![\"A](\"https:\/\/canada-info.ca\/wp-content\/uploads\/2020\/12\/2826671554_1e4982b94c_o.jpg\")
<\/a>Photo credit Chantrelles<\/a> by Suzanne LaGasa via Flickr (CC BY SA, 2.0 License)<\/p><\/div>\n But there are internet resources that say the opposite \u2013 supplements are unproven and those peddling them are pseudoscientists.<\/p>\n Cortes Currents sought to shed light on the importance of the immune system and how we can support it.<\/p>\n We connected with\u00a0Dr Jenna Creaser<\/a>\u00a0from the\u00a0Cortes Community Health Centre<\/a>\u00a0and Dr Philip Calder.<\/p>\n Professor Philip Calder is\u00a0Head of Human Development & Health and Professor of Nutritional Immunology within Medicine<\/a>\u00a0at the\u00a0University of Southampton<\/a>.\u00a0 He has a chair in Nutritional Immunology, his area of expertise.<\/p>\n His work has mostly been with omega-3 fatty acids, but has also researched pre-biotics and pro-biotics (the beneficial organisms we rely on and the conditions that support them).<\/p>\n He authored the paper\u00a0Nutrition, Immunity and COVID-19<\/a>,\u00a0<\/em>which was published in the British Medical Journal \u2013 Nutrition, Prevention & Health.<\/p>\n He also co-authored\u00a0Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections<\/a>,\u00a0<\/em>which was published in the journal\u00a0MDPI Nutrients<\/a>.\u00a0\u00a0<\/em>This is where he first caught our attention.<\/p>\n Professor\/Dr.\u00a0Philip\u00a0Calder - courtesy the University of Southampton<\/p><\/div> We asked Professor Calder:\u00a0 how does a healthy diet contribute to the immune system?<\/p>\n He said that we know that our body relies on the intake of micro-nutrients for normal functioning of all systems including our immune systems.\u00a0 And the reverse is also true: deficiencies in some micro-nutrients results in increased susceptibility to illness, noting especially respiratory tract infections.\u00a0 And\u00a0 the evidence suggests that increasing the levels of micro-nutrients in deficient individuals can increase markers of immune function.<\/p>\n Calder goes on to point out that the vast majority of people who contract COVID-19 are asymptomatic \u2013 and this indicates that our immune systems are \u2018doing reasonably well\u2019.<\/p>\n Professor Calder, along with his co-authors in the paper for MDPI Nutrients, claim that, \u201ca wealth of mechanistic and clincal data\u201d suggest that many nutrients that are critical to proper immune function, and that, \u201cinadequate intake and status of these nutrients are widespread\u201d.<\/p>\n And how does our immune system contribute our interactions with the virus that causes COVID-19?<\/p>\n He says that individuals most at risk of serious illness from COVID-19 are those who, for various reasons, have depressed immune systems and association studies have shown a correlation between outcomes and Vitamin D, Selenium and Zinc deficiencies.\u00a0 He points out that these are associations, and not randomized control trials.<\/p>\n Local family physician, Dr Jenna Creaser, agrees that a healthy diet supports a healthy immune system, and \u201cmakes a huge impact on people\u2019s health\u201d.\u00a0 She says more and more doctors are realizing this.<\/p>\n She says that a varied diet, with lots of fruit and vegetables supports our body\u2019s system, including the immune system. And more and more doctors are turning to diet to prevent and treat illnness.<\/p>\n What potential impact might diet have on COVID-19 prevention and treatment?<\/p>\n Professor Calder describes the association studies that have been done with micro-nutrients.\u00a0 The studies looking at\u00a0Vitamin D<\/a>\u00a0found that deficiency in this nutrient correlated with a 30% increase in hospitalization.\u00a0 Calder adds that there could be other factors that come along with Vitamin D deficiency, and the effect sizes might not be so large.<\/p>\n So there appears to be a reasonable basis for a strong message that implores people to attend carefully to their diet.<\/p>\n We are constantly reminded in the bustling COVID-19 information landscape to rely on Health Agencies for guidance.