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Salehi Z, Askari M, Jafari A, Ghosn B, Surkan PJ, Hosseinzadeh-Attar MJ, Pouraram H, Azadbakht L. Dietary patterns and micronutrients in respiratory infections including COVID-19: a narrative review. BMC Public Health 2024; 24:1661. [PMID: 38907196 PMCID: PMC11193220 DOI: 10.1186/s12889-024-18760-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/02/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND COVID-19 is a pandemic caused by nCoV-2019, a new beta-coronavirus from Wuhan, China, that mainly affects the respiratory system and can be modulated by nutrition. METHODS This review aims to summarize the current literature on the association between dietary intake and serum levels of micronutrients, malnutrition, and dietary patterns and respiratory infections, including flu, pneumonia, and acute respiratory syndrome, with a focus on COVID-19. We searched for relevant articles in various databases and selected those that met our inclusion criteria. RESULTS Some studies suggest that dietary patterns, malnutrition, and certain nutrients such as vitamins D, E, A, iron, zinc, selenium, magnesium, omega-3 fatty acids, and fiber may have a significant role in preventing respiratory diseases, alleviating symptoms, and lowering mortality rates. However, the evidence is not consistent and conclusive, and more research is needed to clarify the mechanisms and the optimal doses of these dietary components. The impact of omega-3 and fiber on respiratory diseases has been mainly studied in children and adults, respectively, and few studies have examined the effect of dietary components on COVID-19 prevention, with a greater focus on vitamin D. CONCLUSION This review highlights the potential of nutrition as a modifiable factor in the prevention and management of respiratory infections and suggests some directions for future research. However, it also acknowledges the limitations of the existing literature, such as the heterogeneity of the study designs, populations, interventions, and outcomes, and the difficulty of isolating the effects of single nutrients from the complex interactions of the whole diet.
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Affiliation(s)
- Zahra Salehi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Mohammadreza Askari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Alireza Jafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Batoul Ghosn
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mohammad Javad Hosseinzadeh-Attar
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetic, Tehran University of Medical Sciences, Tehran, Iran
- Department of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Hamed Pouraram
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran.
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, IR, Iran.
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, IR, Iran.
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Wimalawansa SJ. Controlling Chronic Diseases and Acute Infections with Vitamin D Sufficiency. Nutrients 2023; 15:3623. [PMID: 37630813 PMCID: PMC10459179 DOI: 10.3390/nu15163623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Apart from developmental disabilities, the prevalence of chronic diseases increases with age especially in those with co-morbidities: vitamin D deficiency plays a major role in it. Whether vitamin D deficiency initiates and/or aggravates chronic diseases or vice versa is unclear. It adversely affects all body systems but can be eliminated using proper doses of vitamin D supplementation and/or safe daily sun exposure. Maintaining the population serum 25(OH)D concentration above 40 ng/mL (i.e., sufficiency) ensures a sound immune system, minimizing symptomatic diseases and reducing infections and the prevalence of chronic diseases. This is the most cost-effective way to keep a population healthy and reduce healthcare costs. Vitamin D facilitates physiological functions, overcoming pathologies such as chronic inflammation and oxidative stress and maintaining broader immune functions. These are vital to overcoming chronic diseases and infections. Therefore, in addition to following essential public health and nutritional guidance, maintaining vitamin D sufficiency should be an integral part of better health, preventing acute and chronic diseases and minimize their complications. Those with severe vitamin D deficiency have the highest burdens of co-morbidities and are more vulnerable to developing complications and untimely deaths. Vitamin D adequacy improves innate and adaptive immune systems. It controls excessive inflammation and oxidative stress, generates antimicrobial peptides, and neutralizes antibodies via immune cells. Consequently, vitamin D sufficiency reduces infections and associated complications and deaths. Maintaining vitamin D sufficiency reduces chronic disease burden, illnesses, hospitalizations, and all-cause mortality. Vulnerable communities, such as ethnic minorities living in temperate countries, older people, those with co-morbidities, routine night workers, and institutionalized persons, have the highest prevalence of vitamin D deficiency-they would significantly benefit from vitamin D and targeted micronutrient supplementation. At least now, health departments, authorities, and health insurance companies should start assessing, prioritizing, and encouraging this economical, non-prescription, safe micronutrient to prevent and treat acute and chronic diseases. This approach will significantly reduce morbidity, mortality, and healthcare costs and ensure healthy aging.
