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Feb 10, 2016

Diet and the Immune System

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By Dr. B. M. Hegde, India [ Published Date: May 23, 2009 ]

Dr. B. M. Hegde MD, FRCP, FRCPE, FRCPG, FRCPI, FACC, FAMS, is editor-in-chief of The Journal of the Science of Healing Outcomes; chairman, State Health Society’s Expert Committee, Govt. of Bihar, India, Visiting Prof. Cardiology at The Middlesex Hospital Medical School - University of London, Affiliate Prof. of Human Health - Northern Colorado University, Visiting Prof. Indian Institute of Advanced Studies - Shimla,  Retd.  Vice Chancellor, MAHE University - Manipal. Prof Hedge regularly gives talks on AIR, Doordarshan, BBC and Zee TV, London. 

"Man is what he eats" is one view while an opposite view is that "it is not what one eats that kills him but, it is what eats him (negative thoughts) that kills him." Both have some wisdom in them. Let us confine ourselves to the first view only for this blog as the pandemic season is threatening us and we need to ponder as to what we should be eating to strengthen our immune defense. How scientific is the view that diet has many things to do with human immune system?

This week’s thought by the President of the RCPSG, Professor Brian Owen Williams, in his weekly news review, impressed me very much. This has relevance here. I have taken the liberty of quoting him here: "As much as science has transformed the practice of medicine, our ability to overcome the impact of unconventional illnesses in society has yet to be fully explored. I question whether this phenomenon is a consequence of an evidence-based approach or a subconscious disbelief in society to accept that which is irrational in nature. The 'Hubristic Syndrome', a suffering which presents as a loss of capacity and excessive self confidence which leads to the contempt of anything that is counter to ones own beliefs, is a case in point…."

Let us start with the latest evidence to show how diet controls our health and even our very existence on this planet. In a large study of nearly half a million individuals aged between 50 and 71 wherein the study population included the National Institutes of Health-AARP Diet and Health Study cohort of half a million people aged 50 to 71 years at baseline showed the following facts. Red and processed meat intakes were associated with modest increases in total mortality, cancer mortality, and cardiovascular mortality. (Arch. Int. med. 2009; 169: 562-571)

Writing an editorial in the same issue of the journal, Barry Popkin, an advocate of meat diet, dilutes his message for the future by reducing red meat and processed meat intake by the populace for overall health benefits of the world. He quotes the benefits of a pure vegetarian diet as advocated by Dean Ornish and the Harvard group but, feels that a small amount of meat might be not as bad but, definitely NOT red and processed meat. (Arch. Int. Med 2009; 169: 543-545) The Harvard group, lead by Willet W, suggests a major shift from the usual meat based western diet towards more of a Mediterranean diet with minimal red meat for good health. (Eat, drink and be healthy-Harvard Medical School guide to healthy eating)

Immune deficiency is associated with a number of malignancies. AIDS diagnosis is associated with many malignancies. Certain other immune deficiency states also have this combination. There is thus a strong relationship between cancer and the immune system. The above study, therefore, is very important indirect message to link reducing meat eating to boosting the immune system. (Wood C, Harrington W. "AIDS and associated malignancies". Cell Res.2005; 15: 947–52. and Mellemkjaer L, Hammarstrom L, Andersen V, et al "Cancer risk among patients with IgA deficiency or common variable immunodeficiency and their relatives: a combined Danish and Swedish study". Clin. Exp. Immunol. 2002; 130: 495–500.)

A secondary prevention study showed that a plant-based diet and lifestyle changes resulted in a reduction in cancer markers in a group of men with prostate cancer who were using no conventional treatments at the time. (The Jr. of Urology 2005; 174: 1065-1067) These results were boosted by a 2006 study in which "over 2,400 women were studied, half randomly assigned to a normal diet, the other half assigned to a diet containing less than 20% calories from fat. The women on the low fat diet were found to have a markedly lower risk of breast cancer recurrence. (JAMA 2005; 293; 194-202)

"The WCRF/AICR Expert Report lists 10 recommendations that people can follow to help reduce their risk of developing cancer, including the following dietary guidelines: (1) reducing intake of foods and drinks that promote weight gain, namely energy-dense foods and sugary drinks, (2) eating mostly foods of plant origin, (3) limiting intake of red meat and avoiding processed meat, (4) limiting consumption of alcoholic beverages, and (5) reducing intake of salt and avoiding mouldy cereals (grains) or pulses (legumes)" (Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Chapter 12 World Cancer Research Fund (2007). ISBN 978-0-9722522-2-5).

