Sunday, May 03, 2009

Swine Flu: Does Nutritional Status Aid Immunity?

Swine Flu: Does Nutritional Status Aid Immunity? By Neil E. Levin, CCN, DANLA A new health threat has arrived in our shrinking world: the swine flu. It is an organism for which there is no preventive vaccine; the commonly available flu vaccine does not include this strain, so offers no protection. Likewise, antibiotics target only bacterial strains so are useless to stop the viruses responsible for colds and flus. There are a couple of drugs (Tamiflu® and Relenza®) which are prescribed for those who have actually come down with the flu, and sometimes recommended for those who may come into contact with flu sufferers. However, they are expensive and typically work if you have one at home and take it at the first sign of illness. For example, the Tamiflu® website reports that, if taken within 48 hours of the first appearance of symptoms, adults may feel better about 1.5 days faster than patients who did not take it. When the avian flu (another Type A Influenza, the most common type) scare was around two or three years ago (remember SARS? Avian Flu? Bird Flu?), our family physician offered both my wife and me precautionary prescriptions of Tamiflu®, for which we would have had to pay about $200 out of pocket for a two person one-time supply. It wouldn’t be covered by insurance since we didn’t have an actual diagnosis of influenza. Besides that, there is a shortage and these drugs typically have a relatively short shelf life of only about a year. We respectfully declined the offer. While that is certainly an option for those who want to or need to pay to see a physician and get a prescription, and it may be covered by your insurance, it is not a practical option for most of us just wanting to improve our natural resistance to a known threat; and certainly not a cure. Besides, drugs have their own side effects (including shrinkage of the wallet) that should be noted by potential users. That’s precisely why they are controlled substances that are only available from medical professionals. What is the swine flu and what can we do to protect ourselves from it? According to Dr. Joe Bresee, Chief of the Epidemiology and Prevention Branch of the CDC (Centers for Disease Control and Prevention) Influenza Division, “Swine flu is a respiratory disease of pigs caused by Type A Influenza viruses. The symptoms of [swine] flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and [vomiting] associated with swine flu as well. There is no vaccine available right now to protect against swine flu. However, there are everyday actions that people can take to help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health. Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash can after you use it. Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective. Try to avoid contact with sick people.” Well, that is helpful, but only to a point. Also seemingly important is the fact that Americans who have come down with swine flu to date have had only one death - compared to well over a hundred Mexican deaths - and seem to have had contracted a much milder form of the illness than our unfortunate neighbors to the south. I speculate that the American diet, despite its known shortcomings, may in some ways still be superior in its content of some important nutrients to the average diet of many Mexican citizens, and perhaps support a better immune response. At the time of this writing though, only 20 of the 140 Mexican deaths attributed to pneumonia-like symptoms have actually been confirmed as the swine flu. No doubt new information will be coming in daily. But there are reportedly an estimated 36,000 deaths from the common flu every year, mostly the very old and the very young. After reviewing a number of scientific papers to assess the potential of foods and food supplements to improve our bodies’ natural response to the flu, there are a number of things that you and your physician may want to consider. In the battle to maintain healthy respiratory function and properly modulate immune response, natural nutritional substances can be helpful. Various vitamins, minerals, herbs and amino acids support optimal immune function and respiratory health. In fact, there is evidence that nutrient status of the host even affects the genetic expression of viruses; that is, an unsuitable environment (the well-nourished body) inhibits the ability of the virus to freely replicate and thrive. This is not a list of cures; it is a list of natural substances that have shown promise in improving survival or resistance to influenza as recorded in published studies. Those who want to support their immune system should investigate these with the knowledge and consent of your physician; physicians may want to note these natural products that may support the nutritional status of your patients. · AHCC In a recent study, supplementation with AHCC resulted in a dose-dependent increase in survival in mice in response to acute influenza infection (influenza A virus: avian flu, H1N1, PR8). · Andrographis paniculata has been shown in studies to support a healthy and balanced immune response by modulating the immune system’s production of immune cells (Interferon gamma (IFNg), Interleukin-2 (IL-2), and T-cells). Numerous clinical studies have demonstrated its ability to significantly increase cell-mediated immunity in response to stresses, such as those encountered during seasonal changes. · Astragalus (Astragalus membranaceous) is an Oriental herb well known for aiding the immune system. Astragalus has been shown in non-clinical studies to support a number of aspects of healthy immune function, including the enhancement of T-Cell and Natural Killer (NK) cell activity. Natural killer cells