Nutrition in the COVID era, by Dr. Paul Clayton

Immune health has long been a prime area of interest for consumers, regularly featuring at the top of health concerns (1, 2). The impact of COVID has further increased public awareness of the immune system, and how it might be supported in order to reduce the risks of infection.

Now, a quarter of consumers world-wide are buying more supplements (3), a third have increased their intake of foods considered to provide immune support (4), half have started researching ingredients on the internet (5) and three quarters are now monitoring immunity claims on the foods and supplements they purchase (4).

Sales of immune-targeted supplements in the US have jumped by 25% and global launches of food products with immune health claims have increased in parallel (3, 6). Suppliers of vitamin C, elderberry powder, chaga mushrooms and such report panic buying (7), as do many food retailers (8).

But, will any of this help?

The immune system is undoubtedly impacted by one’s diet and nutritional status, but many other ‘ingredients’ play a role in determining overall immune fitness, including age, obesity, physical fitness, genetic factors, chronic stress and others all impact, and there are no magic bullets. Nor is there any evidence that the immune system can be boosted.

There is plenty of evidence, however, that the modern diet and lifestyle degrades our physiological systems, including the immune system, via a combination of inflammatory stress, dysbiosis, Type B malnutrition and insulin resistance (9, 10). Conversely, undoing or reversing these pathogenic links leads to a general improvement in health, including immune health (9-12).
This has given rise to vague recommendations from governments and quangos to aim for a healthy weight, to be physically active, and to eat whole grains, fruits, vegetables and beans while limiting specific foods such as fast foods, red and processed meats, sugar sweetened drinks and alcohol. While these recommendations are well-meaning, presumably, they are unlikely to achieve much.

There is an opportunity today, however, tobe more effective by being more specific.

The first line of defense encountered by any pathogen is the innate immune system. This cannot be reached via vaccination, which operates within the adaptive immune system, but it is far more important in preventing infection.

When the innate immune system responds to a pathogenic bacterium, the response is primarily cellular and involves neutrophils, macrophages, and localised variants such as Kupfer cells. The innate immune response to viruses is primarily chemical, involving an array of mild oxidants which degrade viral structures and interfere with the cycle of cell entry and multiplication. These are hydrogen peroxide (H2O2), hypochlorous ions (HOCl-), hypoiodite ions (OI-) and hypothiocyanous (HOSCN-) and hypothiocyanite (OSCN-) ions.

OSCN- and HOSCN- ions, in particular, have potent anti-viral activities. Many viruses including coronavirus are rendered ineffective by relatively low concentrations of hypothiocyanous and hypothiocyanite ions because they have sulphydryl groups on their coat (13). When these are oxidized by HOSCN- and OSCN, the- viral coat structure is damaged (14) and the viral cycle is blocked.

There is persuasive evidence that the lactoperoxidase enxyme system (LPO) has the ability, if it is working well, to damage influenza and probably coronaviruses to the point where they cannot infect new cells in the body (15-23).

Innate immune cells produce H2O2 when challenged, and do so more effectively when primed with 1-3, 1-6 beta glucans. H2O2 activates the LPO, which then generates HOSCN- and OSCN- effector ions; but the LPO system requires iron, iodine and a cyanogen in order to produce those effectors.

Due to a dietary shift, intakes of 1-3, 1-6 beta glucans, iodine, iron and cyanogens are all far lower than they were even a century ago (24). Iron depletion is the single most common form of dysnutrition, and dietary levels of cyanogens have declined markedly since at least 1950. Putting these nutrients back into the system does not ‘boost’ the immune system, but merely restores immunological normality.

The modern, ultra-processed diet has degraded the functionality of the innate immune system, and provides a rationale for widespread supplementation programs. The effectiveness of such composite nutritional interventions are not yet proven, but they are supported by circumstantial evidence, and unlike the pharmaceutical approaches, they have very wide therapeutic indices. This makes the solutions suitable for general usage, and for consideration in preventative and interventional public health strategies.

But, there is more that nutrition can offer.

The COVID lockdowns have created sets of problems unrelated to the virus itself, and which are just as serious (25). Stress levels have soared, and weight gain due to stress, comfort eating and lack of exercise is wide-spread. This is a deeply unhealthy combination, and increases the risks of delayed onset problems, such as metabolic syndrome.

Several molecules / extracts which have recently emerged on the nutritional science scene have clear applications in this space. These include CALMaluma™, a standardized extract of the succulent Caralluma fimbriata which combines anorexogenic and anxiolytic effects; and Levagen®, a highly bioavailable form of palmitoylethanolamide (PEA).

Caralluma’s anorexogenic properties have been known for centuries, and the plant itself has been traditionally used as a famine food in North Africa and South East Asia. In the modern era, the plant has been rediscovered and standardized extracts have been shown to exert anti-obesogenic satiety effects in various pre-clinical models (26), together with anxiolysis (27, 28). This unusual combination of effects makes Caralluma an intriguing candidate for reducing stress-related eating, and a number of clinical investigations have shown that it is indeed effective in reducing anxiety, and aiding dietary compliance and weight loss (29-32).
CALMaluma’s ability to reduce appetite and anxiety has even been shown to be effective in Prader-Willi Syndrome (33-35), a rare genetic disorder which presents with hyperphagia / food anxiety. This represents a clinical breakthrough for this previously inaccessible condition; and
CALMaluma’s unique spectrum of actions make this a prime contender for lockdown product of 2020/2021.

Levagen® has an entirely different heritage.

PEA is a simple fatty acid amide, and a food component first identified in 1957. Initially isolated from soybeans, peanuts and egg yolk, and naturally occurring in mammalian tissues, PEA is produced in the body as a biological response and a repair mechanism in chronic inflammation and chronic pain. However, it is more than an analgesic. Evidence shows that PEA, via regulation of persistent inflammatory processes, directly intervenes in nervous tissue alterations responsible for pain and enables healing; making it a genuine disease-modifying agent.

In parallel with its analgesic effects, PEA is also effective in reducing depression / anxiety symptoms in pre-clinical and in clinical studies (36-38).

PEA was initially slow to gain acceptance, however, due in large part to its low bioavailability. It is a waxy substance, difficult to administer and difficult to absorb, and it required a series of technical developments to produce, finally, a form of PEA which overcame those problems.
This has been branded as Levagen®, and has been shown to be a highly effective analgesic and anxiolytic in several studies (39, 40).

In essence, there are a multitude of natural and proven nutritional solutions we can look to in the COVID era that have the ability to contribute to one’s “immune fitness”. These may be an avenue worth exploring as COVID continues in its destructive path.

References

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3. GlobalData Coronavirus (COVID-19) Consumer Survey Consolidated Results: Weeks 1-6 – 11 countries
4. FMCG Gurus ‘Evaluating the Uncertainty & Future Outlook of COVID-19’, (April 2020)
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7. https://www.nutraingredients-usa.com/Article/2020/03/16/Panic-buying-of-immune-products-causes-shortfalls-greater-supply-gaps-loom-in-months-ahead
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Strengthening your immune system. How to fight infection, allergy and autoimmune disease: Evidence based pharmaco-nutrition. Clayton P, 2020
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