\u00a0 And so what is the position of the\u00a0BC Centre for Disease Control<\/a>\u00a0(BCCDC) and\u00a0Health Canada<\/a>\u00a0on the role of diet in battling the pandemic?<\/p>\n It is hard to say.<\/p>\n The COVID-19 page at bccdc.ca,\u00a0COVID-19 for the public<\/em><\/a>, does not mention healthy eating or supplements.<\/p>\n The\u00a0COVID-19 page at canada.ca<\/a>\u00a0has a section called \u2018Your Health\u2019, and a page on prevention and risk \u2013 with no mention of diet or lifestyle.<\/p>\n I was able to find, in another part of Health Canada\u2019s website,\u00a0the nutrition section<\/a>, some messages about diet:<\/p>\n Simple, stand-alone sentences:<\/p>\n And the page goes on to recommend the standard healthy-diet fare.<\/p>\n Cortes Currents requested clarity on these statements from Health Canada \u2013 they seem to neither confirm nor deny the role of diet in prevention of disease or reduction of its severity.<\/p>\n They declined to clarify their position, and declined to be interviewed for this show. But stated that that Health Canada is considering linking their nutritional page to the COVID-19 page.<\/p>\n A dietician with\u00a0HealthLinkBC<\/a>\u00a0shared some deeper insights into the Health Canada position.\u00a0 She read from a document she had received from them:<\/p>\n \u201cVitamin D plays various roles in the body\u2026 including reduction of influenza.\u00a0 There is insufficient evidence suggesting cause-and-effect for outcomes, other than bone health\u2026. In the absence of randomized clinical trials, Health Canada cannot attribute any role or benefit of vitamin D supplementation as a measure to enhance resistance to COVID-19.\u201d<\/p>\n Professor Calder agrees \u2013 there are no completed Randomized Clinical Trials (RTCs) treating COVID-19 with Vitamin D though they are underway, he says. \u00a0 Regardless, he\u2019s more interested in prevention and supporting the immune system prior to infection.<\/p>\n Dr Creaser adds that while RCTs are considered the gold-standard for proving an effect, they can be very hard to do.<\/p>\n Professor Calder offers one example where an RCT was done comparing the effect of increasing fruit and vegetable consumption \u2013 it yielded a result of inceased markers of immune function.<\/p>\n Dr Creaser goes on to say that there should be a role for common sense and extrapolating from all that we do know about the importance of diet to our health and applying that to COVID-19.<\/p>\n Any action taken in healthcare, must weigh costs or risks, against benefits.\u00a0 What are the risks associated with promoting healthy eating and supplementation?<\/p>\n Calder says that he isn\u2019t talking about high dose treatments, but nutritionally relevant doses for prevention.<\/p>\n Creaser has a hard time thinking of what the costs might be to reinforcing healthy eating habits.\u00a0 \u201cI don\u2019t see why, with the amount of messaging that has come out, \u2026 there couldn\u2019t be more on these measures to be more healthy in general\u2026 and not only with COVID, but with anything.\u201d<\/p>\n Dr Creaser alludes to other potential health benefits.\u00a0 What are the potential beneficial side-effects of this type of messaging, beyond our personal COVID-19 outcomes?<\/p>\n Professor Calder explains that our immune system tries to stop viruses from having a place to live and reproduce.\u00a0 \u201cIf the immune system gets the upper hand\u2026 transmission will go down, because viral load will go down.\u201d<\/p>\n \u201cWe have a society with a lot of other disease,\u201d Dr Creaser points out.\u00a0 \u201cA pandemic of heart disease, a pandemic of obesity, a pandemic of stress\u2026 a huge part of that is diet and lifestyle.\u201d<\/p>\n Calder agrees, \u201cThe same healthy eating advice applies to cardiovascular disease, to cancer, to diabetes, and so on\u2026 the big sources of morbidity and mortality.\u201d<\/p>\n Another benefit of maximizing immune systems, Calder says, is that it maximizes vaccine effectiveness.\u00a0 He says, \u201cthe vaccine is an immune challenge, and it works by triggering an immune response.\u00a0 And we need that response to be optimized.