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LearningObjectives
2
1 2 3Detail how
lifestyle habits impact your
immune system.
Understand and implement the
components of a healthy, balanced diet that supports
immunity for yourself and your
clients.
Analyze the science of phytonutrients, gut health,
vitamins, minerals, and nutrient intake relative to
immunity and make recommendations to clients about what works and more
importantly, what’s safe.
LifestyleHabitsThatImpactYourImmunity
It’sNotJustNutrition
StrategiestoSupportImmunity
1. https://www.health.harvard.edu/staying-healthy/how-to-boost-your-immune-system2. https://blogs.cdc.gov/cancer/2020/04/10/alcohol-awareness-month-rethink-your-drink/3. https://immunityageing.biomedcentral.com/articles/10.1186/s12979-020-00212-x
• Don’t start smoking, or quit if you do smoke
• Limit alcohol intake, or don’t drink1,2
• Moderation means no more than one drink per day, and ideally only a few glasses a week, at most
• Avoid binge drinking (binge drinking means more than 4 drinks on one occasion)
• Practice food safety: honor expiration dates, store food at correct temperatures, cook meats/fish thoroughly1
• Be on the journey to maintain a healthy weight and focus on consistent practice of lifestyle habits3:• Obesity is a risk factor for hospitalization and death due to COVID-19• Obesity is known to weaken cellular immune function. Get all recommended vaccines to help
train your immune system to fight disease
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TakeCareofYour MindandBody:GetMore…
1. https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html2. https://www.cdc.gov/physicalactivity/basics/adults/index.htm3. https://www.mayoclinic.org/tests-procedures/meditation/in-depth/meditation/art-
20045858#:~:text=Meditation%20can%20give%20you%20a,symptoms%20of%20certain%20medical%20conditions.
• Sleep: Get 7-9 hours/night for adults (put those phones away at bedtime!)1
• Exercise: Aim for at least 30 minutes of physical activity 5 days a week2
• Meditation: Aim for at least 2 minutes a day3
• Connect with Others: Maintain physical, not social distance2
• De-stress: How can you infuse joy into your day?
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ComponentsofaHealthy,BalancedDietThatSupportsImmunity
Now,Let’sTalkNutrition
Phytonutrients,GutHealth,Vitamins,andMinerals
AnalyzingtheScience:What’sSafeandWhatWorks?
ComponentsofaBalancedDiet
• Balanced Plate Method • Alcohol in moderation• Limit added sugars and ultra-
processed foods• Include plant-based proteins
as often as possible• Emphasis on phytonutrients –
eat the rainbow!•Mediterranean-style of eating
GutHealth:BoostYourImmunity
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515351/2. https://www.hsph.harvard.edu/nutritionsource/microbiome/3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425030/
• 70-80% of our immune cells live in our gut1
• We each have a unique population of microbes:• Makes up our personal microbiome• Supports gut health (or causes imbalance)2
• Research links many diseases to the integrity of our gut bacteria and our gut lining:3
• Inflammatory Bowel Disease (IBD)• Autism • Diabetes• Obesity• Heart disease, CVD• Liver disease• Certain cancers
SupportingaHealthyGut:WhatCanYouDo?• Eat a diet rich in fiber• Fruits, vegetables• Nuts, seeds• Whole grains
HealthyFats:ImmunityandAnti-inflammation• Satiate (regulate hunger/fullness easily)• Some offer electrolytes needed for
energy (eg., avocados have potassium which is an electrolyte)• Contain vitamins, minerals, and anti-
inflammatory compounds • Immunomodulatory effects of omega-3
fats
Gutiérrez S, Svahn SL, Johansson ME. Effects of Omega-3 Fatty Acids on Immune Cells. Int J Mol Sci. 2019;20(20):5028. Published 2019 Oct 11. doi:10.3390/ijms20205028. *See Table 1
Spotlight:VitaminsandMineralsVitaminCVitaminDZinc
SeleniumMagnesium
VitaminC
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6124957/2. https://pubmed.ncbi.nlm.nih.gov/16373990/3. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000980.pub4/full4. https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/
Powerful antioxidant that helps protect our cells from damaging free radicals and is required for wound healing.
Can reduce symptoms, shorten duration and severity of respiratory tract infections and the common cold, especially in those who exercise regularly.
