and chymotryptic peptides and the complete sequence. Eur J Immunol 2005;35:352-6.  Back to cited text no. 20
    
21.
Sinelnikova EM, Dvoretskova TV, Kagan ZS. Intermediate plateaux in kinetics of the reaction catalyzed by biodegradative L-threonine dehydratase from Escherichia coli. Biokhimiia 1975;40:645-51.  Back to cited text no. 21
    
22.
World Health Organization. Six Common Misconceptions about Immunization. World Health Organization; 2013. Available from: https://www.who.int/vaccine_safety/initiati ve/detection/immunization_misconcepti ons/en/index2.html. [Last accessed on 2020 May 18].  Back to cited text no. 22
    
23.
Walsh NP. Recommendations to maintain immune health in athletes. Eur J Sport Sci 2018;18:820-31.  Back to cited text no. 23
    
24.
Available from: https://www.merriam-webster.com/dictionary/system. [Last accessed on 2020 May 18].  Back to cited text no. 24
    
25.
Why Bingeing on Health Foods Won't Boost your Immune System; 24 January, 2016. Available from: https://www.theguardian.com/sci ence/2016/jan/24/health-foods-immune-sys tem-colds-vitamins.[Last accessed on 2020 May 18].  Back to cited text no. 25
    




 

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