Immune function and micronutrient requirements change over the life course

May combine two claims.

Intakes were low for vitamin D (females), vitamin E (males and females) and folate (males and females).

“In particular, intakes were low for vitamin D (females), vitamin E (males and females) and folate (males and females).”

May combine two claims.

Some adolescents had an insufficient intake of vitamin C (males 15-18 years), vitamin D, vitamin A (males 15-18 years; females 10-18 years), vitamin E, folate, zinc (10-18 years), iron and selenium.

“The lower ranges indicate that some adolescents had an insufficient intake of vitamin C (males 15–18 years), vitamin D, vitamin A (males 15–18 years; females 10–18 years), vitamin E, folate, zinc (10–18 years), iron and selenium.”

May combine two claims.

There were children who had an insufficient intake of vitamin D (all ages), vitamin A (females 10+ years), vitamin E, folate, zinc (10+ years), iron (all ages) and selenium (all ages).

“However, the lower ranges indicate that there were children who had an insufficient intake of vitamin D (all ages), vitamin A (females 10+ years), vitamin E, folate, zinc (10+ years), iron (all ages) and selenium (all ages).”

May combine two claims.

The reported micronutrient intake data in Table 2 suggest that over-supplementation is unlikely with most micronutrients, perhaps with the exception of vitamin A in children.

“Although this is theoretically possible, the reported micronutrient intake data in Table 2 suggest that over-supplementation is unlikely with most micronutrients, perhaps with the exception of vitamin A in children.”

May combine two claims.

Micronutrient requirements and deficiencies vary over the life course, with certain micronutrients more likely to be insufficient at different stages.

“certain micronutrients may be more likely to be insufficient at different stages of the life course.”

May combine two claims.

Poor nutrition compromises immune function and increases infection risk.

“while poor nutrition can compromise immune function and increase infection risk.”

• Also stated in: § 1. Introduction · plain

  “the immune response is compromised when nutrition is poor, predisposing individuals to infections”

• cites [5] Calder, 2013, Conference on ‘Transforming the nutrition landscape in Africa’. Plenary Session 1: Feeding the immune system, Proc. Nutr. Soc. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Micronutrient deficiencies and suboptimal intakes are common worldwide.

“Micronutrient deficiencies are a recognized global public health issue”

• Also stated in: § 1. Introduction · plain

  “It is recognized that micronutrient deficiencies and suboptimal intakes are common worldwide [7]”

• cites [7] Ottaway, P.B. (2008). 3—Vitamin and mineral fortification of foods. Food Fortification and Supplementation, Woodhead Publishing. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Even in industrialized nations, social, economic, educational, ethnic and cultural backgrounds influence diet and may adversely affect an individual's micronutrient status.

“Even in industrialized nations, where it may be presumed that healthy, nutritious food is easier to obtain, social, economic, educational, ethnic and cultural backgrounds influence the diet and may adversely affect an individual’s micronutrient status [8].”

• cites [8] Schaefer, 2016, Micronutrient deficiency in women living in industrialized countries during the reproductive years: Is there a basis for supplementation with multiple micronutrients?, J. Nutr. Disord. Ther. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The neonatal innate immune system comprises different protective cell populations compared with adults, as well as qualitative differences in the responses by shared cell populations.

“The neonatal innate immune system comprises different protective cell populations compared with adults, as well as qualitative differences in the responses by shared cell populations [23].”

• cites [23] Brodin, 2017, Human immune system variation, Nat. Rev. Immunol. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Prior to birth, babies lack significant antigenic exposure, have not acquired immunological memory, and their adaptive immunity is not fully developed.

“Prior to birth, babies lack significant antigenic exposure and so have not yet acquired immunological memory and their adaptive immunity is not fully developed [5,10,11,19].”

• cites [5] Calder, 2013, Conference on ‘Transforming the nutrition landscape in Africa’. Plenary Session 1: Feeding the immune system, Proc. Nutr. Soc. sourceNot checked yet

  Not checked in the free run.