Blood levels decline rapidly during times of infection and stress.
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VitaminC:IntakeGuidelinesandFoodSourcesIntake Guidelines: - RDA 75 mg women, 90 mg men, 95 mg pregnancy, 120 mg lactation - Upper limit: 2,000 mg
Food sources include: Citrus, bell peppers, cauliflower, broccoli, berries, dark green leafy veggies, mango, pineapple
Supplement Guidelines:- 250mg-2g per day is safe- Over 1,000mg at once may cause GI upset
15https://ods.od.nih.gov/factsheets/vitaminc-HealthProfessional/
VitaminD
https://www.npr.org/sections/health-shots/2017/02/16/515428944/a-bit-more-vitamin-d-might-reduce-winter-colds-and-fluhttps://www.bmj.com/content/356/bmj.i6583https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399494/https://ods.od.nih.gov/factsheets/Vitamin%20D-HealthProfessional/https://www.aicr.org/resources/blog/high-vitamin-d-levels-linked-to-lower-colorectal-cancer-risk/Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis. Charan J, Goyal JP, Saxena D, Yadav P. J Pharmacol Pharmacother. 2012 Oct; 3(4):300-3.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5949172/#:~:text=Epidemiologic%20studies%20have%20found%20high,free%20during%20the%20study%20period.https://news.harvard.edu/gazette/story/2017/02/study-confirms-vitamin-d-protects-against-cold-and-flu/
Risk for cold and flu has been shown to be higher in people who aren’t getting adequate vitamin D from the sun or in their diet. Data from over 10,000 people found a 10-50% lower risk of infection in those supplementing for a diagnosed deficiency.
Receptors for Vit. D throughout the body. Influences: cardiovascular, endocrine and nervous systems.
Inhibits enzymes involved in age-related mechanisms
Healthy blood levels associated with 22% reduced risk for colorectal cancers.
Reduced risk for respiratory infections and severity of COVID symptoms in persons with blood levels of Vitamin D within the healthy range.
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VitaminD:IntakeGuidelines
https://ods.od.nih.gov/factsheets/Vitamin%20D-HealthProfessional/17
• RDA: • Ages 1-70: 15 mcg (600 IU)• >70 years-old: 20 mcg (800 IU)
• Up to 4,000 IU/day is safe• Generally, 2,000-4,000 IU is considered a healthy daily dose for
adults, especially in winter• Follow blood levels:
• 12 - <20 deficient• <32 insufficient• 40-60 optimal?• >80-100 risky
VitaminD:FoodSources
Dairy products: milk, cottage cheese, yogurt, etc.
Fortified nondairy products
Mushrooms, fatty fish such as sardines, mackerel, herring
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Zinc
https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/https://www.hsph.harvard.edu/nutritionsource/zinc/https://journals.sagepub.com/doi/pdf/10.1258/acb.2011.010266https://www.medicalnewstoday.com/articles/323982#:~:text=Neutrophils%20are%20a%20type%20of,and%20other%20types%20of%20stress.
