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Nutrition and the immune system from birth to old age
Abstract
For millennia, food has been at the center of social events, in times of joy and in times of sorrow. Protein-energy malnutrition is associated with a significant impairment of cell-mediated immunity, phagocyte function, complement system, secretory immunoglobulin A antibody concentrations, and cytokine production. Deficiency of single nutrients also results in altered immune response: this is observed even when the deficiency state is relatively mild. Of the micronutrients, zinc, selenium, iron, copper, vitamins A, C, E and B(6), and folic acid have important influences on immune responses. Overnutrition and obesity also reduce immunity. Low-birth-weight infants have a prolonged impairment of cell-mediated immunity that can be partly restored by providing extra amounts of dietary zinc. In the elderly, impaired immunity can be enhanced by modest amounts of a combination of micronutrients. These findings have considerable practical and public health significance.
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“most older people over the age of 60–65 years (although not all) experience some immune dysregulation that makes them less able to respond to immune challenges [33,34].”
From Immune function and micronutrient requirements change over the life course (2018) · cites this paper as [33]
In the citing paper
“There is a loss of lymphoid tissue, particularly in the thymus, with increasing age [25], and the ability to respond to pathogens, antigens and mitogens decreases [5,33].”
From Immune function and micronutrient requirements change over the life course (2018) · cites this paper as [33]
In the citing paper
“Furthermore, this age group is more likely to suffer prolonged infections, severe symptoms and secondary complications [33].”
From Immune function and micronutrient requirements change over the life course (2018) · cites this paper as [33]
In the citing paper
“The development, maintenance and optional functioning of immune cells is dependent on adequate nutrition, evident at all stages of life [4,5,33,49,69].”
From Immune function and micronutrient requirements change over the life course (2018) · cites this paper as [33]
In the citing paper
“However, micronutrient deficiencies are common in older people; it has been estimated that 35% of those aged 50 years or older in Europe, USA and Canada have a demonstrable deficiency of one or more micronutrients [33].”
From Immune function and micronutrient requirements change over the life course (2018) · cites this paper as [33]
In the citing paper
“In low-birthweight infants, supplementary zinc can partly restore cell-mediated immunity [33].”
From Immune function and micronutrient requirements change over the life course (2018) · cites this paper as [33]
In the citing paper
“Multiple micronutrient supplementation in older people may also reduce antibiotic usage and lead to higher post-vaccination immune responses [33].”
From Immune function and micronutrient requirements change over the life course (2018) · cites this paper as [33]
In the citing paper
“Supplementation with modest amounts of a combination of micronutrients can have beneficial effects [33].”
From Immune function and micronutrient requirements change over the life course (2018) · cites this paper as [33]
In the citing paper
“Impaired immunity in older people, often caused by multiple micronutrient deficiencies, is evident in the increased incidence and severity of common infections that affect the upper and lower respiratory tracts, as well as the urinary and genital tracts [33,116].”
From Immune function and micronutrient requirements change over the life course (2018) · cites this paper as [33]
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“Children with feeding difficulties are less likely to consume a nutritious diet than non-picky eaters [6, 9] and they are at risk for impaired growth [9, 10] or cognitive development [11] along with compromised immune function [12].”
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“Some micronutrients (vitamins and trace elements) can influence several components of innate immunity in addition to their various physiological roles (Chandra 2002), “they may be considered as important TLRs regulators,” as they have immunomodulatory functions (Erickson et al. 2000).”
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“(Chandra, 2002).”
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“In addition to genetic factors, environmental influences such as maternal nutrition play an important role in influencing the developing human immune system (reviewed in Chandra (2002)).”
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Chen, J., Chang, C., Lin, Y., & Hu, M. (2012) · Population Health Management · doi:10.1089/pop.2012.1563 · Cited by 19
“25,29,30 Evidence has shown that micronutrient deficiencies are associated with diminished cell-mediated immunity, which is an established risk factor of HZ and PHN. 4 Not surprisingly, micronutrient deficiencies have been demonstrated to be risk factors for HZ 7–9 and PHN 10,11 in recent studies.”
InfluentialComplications of Oropharyngeal Dysphagia: Malnutrition and Aspiration Pneumonia
Carrión, S., Vérin, É., Clavé, P., & Laviano, A. (2011) · Medical radiology · doi:10.1007/174_2011_348 · Cited by 19
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“Other lifestyle factors examined included BMI and shift working patterns since both obesity and work stress are known to reduce immunity (Nakata et al. 2000, Chandra 2002).”
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“Furthermore, the capacity of phagocytes to consume and destroy pathogens was decreased [10].”
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“…consequences of malnutrition, such as slow recovery and poorer functioning in activities of daily living (ADL), significantly longer length of stay in hospital (Kondrup et al., 2002) and increased incidence of infections (Chandra, 2002), have been described in a number of studies since the 1970s.”