• cites [10] Haryanto, 2015, Multivitamin supplementation supports immune function and ameliorates conditions triggered by reduced air quality, Vitam. Miner.Not checked yet

  Not checked in the free run.

• cites [11] Maggini, 2008, Feeding the immune system: The role of micronutrients in restoring resistance to infections, CAB Rev.Not checked yet

  Not checked in the free run.

• cites [19] Simon, 2015, Evolution of the immune system in humans from infancy to old age, Proc. R. Soc. B sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Immune function changes over the life course, developing in infants and children, potentially optimal in adolescents and young adults, and declining in older people.

“As humans age, the immune system evolves from the immature and developing immune responses in infants and children, through to immune function that is potentially optimal in adolescents and young adults, followed by a gradual decline in immunity (particularly adaptive processes) in older people [1].”

• cites [1] Soveral, 2014, The immune system and aging: A review, Gynecol. Endocrinol. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Restoring deficient micronutrients to recommended levels may improve immune function, thereby increasing resistance to infection and supporting faster recovery when infected.

“Immune function may be improved by restoring deficient micronutrients to recommended levels, thereby increasing resistance to infection and supporting faster recovery when infected.”

• Also stated in: § 1. Introduction · hedged

  “Resistance to infection may be enhanced by adding the deficient nutrient back into the diet and restoring immune function [4].”

• cites [4] Alpert, 2017, The role of vitamins and minerals on the immune system, Home Health Care Manag. Pract. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Adult levels of IgG are reached by the age of 11-12 years, with a further increase during puberty.

“adult levels of IgG (expressed on the surface of mature B cells, and the most prevalent immunoglobulin in serum) are reached by the age of 11–12 years, with a further increase during puberty”

• cites [29] Berg, 1969, Immunoglobulin levels during childhood, with special regard to IgE, Acta Paediatr. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Females generate higher proinflammatory cytokine and chemokine responses to the influenza virus and experience greater morbidity and mortality than males.

“females generating higher proinflammatory cytokine and chemokine responses to the influenza virus and experiencing greater morbidity and mortality than males [31].”

• cites [31] Klein, 2012, Mechanisms of sex disparities in influenza pathogenesis, J. Leukoc. Biol. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

With increasing age, there is a loss of lymphoid tissue, particularly in the thymus, and the ability to respond to pathogens, antigens and mitogens decreases.

“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].”

• cites [25] Valiathan, 2016, Effects of ageing on the immune system: Infants to elderly, Scand. J. Immunol. sourceNot checked yet

  Not checked in the free run.

• cites [5] Calder, 2013, Conference on ‘Transforming the nutrition landscape in Africa’. Plenary Session 1: Feeding the immune system, Proc. Nutr. Soc. sourceNot checked yet

  Not checked in the free run.

• cites [33] Chandra, 2002, Nutrition and the immune system from birth to old age, Eur. J. Clin. Nutr. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Children less than one year old experience an average of six colds per year; the frequency decreases with age to about three colds per year in older children (10-14 years).

“children less than one year old have been noted to experience an average of six colds per year; the frequency decreases with age to about three colds per year in older children (10–14 years) [45].”

• cites [45] Monto, 1974, Acute respiratory illness in an American community: The Tecumseh study, JAMA sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The development of long-term immune memory is impaired with age, with a diminished response to vaccination.

“The development of long-term immune memory is also impaired, with a diminished response to vaccination [5].”

• cites [5] Calder, 2013, Conference on ‘Transforming the nutrition landscape in Africa’. Plenary Session 1: Feeding the immune system, Proc. Nutr. Soc. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Women initiate a higher humoral immune response to the influenza vaccine and experience more adverse reactions than men.

“Women also initiate a higher humoral immune response to the influenza vaccine, and experience more adverse reactions than men [31].”

• cites [31] Klein, 2012, Mechanisms of sex disparities in influenza pathogenesis, J. Leukoc. Biol. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The immune system reaches maturity by adulthood, and small decreases or increases in single selected markers of immune function may not be clinically important after that.

