Nutrition and Infection – A Vicious Cycle: Nestle

Speaker: Dr. Shanta Ghatak - Director, Bhoruka Public Welfare Trust Presented at: Nestlé Nutrition Institute Workshop, Puri

Summary

Nutrition and infection is a vicious cycle. Nutrition, often neglected, is an ‘exact’ science. This presentation explains the importance of complex nutrition effects and correlation between malnutrition and susceptibility to infections. Studies indicate that malnutrition could affect the virulence of infections agents and progression of chronic infection such as HIV. Dr. Ghatak elaborates on the role of Fat Soluble Vitamins – A and E in building and enhancing immunity. She adds that Vitamin C is the most powerful biological reductant available to cells. She also explains the importance and deficiency instances of trace metals like Zinc, Selenium, Iron and Fatty Acids.

Recent evidence suggests malnutrition influences not only immune function but also virulence of infectious agents, progression of chronic infection such as HIV and transcriptional regulations of inflammatory genes that may determine the outcome of sepsis. The major causes of infant deaths are prematurity, pneumonia, birth injury, anaemia, diarrhoea, congenital malformation and others. WHO estimates l00- 140 million children are vitamin A deficient. Implementation of WHO recommended program of Vitamin A supplementation for all at risk people primarily children and women of child bearing age residing in developing nations has been one of the great WHO success stories. Regular consumption of dark green leafy vegetables or yellow fruits and vegetables prevents Vitamin-A deficiency. Breast feeding protects against vitamin A deficiency, the colostrum’s are rich in Vitamin A. Oral prophylactic dose of vitamin A is administered either by one dose 100,000 Interaction Units (IU) to infants (6-11 months) or six months dose of 200,000 IU to children 1-5 years of age. Treatment of vitamin A deficient cases require single oral dose of 200,000 IU of vitamin A immediately at diagnosis and a follow up dose of 200,000 IU, one four weeks later.

Vitamin C has no beneficial effects on the incidence of common cold but a consistent reduction of duration of cold symptoms was seen (07%-39%) reduction in symptom days and larger doses gave greater benefit. As far as Vitamin E is concerned hypovitaminosis is uncommon in western world and almost occurs in severe fat malabsorption, low birth weight infants and with rare genetic disorders such as abetalipoproteinemia. Vitamin E supplementation has multiple immunogenic effects, including enhanced T-cell proliferation. Zinc is critical for cell membrane structure, there are 300 enzymes associated with carbohydrate and energy metabolism, protein synthesis and degradation, nucleic acid synthesis, heme biosynthesis, and C02 transport. Deficiency occurs in starvation, PEM, Malabsorption syndromes, immunocompromised during pregnancy, alcoholism, kidney disease, burns, inflammatory bowel disease, and HIV. Iron is the most common trace element deficiency worldwide affecting 20-50% of world’s population. Effects are seen in multiple systems including immune system. There are 3 major groups of dietary fatty acids, oleic, linoleic, linoleic serve as precursors for the biosynthesis of poly unsaturated fatty acids (PUFA’s).