destroy unhealthy cells in the body virtually on contact. · Black Elderberry (Sambucus nigra) standardized extract may provide protection against oxidative stress and modulate inflammatory cytokines to protect respiratory function. Elderberry provides Vitamins A and C, as well as anthocyanins, which are potent free radical scavengers. Clinical and non-clinical studies have demonstrated Elderberry's immune-supporting properties. One article reported that, “Constituents of European elderberry neutralize the hemagglutinin spikes found on the surface of viruses, including flu viruses, preventing the viruses from piercing cell walls and replicating. European elderberry extracts also enhance immune function by increasing cytokine production.” It also reported that two randomized, double-blind, placebo-controlled clinical trials have shown that a European elderberry preparation “can inhibit influenza A and B viruses when given to patients within 48 hours of symptom development”. · Echinacea (Echinacea purpurea and Echinacea angustifolia) is well known for its immune modulating effects. E. purpurea extracts demonstrate significant immunomodulatory activities. “Among the many pharmacological properties reported, macrophage activation has been demonstrated most convincingly.” E. purpurea has been shown to have antiviral effects, with most studies looking at either rhinoviruses (colds) or herpes simplex virus type-1 (HSV-1). Its polysaccharides were able to exert an antiviral action on the development of HSV-1 disease when supplied prior to infection. Reductions in numbers of upper respiratory infections have been noted in several trials, but generally the differences in the large variety of commercial and non-commercial products studied have resulted in conflicting reports. However, a meta-analysis of previously published studies was published in the British medical journal The Lancet Infectious Diseases and concluded, “Published evidence supports echinacea’s benefit in decreasing the incidence and duration of the common cold.” · Garlic (Allium sativum) compounds have been shown to have some antiviral effects. For example, a compound called allitridin (diallyl trisulfide) has anti-human herpes virus (HCMV) activity via a mechanism associated with suppression of the virus’ gene expression. Other important and better known compounds include allicin and ajoene. Allicin has been shown to reduce the incidence of colds and flus. “Among the viruses which are sensitive to garlic extracts are the human cytomegalovirus, influenza B, herpes simplex virus type 1, herpes simplex virus type 2, parainfluenza virus type 3, vaccinia virus, vesicular stomatitis virus, and human rhinovirus type 2. · Larch tree (Larix occidentalis) polysaccharides (arabinogalactans) help to support healthy intestinal flora and aid healthy immune function. “They stimulate the immune system through the activation of phagocytosis, competitive binding of bacterial fimbrae, and the potentiation of the reticuloendothelial system's effects.” · Resveratrol, naturally occurring in grape vines, grape skins and red wine, improves immune response and down-regulates the activation and production of proinflammatory cytokines. · Selenium has been shown to help the immune system modulate inflammatory response in mice challenged with reactive agents. Animals deficient in the mineral had much poorer outcomes than those whose diets were supplemented with this antioxidant mineral. · Vitamin C (ascorbic acid, ascorbate) in divided doses supports immunity. Taking about 500 mg at a time enhances absorption and avoids a laxative effect possible at higher doses. In a two-year long controlled study, “vitamin C administration resulted in an 85-percent decrease in cold and flu symptoms compared to the control group”. In a controlled trial of 226 patients with influenza A, where about half received 300 mg of vitamin C daily: “Pneumonia was reported in two cases in the treatment group and 10 in the control group, while hospital stays for influenza or related complications averaged nine days in the vitamin C group and 12 days in the control group.” · Vitamin D (cholecalciferol, ergocalciferol) deficiencies have been associated with immune challenges (such as the flu) during the winter months when sunlight is not as able to produce the vitamin in our bodies. A deficiency can inhibit the body’s ability to maintain health and immunity. · Vitamin E (alpha-tocopherol) deficiencies have been shown to decrease immune response and increase inflammatory responses leading to possible tissue damage in the respiratory system. · Zinc is recommended for immunity. Use up to 30 mg per day for this use; higher doses could increase the need for copper. These statements have not been evaluated by the FDA. The information provided by this article is intended for scientific and historical reference only and is not intended to diagnose, treat, prevent or cure any disease. If you have been exposed to or think you may have flu or any disease, see a physician as soon as possible. Do not try to self treat swine flu or any other disease; influenza can be life-threatening. Please inform your physician before taking any food supplements if you take any medications or have a known medical condition. Read all product labels carefully and follow all directions and label cautions, and do not exceed the highest recommended servings. Neil E. Levin, CCN, DANLA is a board certified clinical nutritionist with a Diplomate in Advanced Nutritional Laboratory Assessment. He is a professional member of the International & American Associations of Clinical Nutritionists and serves on the Scientific Council of the national Clinical Nutrition Certification Board. 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