“It should be noted that the immune system reaches maturity by adulthood, and small decreases or increases in single selected markers of immune function may not be clinically important after that.”

May combine two claims.

Some older people age without any major health problems (healthy ageing), and immune system dysfunction appears to be mitigated in this population.

“Some older people age without any major health problems, known as healthy ageing, and immune system dysfunction appears to be mitigated in this population [1].”

• cites [1] Soveral, 2014, The immune system and aging: A review, Gynecol. Endocrinol. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Microbial antigens are essential for the education of the immune system and development of Th-1 type responses, and breakdown in such immune education may predispose to allergic, inflammatory and autoimmune diseases.

“Microbial antigens are essential for the education of the immune system and development of Th-1 type responses and breakdown in such immune education may predispose to allergic, inflammatory and autoimmune diseases [5,10].”

• cites [5] Calder, 2013, Conference on ‘Transforming the nutrition landscape in Africa’. Plenary Session 1: Feeding the immune system, Proc. Nutr. Soc. sourceNot checked yet

  Not checked in the free run.

• cites [10] Haryanto, 2015, Multivitamin supplementation supports immune function and ameliorates conditions triggered by reduced air quality, Vitam. Miner.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Many children in industrialized countries experience more than one episode of infective gastroenteritis per year, usually caused by rotavirus.

“many children in industrialized countries experiencing more than one episode of infective gastroenteritis per year, usually caused by rotavirus [47].”

• cites [47] (2018, April 28). National Institute for Health and Care Excellence Diarrhoea and Vomiting Caused by Gastroenteritis in under 5s: Diagnosis and Management. Available online: https://www.nice.org.uk/guidance/cg84.Not checked yet

  Not checked in the free run.

May combine two claims.

Immunosenescence mostly affects adaptive immunity but also the innate immune system to a lesser extent.

“This is commonly referred to as immunosenescence, which mostly seems to affect adaptive immunity but also the innate immune system to a lesser extent [32].”

• cites [32] Robert, 2014, On the immunological theory of aging, Aging: Facts and Theories sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Older people are more likely to suffer prolonged infections, severe symptoms and secondary complications.

“Furthermore, this age group is more likely to suffer prolonged infections, severe symptoms and secondary complications [33].”

• cites [33] Chandra, 2002, Nutrition and the immune system from birth to old age, Eur. J. Clin. Nutr. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

In contrast to children, sickness and diarrhea in adults are often caused by norovirus and campylobacter.

“In contrast to children, sickness and diarrhea in adults are often caused by norovirus [62] and campylobacter [63].”

• cites [62] Marshall, 2011, The dynamics of norovirus outbreak epidemics: Recent insights, Int. J. Environ. Res. Public Health sourceNot checked yet

  Not checked in the free run.

• cites [63] Man, 2011, The clinical importance of emerging Campylobacter species, Nat. Rev. Gastroenterol. Hepatol. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Micronutrients have essential roles in the immune system and an inadequate intake may have deleterious effects.

“As outlined in Table 1, micronutrients have essential roles in the immune system and an inadequate intake may have deleterious effects [4].”

• cites [4] Alpert, 2017, The role of vitamins and minerals on the immune system, Home Health Care Manag. Pract. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Prolonged bouts of exercise and heavy training regimens in adults may create an imbalance between ROS and antioxidant defenses, leading to oxidative stress that alters signal transmission in the immune system and impairs the immune response.

“Nevertheless, prolonged bouts of exercise and heavy training regimens in adults may create an imbalance between ROS and antioxidant defenses [54], leading to oxidative stress that alters signal transmission in the immune system and impairs the immune response [10].”

• cites [54] Nieman, 2008, Immunonutrition support for athletes, Nutr. Rev. sourceNot checked yet

  Not checked in the free run.

• cites [10] Haryanto, 2015, Multivitamin supplementation supports immune function and ameliorates conditions triggered by reduced air quality, Vitam. Miner.Not checked yet

  Not checked in the free run.