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Affiliation(s)
- Sunil J Wimalawansa
- Department of Medicine, CardioMetabolic & Endocrine Institute, North Brunswick, NJ 08902, USA
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Zhao X, Hu M, Zhou H, Yang Y, Shen S, You Y, Xue Z. The role of gut microbiome in the complex relationship between respiratory tract infection and asthma. Front Microbiol 2023; 14:1219942. [PMID: 37577440 PMCID: PMC10413575 DOI: 10.3389/fmicb.2023.1219942] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/19/2023] [Indexed: 08/15/2023] Open
Abstract
Asthma is one of the common chronic respiratory diseases in children, which poses a serious threat to children's quality of life. Respiratory infection is a risk factor for asthma. Compared with healthy children, children with early respiratory infections have a higher risk of asthma and an increased chance of developing severe asthma. Many clinical studies have confirmed the correlation between respiratory infections and the pathogenesis of asthma, but the underlying mechanism is still unclear. The gut microbiome is an important part of maintaining the body's immune homeostasis. The imbalance of the gut microbiome can affect the lung immune function, and then affect lung health and cause respiratory diseases. A large number of evidence supports that there is a bidirectional regulation between intestinal flora and respiratory tract infection, and both are significantly related to the development of asthma. The changes of intestinal microbial components and their metabolites in respiratory tract infection may affect the occurrence and development of asthma through the immune pathway. By summarizing the latest advancements in research, this review aims to elucidate the intricate connection between respiratory tract infections and the progression of asthma by highlighting its bridging role of the gut microbiome. Furthermore, it offers novel perspectives and ideas for future investigations into the mechanisms that underlie the relationship between respiratory tract infections and asthma.
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Affiliation(s)
| | | | | | | | | | - Yannan You
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zheng Xue
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Kuang L, Liang Z, Wang C, Lin T, Zhang Y, Zhu B. Serum 25-Hydroxy Vitamin D Levels in Children with Acute Respiratory Infections Caused by Respiratory Virus or Atypical Pathogen Infection. Nutrients 2023; 15:nu15061486. [PMID: 36986216 PMCID: PMC10056357 DOI: 10.3390/nu15061486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
We aimed to clarify the involvement of vitamin D status in virus or atypical pathogens infection in children with acute respiratory infections (ARIs). In this retrospective study, 295 patients with ARIs were attacked by a respiratory virus or a single atypical pathogen; 17 patients with ARIs induced by two pathogens, and 636 healthy children were included. Serum 25(OH)D levels of all children were measured. Oropharyngeal samples of the patients for viruses or atypical pathogens were studied by polymerase chain reaction (PCR) or reverse transcription-polymerase chain reaction (RT-PCR). In our studies, 58.98% of the 295 single-infected subjects and 76.47% of the 17 co-infected subjects had 25(OH)D levels below the recommended 50.0 nmol/L; the mean 25(OH)D levels were 48.48 ± 19.91 nmol/L and 44.12 ± 12.78 nmol/L. Low serum 25(OH)D levels were remarkable in patients with one of seven viruses or atypical pathogens infected. These results were significantly different from those in the healthy group. There were no significant differences in 25(OH)D levels between single infection and co-infection groups. There were no differences in severity among means of 25(OH)D levels. Female or >6-year-old children patients with low serum 25(OH)D levels were more vulnerable to pathogenic respiratory pathogens. However, serum 25(OH)D levels may be related to the recovery of ARIs. These findings provide additional evidence for the development of strategies to prevent ARIs in children.
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Affiliation(s)
- Lu Kuang
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510120, China
| | - Zhuofu Liang
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510120, China
| | - Changbing Wang
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510120, China
| | - Tao Lin
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510120, China
| | - Yingying Zhang
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510120, China
| | - Bing Zhu
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510120, China
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Wimalawansa S. Overcoming Infections Including COVID-19, by Maintaining Circulating 25(OH)D Concentrations Above 50 ng/mL. PATHOLOGY AND LABORATORY MEDICINE INTERNATIONAL 2022. [DOI: 10.2147/plmi.s373617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Sun M, Yan Z, Sun R, Tian W, Yi W, Zhang J. Dynamic monitoring and a clinical correlation analysis of the serum vitamin A, D, and E levels in children with recurrent respiratory tract infections. Am J Transl Res 2022; 14:3533-3538. [PMID: 35702083 PMCID: PMC9185048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/17/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To investigate the correlation of the serum vitamin A, D, and E (VA, VD, and VE) levels with the occurrence and development of recurrent respiratory tract infections (RRTIs). METHODS A total of 129 children with respiratory tract infections (RTIs) treated in our hospital from January 2018 to February 2020 (the RTIs group) and 50 healthy children undergoing physical examinations (the control group) in our hospital were recruited as the study cohort. The serum VA, VD, and VE levels were measured upon admission (the active phase) and at two weeks after discharge (the stable phase). The serum VA, VD, and VE levels in the children with RRTIs were compared with the levels in the control group, and the correlation between these three vitamins and the occurrence and development of RRTIs was analyzed. RESULTS The RRTIs group and the RTIs group witnessed markedly lower serum VA, VD, VE, and humoral immunity index levels, including IgG, IgA, and IgM, compared to the control group, with an apparent lower outcome in the RRTIs group than in the RTIs group. The serum levels of the above indexes in the RRTIs children were reduced in the active phase compared with the stable phase. A Pearson correlation analysis showed a positive correlation between VA and IgA. A multivariate logistic regression analysis revealed that a low BMI (Body mass index), prematurity, VA deficiency, VD deficiency, and VE deficiency were the risk factors for RRTIs in children, and outdoor activity was the protective factor. CONCLUSION The VA, VD, and VE levels are closely related to RRTIs in children. It is important to determine and supplement the VA, VD, and VE levels to prevent RTIs in children.