Required for immune cells to form and function properly: • Primary defenders like specialized white
blood cells (lymphocytes, neutrophils, and macrophages) that heal damaged tissue and destroy harmful organisms like bacteria • Zinc deficiency impairs wound healing,
increased risk of pneumonia, and loss of taste and smell
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Zinc:IntakeGuidelinesandFoodSources
RDA: 8- 11 mg Upper Limit: 40 mg
Seafood (lobster, crab, oysters), chickpeas, baked beans, cashews, pumpkin seeds
20https://ods.od.nih.gov/factsheets/zinc-HealthProfessional/
Selenium• Antioxidant and key component of
vital mechanisms including immune cell regulation
• Persons deficient in selenium or selenoprotein production carry greater risks for inflammatory and immune based illnesses
• Deficiency impairs cardiovascular function and increases infection risk• Food sources: Brazil nuts, seafood;
also, whole grains, meat, poultry, eggs • Amounts of selenium in sources is
dependent on soil richness https://pubmed.ncbi.nlm.nih.gov/30200430/https://pubmed.ncbi.nlm.nih.gov/1702669/
Selenium:IntakeGuidelinesandFoodSources
RDA: 55 mcg for men and women (60-70 mcg pregnancy/lactation)50-200 mcg/day for immunity
Upper Limit: 400 mcg
Brazil nuts, seafood, whole grains, meat, poultry, eggs
https://ods.od.nih.gov/factsheets/selenium-HealthProfessional/
Magnesium
https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/ https://pubmed.ncbi.nlm.nih.gov/18705536/https://www.health.harvard.edu/staying-healthy/what-you-should-know-about-magnesium2https://www.ncbi.nlm.nih.gov/books/NBK507265/
• Deficiency associated with weakened immunity and increased inflammation
• Required throughout the body, including over 300 enzymes• Enables the building of proteins including immune cells
• Required for glutathione production, a potent intracellular antioxidant
• Protects athletes from exercise-induced immune compromise
• May help promote sleep and reduction of stress and anxiety
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Magnesium:IntakeGuidelinesandFoodSources
https://ods.od.nih.gov/factsheets/magnesium-HealthProfessional/
RDA: - 320 mg for women, 420 mg for men- Upper limit w/ supplementation, 350 mg
Whole grains: barley, bulgur, oats, amaranth, quinoa, wheat germ
Black strap molasses, dark chocolate, almonds, pumpkin seeds, cashews, walnuts; legumes, green leafy veggies, potatoes
TheImmunity“Category”MarketShare&CommonFeatures
MarketShare&Popularity
https://www.healthline.com/health/food-nutrition/immune-system-bitters-recipe#About-the-herbs
Immunity as a category saw $22.76 billion in 2020, up from $16.3B in 2019, expected $29.4B by 2027
Up to 61% of Instagram posts studied featured “immune boosting” as central idea
Immune-, cold-, flu-specific supplement sales forecast $3.94 million by 2022
Top herbal ingredients for immunity include curcumin, ginger, green tea, cinnamon, ginseng, maca, echinacea, and reishi mushrooms
Mintel study: top 10 micronutrient supplements for immunity were vitamins A, B1, B3, B6, C, D, E, Zinc, Calcium, Folic Acid. B6, C, D, and Zinc were top nutrients across food, beverage, and supplements
https://www.businesswire.com/news/home/20201209005657/en/Global-Immunity-Boosting-Food-Products-Market-Report-2020-2030-with-COVID-19-Implications-and-Growth-Insights---ResearchAndMarkets.com#:~:text=The%20global%20immunity%20boosting%20food,(CAGR)%20of%2039.6%25.https://aacijournal.biomedcentral.com/articles/10.1186/s13223-020-00474-6https://www.glanbianutritionals.com/en/news-insights/case-study/nutrition-boosts-immunity-look-2020-global-consumer-trends
HerbalRemediesforImmunity
https://www.healthline.com/health/food-nutrition/immune-system-bitters-recipe#About-the-herbs
Astragalus root
Echinacea
Honey, ginger
Turmeric, curcumin
Elderberry
Probiotics and prebiotics
Astragalus
https://www.healthline.com/health/food-nutrition/immune-system-bitters-recipe#About-the-herbshttps://cmjournal.biomedcentral.com/articles/10.1186/1749-8546-6-32https://pubmed.ncbi.nlm.nih.gov/22981502/https://pubmed.ncbi.nlm.nih.gov/15035888/
Preclinical and animal research suggests effectiveness with helping regulate immune response, however more research is needed
Long history of medicinal use in Chinese medicine, popular now due to COVID-19
Native to Russia and Scandinavia
Best known for anti-inflammatory and antibacterial properties
Echinacea
https://www.consumerlab.com/reviews/echinacea_review/echinacea/https://pubmed.ncbi.nlm.nih.gov/17597571/https://www.hindawi.com/journals/ecam/2012/841315/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6278270/pdf/molecules-23-02778.pdf
Typically consumed as a tea or supplement; native to North America
Doses ranging from 10-500mg are show as generally safe in healthy adults
Long history of use as a medicinal plant to boost immunity and reduce effects of upper respiratory infections