May combine two claims.

A poor diet may be combined with a sedentary lifestyle, leading to obesity, suboptimal immune response, and increased risk of infection.

“A poor diet may be combined with a sedentary lifestyle, leading to obesity, suboptimal immune response, and increased risk of infection [51].”

• cites [51] Milner, 2012, Micronutrients, immunology and inflammation. The impact of obesity on the immune response to infection, Proc. Nutr. Soc. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Reactive oxygen species in, and caused by, pollution can also upset the oxidant-antioxidant balance within the body and cause oxidative stress, which must be counteracted by an adequate supply of antioxidants.

“Reactive oxygen species in, and caused by, pollution can also upset the oxidant–antioxidant balance within the body and cause oxidative stress, which must be counteracted by an adequate supply of antioxidants [10].”

• cites [10] Haryanto, 2015, Multivitamin supplementation supports immune function and ameliorates conditions triggered by reduced air quality, Vitam. Miner.Not checked yet

  Not checked in the free run.

May combine two claims.

Thymic involution and the relative paucity of naïve lymphocytes in older people means that they are less able to mount an adequate defense against neoantigens and thus exposure to them is more hazardous than in younger people.

“In addition, thymic involution and the relative paucity of naïve lymphocytes in older people means that they are less able to mount an adequate defense against neoantigens and thus exposure to them is more hazardous than in younger people [36].”

• cites [36] Pawelec, 2017, Does the human immune system ever really become “senescent”?, F1000Research sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Nutritional status can be compromised by a poor diet, which is often observed in adults with a hectic and stressful lifestyle and ready access to fast food or energy-dense, micronutrient-poor convenience food.

“In particular, nutritional status can be compromised by a poor diet, which is often observed in adults with a hectic and stressful lifestyle and ready access to fast food or energy-dense, micronutrient-poor convenience food.”

May combine two claims.

Several lifestyle-related factors affect immune competence in healthy adults and increase their risk of infection.

“Nevertheless, several lifestyle-related factors affect immune competence in healthy adults and increase their risk of infection (Figure 2).”

May combine two claims.

Immunological maturity is achieved by adolescence, and young adults should be well fortified against attack by pathogens.

“Immunological maturity is achieved by adolescence, and young adults should be well fortified against attack by pathogens [19].”

• cites [19] Simon, 2015, Evolution of the immune system in humans from infancy to old age, Proc. R. Soc. B sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Excessive consumption of alcohol can suppress many aspects of immune function and consequently increase the risk of infection.

“Alcohol consumption has variable effects on immunity; moderate amounts of polyphenol-rich alcoholic beverages potentially provide some immune protection while excessive consumption of alcohol can suppress many aspects of immune function and consequently increase the risk of infection [57].”

• cites [57] Romeo, 2007, Moderate alcohol consumption and the immune system: A review, Br. J. Nutr. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Lower respiratory tract infections are more common in children under five years old than any other age group worldwide, with risk factors including air pollution and suboptimal breastfeeding.

“Lower respiratory tract infections (e.g., bronchitis and pneumonia) are more common in children under five years old than any other age group worldwide, and risk factors include air pollution and suboptimal breastfeeding [48].”

• cites [48] GBD 2015 LRI Collaborators (2017). Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory tract infections in 195 countries: A systematic analysis for the Global Burden of Disease Study 2015. Lancet Infect. Dis., 17, 1133–1161.Not checked yet

  Not checked in the free run.

May combine two claims.

Micronutrient deficiencies cause specific immune impairments that affect both the innate and adaptive immune systems, such as impaired phagocyte and lymphocyte activity with zinc deficiency, or compromised development of neutrophils, macrophages and NK cells with vitamin A deficiency.

“micronutrient deficiencies cause specific immune impairments that affect both the innate and adaptive immune systems, such as impaired phagocyte and lymphocyte activity with zinc deficiency, or compromised development of neutrophils, macrophages and NK cells with vitamin A deficiency [50].”