A symposium on Diet, Nutrition and Immunity held in Singapore on April, 2008, reviewed the current scientific information on the development of the immune system particularly in infancy and the role of diet, exercise and ageing on immune-competence, together with the molecular processes involved." The role of nutrients like zinc, iron, vit. D and E and long chain polyunsaturated fatty acids on enhancing immunity were discussed. The foods mainly discussed were some common Asian foods such as Soybeans, wolfberry, and mushroom which might have a strong health giving effect in all inflammatory conditions. Meat eating was not advocated for good health. (Florentino RF. Asia. Pac J Clin. Nutr, 2009; 18: 137-142.)

Interestingly, the last paper that came out of the Colindale’s Cold Research Centre had advocated Indian spices as good anti-dote for viral infections. Now comes a study of one such spice used extensively in Indian cooking that helps boost one’s immunity and cell wall integrity to prevent infections. That spice is Turmeric. Curcumin is the active ingredient of turmeric powder. It is a broad spectrum anti-cancer, antioxidant, and anti-inflammatory chemical. Because of its various effects on the multiple membrane proteins it has been suggested that Curcumin affects the properties of the cell wall bilayer itself. Solid state NMR and differential calorimetric studies have confirmed this fact. Indian curries, both vegetarian and non-vegetarian, do use a lot of turmeric. What makes it more important is that curcumin, even in small doses, is effective! (Barry J Amer Chem Soc. 2009; 131: 4490-4498)

Eaton from the anthropology department of Emory, writing on our ancestral human diet, showed that the human genome has hardly changed from the time of the behaviouraly-modern humans evolved 100-50 into 10(3) years ago. Our diet, however, has changed drastically, especially in the western world, giving rise to a gene-food mismatch. The evidence suggested that our ancestors got 35% of their energy from fats, 35% from carbohydrates, and 30% from proteins. Saturated fatty acids gave 7.5% of energy while trans-fatty acids never existed. Cholesterol consumption was significant. Carbohydrates came from uncultivated fruits and vegetables which gave 50% of energy. High fruit and vegetable diet with minimal grain and diary gave them a base yielding diet unlike today’s acid-producing pattern. Honey was the sweetening agent and not white sugar. Fibre content was very high. Vitamin, mineral and photochemical contents were higher than today but not SODIUM. There is NO MENTION of MEAT. (Proc. Nutr. Soc. 2006; 65: 1-6)

Now I move to more slippery area of Indian Ayurveda that advocates vegetarianism for good health although meat is not taboo there. For those that regularly meditate and practice yoga vegetarian diet is advised. (Saathvik diet) I have some solace that a western researcher has done significant research in that area of Yoga and meditation and the immune system. Kevin Tracy MD, the CEO of the Feinstein Institute of Medical Research in New York, in his book,  Fatal Sequence: The killer within, recounts the how the spiral of sepsis, an immune system over-reaction to infection works, and goes on to say "that the body getting the best care-and recovering-suddenly and fatally veer off track." He further goes on to say that the"western science requires, "show us how it works." Today we know that we can study the vagus nerve in a clinical experiment to learn whether it connects some of these Eastern medical practices to improved health. My colleagues and I did not set out to try to understand the biological basis of meditative practice, nor are we doing that now, but what we discovered is clearly a hypothesis, a theory, which can be tested and studied in people who meditate, in people who do biofeedback and in people who have relaxation therapy. Each of these activities increases vagus nerve activity."

In conclusion, I feel the scale is tilted on the side of vegetarian diet (with, may be, a very small amount of non-red meat) to safeguard our immune system when it gets overwhelmed by cunning organisms like the H1N1 virus.

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Austin Prabhu, USA :
Very valuable article Dr. Hegde! Whatever look good and taste good is not good for health for sure!!
Shenoy, India :
A secondary prevention study showed that a plant-based diet and lifestyle changes resulted in a reduction in cancer markers in a group of men with prostate cancer who were using no conventional treatments at the time. (The Jr. of Urology 2005; 174: 1065-1067)

A diet rich in tomatoes can help. Lycopene in tomatoes is supposed to help prevent prostate cancer. Prostate cancer is uncommon in Indians. It is very common in the African American men who generally have a high testosterone levels. Interestingly enough, it is comparatively less common in Africans themselves as compared to Afro Americans. This is attribuited to their diet which is essentially different from Amercian diet which is a high fat high calrie diet. Africans eat more complex carbohydrates and fruits apart from vegetables and fish, They are generally more hard working and burn off their calories. The more affluent Americans eventually pay the price for their affordability of rich food.Selenium again is useful.

Thanks Dr Hegde for that useful article. I look forward to your contributions on cardiac health and management of chronic life style diseases.
mervyn pinto, Canada :
dear Dr. hegde,
I always appreciated your commitmennt to patient well being. My famaily had interacted with you during sickness and we were touched by your caring attitude. You are a true doctor.
Ruchir Agarwal, India :
There is a popular saying
" Eat to live,... not live to eat"
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