Recommended globally by the WHO, Germany, and Canada
May help reduce duration, severity, or possibly incidence of colds when used consistently (no evidence related to Covid-19)
GingerandHoney
https://www.healthline.com/nutrition/ginger-shots#benefitshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665023/https://pubmed.ncbi.nlm.nih.gov/26669122/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3848205/
https://www.healthline.com/health/food-nutrition/top-raw-honey-benefits#riskshttps://pubmed.ncbi.nlm.nih.gov/21479349/https://pubmed.ncbi.nlm.nih.gov/29138732/
Ginger has potent anti-inflammatory and antioxidant phytochemicals, like gingerols, paradols, and zingerone
Human studies with ginger have yielded positive results: 2 gm/d associated with reduced inflammatory markers in persons with Type2 DM (TNF, CRP)
Ginger “shots” have seen growth, marketed for immunity, usually combined with lemon or honey
Preclinical data shows antiviral potency of ginger, related to URI
Raw honey contains antiseptic properties like hydrogen peroxide, is a potent prebioticManuka honey a medical-grade honey shown to promote wound healing; most research on honey is in vitro and in bees
Turmeric&Curcumin
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6278270/pdf/molecules-23-02778.pdfhttps://pubmed.ncbi.nlm.nih.gov/17211725/
In the same family as ginger, native to India and Southeast AsiaCurcuminoids are the ‘active compounds’ in turmeric
Potent anti-inflammatory and antioxidant compounds with varying efficacy in human studies. Pharmacokinetics makes study challenging , bioavailability in the body is variable
Immunomodulatory agent can influence activation of T cells, Bcells, macrophages, neutrophils, NK cells & dendritic cellsCan downregulate proinflammatory cytokines like TNF, IL1/2/6/12 and may enhance antibody responses
Combine with piperine/black pepper to boost bioavailability and reduce rapid degradation in the body; food doses of 2-4Tbsp/day prohibitive in many western diets500-2000mg common supplement dosing
Elderberry
https://www.consumerlab.com/reviews/elderberry-supplements-reviewed/elderberry/https://pubmed.ncbi.nlm.nih.gov/11399518/https://pubmed.ncbi.nlm.nih.gov/15080016/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4848651/https://pubmed.ncbi.nlm.nih.gov/28198157/
https://www.sciencedirect.com/science/article/abs/pii/S0308814608011710https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372600/https://pubmed.ncbi.nlm.nih.gov/26781385/https://pubmed.ncbi.nlm.nih.gov/19793846/https://pubmed.ncbi.nlm.nih.gov/27734518/
Consumed in ancient Egypt; rich in the antioxidant, anthocyanin
Phenolic compounds may elicit antiviral and antimicrobial properties
Flavonoids quercetin, rutin, and kaempferol modulate inflammation
May help reduce duration of colds and influenzas
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Elderberry:IntakeGuidelinesandFoodResources
1. https://www.consumerlab.com/reviews/elderberry-supplements-reviewed/elderberry/2. https://pubmed.ncbi.nlm.nih.gov/27734518/
Doses ranging from 50 mg to 500 mg are safe for healthy adults1
Typically consumed as a tea, syrup or supplement
The fruit grows in Europe & the US Concentrations of active compounds are greater in higher elevations2
Raw or under-ripe Elderberry can be toxic The bark, roots and leaves shouldn't be consumed at all2
ProbioticsandPrebiotics:Beverages
Gut health-focused: kombucha, vinegars
Shots and tonics: ginger, turmeric
Teas: ginger, lemon, green tea, herbal
Mushroom-based elixirs
Juices: homemade, cleanse/detox, bottled
SummaryPuttingItIntoPractice
PuttingItIntoPractice• There are many immune-supportive foods with additional health and
wellness benefits! • Help your clients include these foods in their daily eating patterns:
• In new recipes • As additions to their favorite recipes
• Many immune-supportive foods are:• Globally-sourced • Enjoyed by cultures around the globe as part of their regular diet
• Supplements can be included as part of a healthy eating pattern for supporting immunity, but:• Use caution around dosing • Investigate any drug interactions or contraindications with reliable resources• Always recommend consulting with a GP in addition to an RD
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PuttingItIntoPractice• Maintain an open mind • Encourage your clients to talk with you about immunity and
foods and supplements• It’s important to learn about what your clients are hearing,
reading, and thinking as they engage with popular media• This will help you advise them effectively by separating
fact from fiction
It all starts by listening to and understanding your client’s point of view!
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Questions?
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/stacy.kennedy.5
@stacykennedyrd
StacyKennedy,MPH,RD,CSO,LDN
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