• cites [50] Bresnahan, 2014, Undernutrition, the acute phase response to infection, and its effects on micronutrient status indicators, Adv. Nutr. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The incidence of common cold is lowest in adolescents compared with all other age groups, but increases in adults aged 20-30 years.

“The incidence of common cold is lowest in adolescents compared with all other age groups, but increases in adults aged 20–30 years [45]; the risk is likely to be greater in those who come into close contact with children, who are at highest risk.”

• cites [45] Monto, 1974, Acute respiratory illness in an American community: The Tecumseh study, JAMA sourceNot checked yet

  Not checked in the free run.

May combine two claims.

These factors, alone or in combination, weaken the immune system in adults and can increase the risk of infection.

“These factors, alone or in combination, weaken the immune system in adults and can increase the risk of infection.”

May combine two claims.

Sleep is an important homeostatic regulator of immune function and plays a specific role in immunological memory.

“Sleep is an important homeostatic regulator of immune function and plays a specific role in immunological memory [58].”

• cites [58] Besedovsky, 2012, Sleep and immune function, Eur. J. Physiol. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Breastmilk contains various immunological components such as antibodies (e.g., antigen-specific IgA), anti-inflammatory cytokines and other antimicrobial factors, but also most of the micronutrients necessary to support neonatal development, including of the immune system.

“Breastmilk contains various immunological components such as antibodies (e.g., antigen-specific IgA), anti-inflammatory cytokines and other antimicrobial factors, but also most of the micronutrients necessary to support neonatal development, including of the immune system [49,71].”

• cites [49] Calder, P., Prescott, S., and Caplan, M. (2007). Scientific Review: The Role of Nutrients in Immune Function of Infants and Young Children, Mead Johnson & Company. Emerging Evidence for Long-Chain Polyunsaturated Fatty Acids.Not checked yet

  Not checked in the free run.

• cites [71] Prentice, 2017, They are what you eat: Can nutritional factors during gestation and early infancy modulate the neonatal immune response?, Front. Immunol. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

In industrialized countries, influenza-associated deaths occur most often among people aged 65 years or older.

“Although influenza is not a life-threatening illness in most adults [67], in industrialized countries, influenza-associated deaths occur most often among people aged 65 years or older [46].”

• cites [46] World Health Organization (2018, April 28). Influenza (Seasonal). Available online: http://www.who.int/mediacentre/factsheets/fs211/en/.Not checked yet

  Not checked in the free run.

May combine two claims.

Micronutrient deficiencies are prevalent in infants and preschool children in developing and low- to middle-income countries, and this age group is at the highest risk of multiple micronutrient deficiencies.

“Nevertheless, micronutrient deficiencies are prevalent in infants and preschool children in developing and low- to middle-income countries (e.g., [17,79,80,81,82]), and this age group is at the highest risk of multiple micronutrient deficiencies [83].”

• cites [17] World Health Organization, and Food and Agricultural Organization of the United Nations (2006). Part 2. Evaluating the public health significance of micronutrient malnutrition. Guidelines on Food Fortification with Micronutrients, World Health Organization.Not checked yet

  Not checked in the free run.

• cites [79] Marasinghe, 2015, Micronutrient status and its relationship with nutritional status in preschool children in urban Sri Lanka, Asia Pac. J. Clin. Nutr.Not checked yet

  Not checked in the free run.

• cites [80] Luo, 2015, Micronutrient deficiencies and developmental delays among infants: Evidence from a cross-sectional survey in rural China, BMJ Open sourceNot checked yet

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• cites [81] Özden, T.A., Gökçay, G., Cantez, M.S., Durmaz, Ö., İşsever, H., Ömer, B., and Saner, G. (2015). Copper, zinc and iron levels in infants and their mothers during the first year of life: A prospective study. BMC Pediatr., 15. sourceNot checked yet

  Not checked in the free run.

• cites [82] 2016, Micronutrient deficiencies in normal and overweight infants in a low socio-economic population in north-east Brazil, Paediatr. Int. Child Health sourceNot checked yet

  Not checked in the free run.