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Affiliation(s)
- Mei Sun
- Department of Pediatrics, Cangzhou Central Hospital Cangzhou, China
| | - Zhixin Yan
- Department of Pediatrics, Cangzhou Central Hospital Cangzhou, China
| | - Rongrong Sun
- Department of Pediatrics, Cangzhou Central Hospital Cangzhou, China
| | - Wenqiu Tian
- Department of Pediatrics, Cangzhou Central Hospital Cangzhou, China
| | - Wenxia Yi
- Department of Pediatrics, Cangzhou Central Hospital Cangzhou, China
| | - Jing Zhang
- Department of Pediatrics, Cangzhou Central Hospital Cangzhou, China
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Roth M, Sun Q, Tamm M. Up-Regulated Vitamin D Receptor by Pelargonium sidoides Extract EPs ® 7630 Contributes to Rhinovirus Defense in Bronchial Epithelial Cells. Pharmaceuticals (Basel) 2021; 14:ph14020172. [PMID: 33671804 PMCID: PMC7926416 DOI: 10.3390/ph14020172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/19/2021] [Accepted: 02/19/2021] [Indexed: 12/26/2022] Open
Abstract
EPs®7630, extracted from Pelargonium sidoides, reduces the severity of viral upper respiratory tract infections. Vitamin D also improves anti-viral host defense through similar signaling pathways. This study assessed if EPs®7630 modifies vitamin D receptor (VDR) expression and function by human bronchial epithelial cells. Bronchial epithelial cells were incubated with EPs®7630 over 48 h before calcitriol stimulation and/or infection with Rhinovirus (RV)-16. Protein expression was determined by Western-blotting. Intracellular signaling of mitogen activated protein kinases (MAPK) was studied by chemical inhibitors. The anti-viral effect was assessed by immunofluorescence for RV-16 protein. EPs®7630 upregulated VDR expression through Erk1/2 MAPK and thereby increased the cell's sensitivity to calcitriol. Compared ton untreated cells, the shift of the VDR into the nucleus at 5.3 times lower calcitriol concentration. EPs®7630 increased Erk1/2 MAPK signaling, but reduced p38 phosphorylation, and had no effect on Jun N-terminal kinase (JNK). EPs®7630 improved the anti-viral effect of vitamin D on RV-16 infection by 2.1 folds compared to vitamin D alone or to untreated cells. Furthermore, EPs®7630 improved the differentiation of epithelial cells by upregulating E-cadherin expression through Erk1/2. In conclusion, EPs®7630 increased host defense against Rhinovirus infection by upregulating the VDR and the differentiation of epithelial cells.
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Affiliation(s)
- Michael Roth
- Pulmonary Cell Research & Pneumology, Department Biomedicine & Internal Medicine, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland; (Q.S.); (M.T.)
- Correspondence: ; Tel.: +41-61-265-2337
| | - Qingzhu Sun
- Pulmonary Cell Research & Pneumology, Department Biomedicine & Internal Medicine, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland; (Q.S.); (M.T.)
- College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China
| | - Michael Tamm
- Pulmonary Cell Research & Pneumology, Department Biomedicine & Internal Medicine, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland; (Q.S.); (M.T.)
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Mahmoudzadeh H, Nikibakhsh AA, Pashapour S, Ghasemnejad-Berenji M. Relationship between low serum vitamin D status and urinary tract infection in children: a case-control study. Paediatr Int Child Health 2020; 40:181-185. [PMID: 32490740 DOI: 10.1080/20469047.2020.1771244] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND A link between vitamin D deficiency and susceptibility to bacterial and viral infections has recently been suggested. AIM To investigate a possible association between vitamin D deficiency and urinary tract infection (UTI). METHODS A case-control study was undertaken comprising 75 children aged 2-7 years with UTI (cases) compared with 75 healthy controls in terms of serum 25 hydroxyvitamin D [25(OH)D] levels. Serum 25(OH)D levels were measured using a chemiluminescence assay. For cases, dimercaptosuccinic acid (DMSA) renal scan was used as the gold standard to distinguish between acute lower UTI (cystitis) and acute pyelonephritis. RESULTS Median (IQR) 25(OH)D levels were lower in the UTI group [14.5 ng/mL (9.4-18.8)] than in the controls [27 ng/mL (22.4-39.0)] (p< 0.001). In addition, the prevalence of 25(OH)D levels <20 ng/mL was higher in the children with UTI than in the controls (68% vs 18%) (p< 0.001). There was a statistically significant difference between the cystitis and pyelonephritis groups in mean (SD) serum 25(OH)D levels-18.76 (9.35) ng/mL vs 13.94 (6.97) ng/mL, p< 0.05, respectively. CONCLUSION Low serum vitamin D is associated with UTI and supports the hypothesis that children with low vitamin D levels could be at greater risk of UTI.