\u201d<\/p>\n And, while it may sound like a silver bullet \u2013 Professor Calder points out that there is still death from influenza, despite having vaccinations for that.\u00a0 \u201cTherefore, helping the immune system out makes some sense.\u201d<\/p>\n So, with so much, potentially, to gain and little in sight to lose \u2013 why is there such sparse public health advice to focus on our diet?<\/p>\n Professor Calder believes that the health authorities may simply have a higher standard of evidence than that which may be warranted.<\/p>\n \u201cWe don\u2019t have \u2026 COVID-19 specific evidence at the level that the health authorities would want to make a statement,\u201d he says.<\/p>\n Dr Creaser comments that even before the pandemic, our healthcare ignored preventative measures, stating, \u201cI truly feel like our healthcare system, doesn\u2019t ignore, but, looks at it in a very bare minimum type fashion.\u201d<\/p>\n Calder points out that, in the management of cardiovascular disease, dietary treatments exist alongside drug and surgical therapies \u2013 so the pairing does have precedent.\u00a0 Though in the treatment of infectious disease, he says, \u201cthat seems to be \u2026 one step too far maybe.\u201d<\/p>\n When he recalls the progression of the medical response to the pandemic, Calder notices that the response was dominated by anti-retroviral testing, and vaccine development and off-label drug use. \u201cThe emphasis hasn\u2019t been an inappropriate one, but I think an emphasis on lifestyle, including diet, have been made\u201d, he said.<\/p>\n Professor Calder describes three aspects to the response in the UK that demonstrate that there is room for advocating for a dietary response to COVID-19.<\/p>\n First, the UK government acknowledged that despite restrictive lockdowns, it was necessary that people got outside to exercise, for their general health, despite potential increased risk of transmission.<\/p>\n Second, in the UK, health authorities recognized that with people spending more time indoors due to lockdowns, they would be getting less vitamin D from the sun and promoted supplementation \u2013 not for COVID-19 mitigation effects, but for general health and bone health.<\/p>\n And third, the UK Health authorities did take seriously evidence of an association between COVID-19 and obesity. \u00a0 They began an intensive program to promote weight loss, using TV ads, billboards and posters to spread the message.<\/p>\n Professor Calder concludes: these pandemic response measures demonstrate the kind of thinking and messaging that he would like see applied to diet.<\/p>\n Dr Creaser offers another theory to explain the missing health advice:<\/p>\n \u201cSome healthcare workers or decision makers are concerned people won\u2019t take it seriously if they think they\u2019re healthy because they\u2019re eating a certain way.\u00a0 But I think that\u2019s a false assumption.\u201d<\/p>\n Calder thinks that could be part of the explaination \u2014\u00a0 authorities don\u2019t want to be seen to be telling people \u201cif you do this, you won\u2019t catch COVID-19\u201d.<\/p>\n But the message could be carefully crafted \u2013 Calder suggests, \u201cyou don\u2019t have to say it\u2019s the answer to the problem.\u201d<\/p>\n Dr Jenna Creaser\u00a0\u2013 courtesy Rising Rose Wellness website<\/p><\/div><\/figure>\n<\/div>\n Dr Creaser offers up another theory \u2013 she recounts how a recent version of the Canada Food Guide was met with some resistance from health experts.\u00a0 Health Canada was gracious and made some changes to better reflect the science.\u00a0 But perhaps that sort of institutional hazard, of making claims too early before the dust has settled on the science, could contribute to reluctance to suggest that perhaps diet is important to immune function.<\/p>\n Dr Creaser suggests that the fast paced scientific changes, might make authorities slow to promote options \u2013 \u201cbecause maybe it won\u2019t be the most correct\u2026 thing\u201d, she says.<\/p>\n But Professor Calder is quick to calm that concern as well.