• cites [83] Bailey, 2015, The epidemiology of global micronutrient deficiencies, Ann. Nutr. Metab. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Human milk is a poor source of iron and zinc and the needs of the child cannot be met by breast milk alone for zinc, or beyond six months for iron.

“However, human milk is a poor source of iron and zinc and the needs of the child cannot be met by breast milk alone for zinc, or beyond six months for iron [72].”

• cites [72] Butte, N., Lopez-Alarcon, M., and Garza, C. (2017, December 12). Nutrient Adequacy of Exclusive Breastfeeding for the Term Infant during the First Six Months of Life. Available online: http://apps.who.int/iris/handle/10665/42519.Not checked yet

  Not checked in the free run.

May combine two claims.

The concentrations of certain micronutrients in breastmilk (e.g., calcium, magnesium, and copper) are regulated by maternal homeostatic mechanisms (i.e., independent of maternal nutritional status and diet) to ensure they are sufficient to meet infant needs and to protect them against deficiency or excess.

“The concentrations of certain micronutrients in breastmilk (e.g., calcium, magnesium, and copper) are regulated by maternal homeostatic mechanisms (i.e., independent of maternal nutritional status and diet) to ensure they are sufficient to meet infant needs [72] and to protect them against deficiency or excess [71,73,74,75].”

• cites [72] Butte, N., Lopez-Alarcon, M., and Garza, C. (2017, December 12). Nutrient Adequacy of Exclusive Breastfeeding for the Term Infant during the First Six Months of Life. Available online: http://apps.who.int/iris/handle/10665/42519.Not checked yet

  Not checked in the free run.

• cites [71] Prentice, 2017, They are what you eat: Can nutritional factors during gestation and early infancy modulate the neonatal immune response?, Front. Immunol. sourceNot checked yet

  Not checked in the free run.

• cites [73] Vahter, 2012, Metals and trace element concentrations in breast milk of first time healthy mothers: A biological monitoring study, Environ. HealthNot checked yet

  Not checked in the free run.

• cites [74] Lowe, 2010, Nutritional requirements during lactation. Towards European alignment of reference values: The EURRECA network, Matern. Child HealthNot checked yet

  Not checked in the free run.

• cites [75] Kominiarek, 2016, Nutrition recommendations in pregnancy and lactation, Med. Clin. N. Am. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Children do not need micronutrients in the same intakes as adults, and lower amounts are adequate to fulfill their various roles throughout the body, including within the immune system.

“Children do not need micronutrients in the same intakes as adults [78] (Table 2), and lower amounts are adequate to fulfill their various roles throughout the body, including within the immune system.”

• cites [78] Institute of Medicine (2011). Dietary Reference Intakes for Calcium and Vitamin D, The National Academies Press.Not checked yet

  Not checked in the free run.

May combine two claims.

In babies and infants, breast milk is the major nutritional influence and is formulated to ensure that nutritional needs are met.

“In babies and infants, breast milk is the major nutritional influence and is formulated to ensure that nutritional needs are met [49,71].”

• cites [49] Calder, P., Prescott, S., and Caplan, M. (2007). Scientific Review: The Role of Nutrients in Immune Function of Infants and Young Children, Mead Johnson & Company. Emerging Evidence for Long-Chain Polyunsaturated Fatty Acids.Not checked yet

  Not checked in the free run.

• cites [71] Prentice, 2017, They are what you eat: Can nutritional factors during gestation and early infancy modulate the neonatal immune response?, Front. Immunol. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The excretion of fat- and water-soluble micronutrients (e.g., vitamin A, and vitamins B1, B2, B6, B12, and C, respectively) into breast milk is dependent on maternal intake and varies worldwide.

“In contrast, the excretion of fat- and water-soluble micronutrients (e.g., vitamin A, and vitamins B1, B2, B6, B12, and C, respectively) into breast milk is dependent on maternal intake and varies worldwide [71,74,75].”

