New research reveals Brit’s immunity shortfalls as we face winter respiratory threats

Most Brits (nearly 2 in 3) have finally ‘got’ the importance of vitamin D for optimal immune function^[1], but that could be too little too late, according to a new research review commissioned by the Health and Food Supplements Information Service (www.hsis.org) and published in Nutrition & Food Technology Journal^[2].

By reviewing evidence from more than 70 studies, lead author and nutritionist, Dr Pam Mason found that no fewer than 10 different nutrients are required for a normally, healthy immune system. These are vitamins A, C, D & E; B complex; iron, zinc; selenium; copper; and omega-3 fats. Probiotic and prebiotic supplements are also proven to give our immunity a helping hand.

Yet, as revealed by national dietary surveys, many people – especially teens, young adults, and elderly people – are simply not getting the right amounts of crucial immunity nutrients in their diets. More worryingly, intakes of several vitamins and minerals are going in the wrong direction by declining over the past decade.

Dr Pam Mason says: “Nutrition has a significant impact on immune function. This is recognised by the European Food Safety Authority and other expert bodies around the world. Studies show clearly that people with a good nutritional status – who have the recommended amounts of nutrients in their diets – fare better in terms of resisting viral infections, recovering quicker, and experiencing less severe illness. In contrast, studies show that people with a poor nutritional status and low intake of immune-supporting nutrients are worse off.

“The good news is that dietary changes really do help, especially for vulnerable groups such as children and elderly people who are typically more at risk of infection. An international study of nearly half a million people by King’s College^[3] found that those who regularly took multivitamins, vitamin D, omega-3 fats and probiotics had a lower risk of coronavirus infection.

“There is also compelling evidence that vitamin deficiency can lead to poor vaccine response. For example, a meta-analysis of nine studies^[4] found that vitamin D deficiency led to less protection from flu vaccines. However, supplementation with vitamin E, selenium, probiotics, and prebiotics has been found to improve vaccine responses. This led to academics in the British Journal of Nutrition calling for supplements to be provided to elderly people before they receive their Covid vaccine boosters^[5].

“Eating foods rich in vitamins and minerals, like vegetables, wholegrains, fish and eggs is important. However, as government surveys continually show, many of us are guilty of not eating the right foods rich in nutrients so taking a daily multinutrient supplement is pure common sense to bridge these gaps. Plus, studies show that optimal immunity requires more vitamin D and vitamin C than typically recommended^[6], which is difficult for many people to achieve from diet alone. An omega-3 supplement is also vital for those who don’t eat fish and seafood”.

10 hero nutrients for immunity: The research review, commissioned by HSIS, found that 10 key nutrients are needed for optimal immunity. These are:

1. Vitamin A: protects membranes in the nose, mouth and gut which are the first line of defence against bacteria and viruses. Antioxidant effects.
2. Vitamin C: essential for making new immune cells, guides white blood cells to sites of infection. Antioxidant effects.
3. Vitamin D: protects the lungs and eyes from infection, essential for making immunity cells like macrophages and monocytes, anti-inflammatory effects.
4. Vitamin E: supports the skin and gut barriers, enhances natural killer cells and boosts memory T-cells which help with long-term immunity. Antioxidant effects.
5. B vitamins: B6 boosts natural killer cells which seek and destroy pathogens, B12 is needed for the production of T immunity cells, folate supports antibody production.
6. Iron: helps neutrophil cells kill bacteria, component of enzymes critical for the functioning of immune cells, regulates inflammation.
7. Zinc: essential for normal function of natural killer cells and phagocytes which directly target invading pathogens. Maintains the barriers in the nose and mouth, and on the skin.
8. Selenium: major antioxidant to help protect cells from damage – for example when a patient experiences a cytokine storm. Needed for antibody production.
9. Copper: direct anti-microbial effects, helps to regulate the balance between different types of T-cells, such as T-helper and T-killer cells.
10. Omega-3 fats: vital for reducing inflammation by targeting prostaglandins which are the inflammatory substances released during the body during infection.

And GP, Dr Gill Jenkins, from the Health Supplements Information Service (HSIS) comments: “The evidence is clear about which nutrients we need to safeguard our immune function this winter, but unfortunately many people in the UK are simply not achieving the recommended amounts in their diets. Intakes of key immunity nutrients have gone down in the past decade, and two to four people in ten are vitamin D deficient depending on the age group, with worse rates seen in people from ethnic minorities. Action is needed if we are to ensure that everyone is ready for whatever winter brings.”

The review also reveals the major nutrient shortfalls in the UK diet from the latest National Diet and Nutrition Survey^[7]:

• Women are now getting less vitamin A, vitamin B2, folate, iron, and zinc than they did 10 years ago;
• Around one in ten children and elderly people, and a massive 18% of teenagers, are at risk of vitamin A deficiency^[8];
• People cutting out meat and fish, as they turn to plant-based diets, is contributing to shortfalls in iron, zinc, and omega-3 fats;
• Blood levels of folate have fallen by a fifth in women of childbearing age (16 to 49 years);
• Nearly half of teenage girls and a quarter of adult women aged 19-64 are at risk of iron deficiency.

So how do we get our immune function in tip top condition? Dietitian, Dr Carrie Ruxton, offers 5 dietary tips for Better Winter Immunity:

1. Eatwell be well: Follow the recommendations from the Eatwell Guide7 to help you achieve the recommended intake of protein, fats, fibre, vitamins, and minerals.

2. Bridge dietary gaps: Target any nutrient shortfalls in your diet with a multivitamin and multimineral supplement appropriate to your age group.

3. Get fishy: Aim to eat at least one portion (140g) of oily fish a week to get vital omega-3s or take a fish oil or vegan algae oil supplement if you don’t eat fish.

4. Top up your sunshine D: Take a 10μg daily vitamin D supplement between October and early March and aim to get outdoors in spring and summer to get a natural vitamin D hit from sunshine.

5. Snack on plants: Instead of reaching for a sugary, salty snack, try to eat more vegetables, fruit, nuts, and seeds which are rich in vitamin A, vitamin C and B vitamins.