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Affiliation(s)
- Hashem Mahmoudzadeh
- Department of Pediatrics, Faculty of Medicine, Urmia University of Medical Sciences , Urmia, Iran
| | - Ahmad Ali Nikibakhsh
- Department of Pediatrics, Faculty of Medicine, Urmia University of Medical Sciences , Urmia, Iran
| | - Sarvin Pashapour
- Department of Pediatrics, Faculty of Medicine, Urmia University of Medical Sciences , Urmia, Iran
| | - Morteza Ghasemnejad-Berenji
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Urmia University of Medical Sciences , Urmia, Iran
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Czerwińska A, Krzyścin J. Numerical estimations of the daily amount of skin-synthesized vitamin D by pre-school children in Poland. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2020; 208:111898. [PMID: 32460118 DOI: 10.1016/j.jphotobiol.2020.111898] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/18/2020] [Accepted: 05/13/2020] [Indexed: 11/27/2022]
Abstract
According to Polish guidelines, children need a daily dose of 600-1000 I·U. vitamin D, which could be skin-synthesized in the period May to September, after at least 15 min solar exposure between 10 am and 3 pm with uncovered forearms and lower legs. In Poland, doctors only prescribe oral supplementation to infants and small children up to 2 years old, rarely for the older children. Numerical estimates of the daily amount of vitamin D (expressed in I.U. vitamin D taken orally) due to the solar exposure for preschoolers have been made on the basis of an observation campaign in Warsaw, Poland. In the period from April to September, the observations of children's clothing of age 4-6 years and the measurements of UV index were carried out in the kindergarten playground and a nearby park (52.31oN, 21.06°E). It appears, that longer exposures (~45 min) are needed to gain the recommended dose. However, the estimation is burden with large uncertainties. The alternative scenario is to allow children to play outside for as long as possible without getting sunburn, i.e. until the personal erythemal threshold is reached. Then, sunscreens should be applied.
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Affiliation(s)
| | - Janusz Krzyścin
- Institute of Geophysics, Polish Academy of Sciences, Warsaw, Poland
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Feketea G, Bocsan CI, Stanciu LA, Buzoianu AD, Zdrenghea MT. The Role of Vitamin D Deficiency in Children With Recurrent Wheezing-Clinical Significance. Front Pediatr 2020; 8:344. [PMID: 32695735 PMCID: PMC7338661 DOI: 10.3389/fped.2020.00344] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/26/2020] [Indexed: 01/25/2023] Open
Abstract
Recurrent wheezing (RW) in infancy is one of the most frequent reasons for parents to consult health care providers and creates a significant global burden. Clinical course of RW is difficult to predict, also which infants will progress to asthma, since no valid biomarkers have been established. Identification of those infants with RW who are at risk of further recurrences and/or severe acute respiratory tract infection (ARTI) could help pediatricians to improve their therapeutic decisions. Increasing research interest is focused on the extra-skeletal actions of vitamin D (VD) and the clinical impact of VD insufficiency/deficiency. As VD deficiency could be a risk factor for causing RW in children, measurement of their serum level of 25-hydroxycholecalciferol [25(OH)D] is recommended. In the case of deficiency, VD administration is recommended in age-appropriate doses for at least 6 weeks, until achievement of normal blood 25(OH)D level, followed by supplementation as long as exposure to sun is inadequate. Higher doses of VD given in an attempt to prevent asthma development appear to be of no additional benefit. In children with severe ARTI, VD level is recommended to be assess.
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Affiliation(s)
- Gavriela Feketea
- Department of Hematology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Pediatrics, Pediatric Allergy Outpatient Clinic, "Karamandaneio" Children Hospital, Patras, Greece
| | - Corina I Bocsan
- Department of Pharmacology, Toxicology and Clinical Pharmacology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Luminita Aurelia Stanciu
- Airways Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Anca Dana Buzoianu
- Department of Pharmacology, Toxicology and Clinical Pharmacology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihnea Tudor Zdrenghea
- Department of Hematology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Hematology, Ion Chiricuta Oncology Institute, Cluj-Napoca, Romania
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