• cites [71] Prentice, 2017, They are what you eat: Can nutritional factors during gestation and early infancy modulate the neonatal immune response?, Front. Immunol. sourceNot checked yet

  Not checked in the free run.

• cites [74] Lowe, 2010, Nutritional requirements during lactation. Towards European alignment of reference values: The EURRECA network, Matern. Child HealthNot checked yet

  Not checked in the free run.

• cites [75] Kominiarek, 2016, Nutrition recommendations in pregnancy and lactation, Med. Clin. N. Am. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Vitamins A (and beta carotene), C, D, B2, and B12, folic acid, iron, zinc and selenium are just some micronutrients that have immunomodulatory and/or antioxidant effects and thus influence the susceptibility of a host to infectious diseases, as well as the course and outcome of infection.

“Vitamins A (and beta carotene), C, D, B2, and B12, folic acid, iron, zinc and selenium are just some micronutrients that have immunomodulatory and/or antioxidant effects and thus influence the susceptibility of a host to infectious diseases, as well as the course and outcome of infection [70].”

• cites [70] Bhaskaram, 2002, Micronutrient malnutrition, infection, and immunity: An overview, Nutr. Rev. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Immune defenses can be impaired by undernutrition, which increases susceptibility to infection.

“Immune defenses can be impaired by undernutrition, which increases susceptibility to infection [4,5,70].”

• cites [4] Alpert, 2017, The role of vitamins and minerals on the immune system, Home Health Care Manag. Pract. sourceNot checked yet

  Not checked in the free run.

• cites [5] Calder, 2013, Conference on ‘Transforming the nutrition landscape in Africa’. Plenary Session 1: Feeding the immune system, Proc. Nutr. Soc. sourceNot checked yet

  Not checked in the free run.

• cites [70] Bhaskaram, 2002, Micronutrient malnutrition, infection, and immunity: An overview, Nutr. Rev. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Although the recommended dietary allowances for older people indicate that their energy needs are lower than their younger counterparts, micronutrient requirements are mostly the same.

“Although the recommended dietary allowances for older people indicate that their energy needs are lower than their younger counterparts, micronutrient requirements are mostly the same [78] (Table 2).”

• cites [78] Institute of Medicine (2011). Dietary Reference Intakes for Calcium and Vitamin D, The National Academies Press.Not checked yet

  Not checked in the free run.

May combine two claims.

Many older people have chronic health conditions requiring hospitalization, live in care homes, or tend to eat less and make different food choices (e.g., choosing low nutrient density, often cheaper, and foods).

“Many older people have chronic health conditions requiring hospitalization, live in care homes, or tend to eat less and make different food choices (e.g., choosing low nutrient density, often cheaper, and foods) [99,100].”

• cites [99] Montgomery, 2014, Micronutrient needs of the elderly, Nutr. Clin. Pract. sourceNot checked yet

  Not checked in the free run.

• cites [100] Drenowski, 2001, Impact of aging on eating behaviors, food choices, nutrition, and health status, J. Nutr. Health AgingNot checked yet

  Not checked in the free run.

May combine two claims.

An adequate supply of micronutrients that affect the thymus is also important; for example, even marginal zinc deficiency is known to result in thymic atrophy and can increase the risk of infection.

“An adequate supply of micronutrients that affect the thymus is also important; for example, even marginal zinc deficiency is known to result in thymic atrophy and can increase the risk of infection [97].”

• cites [97] Savino, 2010, Nutritional imbalances and infections affect the thymus: Consequences on T-cell-mediated immune responses, Proc. Nutr. Soc. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

A low vitamin C status also increases susceptibility to infections such as pneumonia, possibly because low levels of antioxidants such as vitamin C are unable to counteract the oxidative stress observed in pneumonia.

“A low vitamin C status also increases susceptibility to infections such as pneumonia [71], possibly because low levels of antioxidants such as vitamin C are unable to counteract the oxidative stress observed in pneumonia [104].”