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Physiological functions should be considered as true end points of nutritional intervention studies
Genton, L., van Gemert, W., Pichard, C., & Soeters, P. B. (2005) · Proceedings of The Nutrition Society · doi:10.1079/pns2005434 · Cited by 17
“Protein–energy malnutrition affects both the cellular and humoral immunity, i.e. phagocytic function, cytokine production, generation of complement factors and the production of secretory immunoglobulin A (Chandra, 2002; Keusch, 2003).”
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“In animal models, gestational zinc deficiency also results in suppression of fetal immunoglobulin production, such as IgA and IgM, which persists into adulthood (Beach et al., 1982a; Chandra, 2002; Keen & Gershwin, 1990; Rink & Gabriel, 2000).”
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de Melo, J. F., da Costa, T. B., Lima, T. D. D. C., Chaves, M. E. C., Vayssade, M., Nagel, M. D., & de Castro, C. M. M. B. (2012) · European Journal of Nutrition · doi:10.1007/s00394-012-0453-y · Cited by 10
Leibovitz, A., Sharon-Guidetti, A., Segal, R., et al. (2004) · Dysphagia · doi:10.1007/s00455-003-0503-y · Cited by 10
“Nutrition-related factors that influence the immune system are complex and include protein energy malnutrition, lack of micronutrients such as zinc [20], low intake of vitamins like B6 and folic acid [13], and even low leptin levels triggered by starvation [21].”
BackgroundSchmieder, H., Leischner, C., Piotrowsky, A., Marongiu, L., Venturelli, S., & Burkard, M. (2025) · Immunity & Ageing · doi:10.1186/s12979-025-00501-3 · Cited by 14
“Nevertheless, approximately 35% of the people in India, Europe, USA, and Canada aged 50 and older exhibit an insufficient status of at least one of the essential micro-nutrients [49].”
Yang, X., Sun, H., Hou, S., Zhang, W., & Meng, H. (2025) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2025.108334 · Cited by 9
Iwasa, T., Matsuzaki, T., Tungalagsuvd, A., et al. (2015) · International Journal of Developmental Neuroscience · doi:10.1016/j.ijdevneu.2015.04.004 · Cited by 9
“It has also been reported that prenatal undernutrition affects the development of the immune system (Chandra, 2002).”
BackgroundLin, S., Wei, S., Zhao, Y., et al. (2019) · Infection and Drug Resistance · doi:10.2147/idr.s223828 · Cited by 9
“nutritional status, and impair the immune responses against challenges with mycobacteria.(28) Hence, a relatively higher number of NTM isolates were identified among illiterate patients.”
BackgroundThe problem of hospital malnutrition and its consequences
Pierzak, M., Szczukiewicz-Markowska, G., & Głuszek, S. (2020) · Medical Studies · doi:10.5114/ms.2020.94088 · Cited by 9
“Malnutrition impairs the functioning of the immune system through the weakening of cellular response and immunity to infections [14].”
BackgroundSoria-Comes, T., Abril, V. P., Ureste, M. M., Sánchez, J. G., Buades, J. M., Llavador, M. J. F., Gabaldón, A. L., Jurado, M. G., & Maestu, I. (2020) · Translational Cancer Research · doi:10.21037/tcr-20-1997 · Cited by 9
“Moreover, besides aging, another crucial prognostic factor in lung cancer, that has also been related to immune modulation during aging is nutritional status (39-41).”
BackgroundLombardi, V., Fernández‐Novoa, L., Etcheverrı́a, I., et al. (2004) · International Immunopharmacology · doi:10.1016/j.intimp.2004.09.034 · Cited by 9
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“Inadequate nutritional intake may lead to decreased lymphocyte counts and leads to functional alterations in cellular and humoral responses (44, 45).”
de Morais, N. G., da Costa, T. B., Severo, M. S., et al. (2014) · Revista de Nutrição · doi:10.1590/1415-52732014000500005 · Cited by 8
Metadata
- Authors
- Chandra, R.
- Affiliations
- Memorial University of Newfoundland (CA)
- Corresponding author
- Chandra, RK
- Venue
- European Journal of Clinical Nutrition
- Published
- 2002-07-30
- Volume
- 56
- Issue
- S3
- Pages
- S73-S76
- ISSN
- 0954-3007 (ISSN-L)
- 1476-5640
- OpenAlex
- W2054621363
- Cited by
- 369
- References
- 0
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 7 · 2023: 13 · 2022: 15 · 2021: 23 · 2020: 24 · 2019: 14 · 2018: 14 · 2017: 17 · 2016: 15 · 2015: 25 · 2014: 13 · 2013: 20 · 2012: 19
- FWCI
- 15.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Trace Elements in Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Keywords
- nutrition and immunity, protein-energy malnutrition, cell-mediated immunity, micronutrient deficiency, zinc, selenium, iron, copper, vitamins, folic acid, obesity, overnutrition, low birth weight, older adults, immunosenescence, cytokine production, secretory IgA
- MeSH terms
- Adolescent, Adult, Aged, Aging, Child, Child, Preschool, Deficiency Diseases, Humans, Immune System, Infant, Infant, Low Birth Weight, Infant, Newborn, Middle Aged, Nutritional Physiological Phenomena, Protein-Energy Malnutrition, Vitamins, Micronutrients
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