\u00a0 He says, \u201cwe don\u2019t need more evidence for the \u2018healthy eating\u2019 message, not reinforcing that message has been something that\u2019s been missing.\u201d<\/p>\n So, what should that message be?<\/p>\n \u201cFood first\u201d, Dr Creaser offers.<\/p>\n Both recommend a diverse diet with plenty of different and colorful vegetables and protein.<\/p>\n Both recommend supplementing with Vitamin D, especially in the winter.\u00a0 Creaser suggests 2000 IU\/day seems to have the most evidence in support.<\/p>\n Dr Creaser also recommends garlic, ginger and mushrooms, the latter being a whole kingdom worthy of its own exploratory article or book.<\/p>\n Creaser says hydration is important.\u00a0 Zinc shows benefits for immune function (25-50mg\/day for most people.\u00a0 And people can consider Elderberry and vitamin C, probiotic and prebiotic foods (she\u2019s not so sure on the evidence for probiotic supplements).<\/p>\n And Creaser says that people should have some form of regular practice such as walking in nature, meditation or yoga.<\/p>\n \u201cIt seems so obvious, when I say it.\u00a0 So I hope that\u2019s helpful\u201d, Dr Creaser says.<\/p>\n So, there you have it.\u00a0 There\u2019s the missing message.\u00a0 Choose food.\u00a0 Take a breather.\u00a0 And supplement as needed.<\/p>\n Many thanks to Dr Jenna Creaser and Professor Philip Calder for taking the time to share their insights and expertise.\u00a0 For more information, you can find links to the studies in the article for this piece on cortescurrents.ca.\u00a0 You can speak with a dietician for nutritional guidance by calling 811.<\/p>\n Dr Creaser recommends checking out ifm.org for more immune supporting diet and supplement advice.<\/p>\n By Max Thaysen Around the globe, people are dealing as best they can with the novel coronavirus outbreak, SARS-CoV-2, also known as COVID 19. After we wash our hands, don a facemask and avoid non-essential travel and socialization, many of us are looking for ways to maximize our immune function. A quick internet search will…<\/p>\n","protected":false},"author":34,"featured_media":26014,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[218,223],"tags":[3978,3975,3976,3977],"radio":[252],"origine":[280,266,231],"acf":[],"_links":{"self":[{"href":"https:\/\/canada-info.ca\/en\/wp-json\/wp\/v2\/posts\/25993"}],"collection":[{"href":"https:\/\/canada-info.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/canada-info.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/canada-info.ca\/en\/wp-json\/wp\/v2\/users\/34"}],"replies":[{"embeddable":true,"href":"https:\/\/canada-info.ca\/en\/wp-json\/wp\/v2\/comments?post=25993"}],"version-history":[{"count":0,"href":"https:\/\/canada-info.ca\/en\/wp-json\/wp\/v2\/posts\/25993\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/canada-info.ca\/en\/wp-json\/wp\/v2\/media\/26014"}],"wp:attachment":[{"href":"https:\/\/canada-info.ca\/en\/wp-json\/wp\/v2\/media?parent=25993"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/canada-info.ca\/en\/wp-json\/wp\/v2\/categories?post=25993"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/canada-info.ca\/en\/wp-json\/wp\/v2\/tags?post=25993"},{"taxonomy":"radio","embeddable":true,"href":"https:\/\/canada-info.ca\/en\/wp-json\/wp\/v2\/radio?post=25993"},{"taxonomy":"origine","embeddable":true,"href":"https:\/\/canada-info.ca\/en\/wp-json\/wp\/v2\/origine?post=25993"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}Stressing foods, lifestyle and supplements \u2013 Pseudoscience? Or much more?<\/h2>\n
Professor Phillip Calder<\/h2>\n
Healthy Diets<\/h2>\n
Our immune system<\/h2>\n
Vitamin D<\/h2>\n
What do Health Canada or the BCCDC say?<\/h2>\n
\n
Declined to clarify<\/h2>\n
Clinical data for Vitamin D<\/h2>\n
Clinical data for fruit and veggies<\/h2>\n
Possible risk from a \u2018healthier\u2019 diet<\/h2>\n
Possible benefits of a healthy diet<\/h2>\n
Vaccines<\/h2>\n
Why aren\u2019t we hearing more about diet?<\/h2>\n
Go outside to get exercise<\/h2>\n
Want to be taken seriously<\/h2>\n
Not making claims too early<\/h2>\n
Food First<\/h2>\n
Recommendations<\/h2>\n
Links of interest:<\/h2>\n
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