• cites [71] Prentice, 2017, They are what you eat: Can nutritional factors during gestation and early infancy modulate the neonatal immune response?, Front. Immunol. sourceNot checked yet

  Not checked in the free run.

• cites [104] Hemilä, H. (2017). Vitamin C and infections. Nutrients, 9. sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

It is especially important to ensure that antioxidant levels (e.g., vitamins C, E, and A) and micronutrients that are components of antioxidant enzymes (e.g., zinc, copper, iron, and selenium) are sufficient to combat the oxidative stress that is induced by many lifestyle factors common in this group, and which has great impact on immune function.

“It is especially important to ensure that antioxidant levels (e.g., vitamins C, E, and A) and micronutrients that are components of antioxidant enzymes (e.g., zinc, copper, iron, and selenium) are sufficient to combat the oxidative stress that is induced by many lifestyle factors common in this group, and which has great impact on immune function [10,23,35,36,44].”

• cites [10] Haryanto, 2015, Multivitamin supplementation supports immune function and ameliorates conditions triggered by reduced air quality, Vitam. Miner.Not checked yet

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• cites [23] Brodin, 2017, Human immune system variation, Nat. Rev. Immunol. sourceNot checked yet

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• cites [35] Ventura, 2017, Immunosenescence in aging: Between immune cells depletion and cytokines up-regulation, Clin. Mol. Allergy sourceNot checked yet

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• cites [36] Pawelec, 2017, Does the human immune system ever really become “senescent”?, F1000Research sourceNot checked yet

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• cites [44] Fulop, 2017, Immunosenescence and inflamm-aging as two sides of the same coin: Friends or foes?, Front. Immunol. sourceNot checked yet

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May combine two claims.

Zinc deficiency can increase thymic atrophy, decrease lymphocyte number and activity, and increase oxidative stress and inflammation by altering cytokine production.

“For example, zinc deficiency can increase thymic atrophy, decrease lymphocyte number and activity, and increase oxidative stress and inflammation by altering cytokine production [14,97].”

• cites [14] Micronutrient Information Center (2018, April 17). Immunity in Depth. Available online: http://lpi.oregonstate.edu/mic/health-disease/immunity.Not checked yet

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• cites [97] Savino, 2010, Nutritional imbalances and infections affect the thymus: Consequences on T-cell-mediated immune responses, Proc. Nutr. Soc. sourceNot checked yet

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May combine two claims.

An adequate amount of all micronutrients is required for optimal immune function in adolescents and adults (and throughout life), but in higher amounts compared with infants and children.

“An adequate amount of all micronutrients is required for optimal immune function in adolescents and adults (and throughout life), but in higher amounts compared with infants and children [78] (Table 2).”

• cites [78] Institute of Medicine (2011). Dietary Reference Intakes for Calcium and Vitamin D, The National Academies Press.Not checked yet

  Not checked in the free run.

May combine two claims.

Menopause affects utilization of micronutrients; for example, vitamin C gradually decreases as menopause advances, correlated negatively to body mass index.

“Furthermore, menopause affects utilization of micronutrients; for example, vitamin C gradually decreases as menopause advances, correlated negatively to body mass index [102].”

• cites [102] Wiacek, 2013, Menopause and age-driven changes in blood level of fat- and water-soluble vitamins, Climacteric sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The skin of older adults is less able to synthesize vitamin D, and synthesis is about 75% slower in people aged 65 years than in younger adults.

“The skin of older adults is less able to synthesize vitamin D, and synthesis is about 75% slower in people aged 65 years than in younger adults [17].”

• cites [17] World Health Organization, and Food and Agricultural Organization of the United Nations (2006). Part 2. Evaluating the public health significance of micronutrient malnutrition. Guidelines on Food Fortification with Micronutrients, World Health Organization.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Worldwide, the three most common deficiencies are for iron, vitamin A and iodine, but zinc deficiencies are also common.

“Worldwide, the three most common deficiencies are for iron, vitamin A and iodine [84], but zinc deficiencies are also common [83].”

• cites [84] Allen, L., de Benoist, B., Dary, O., and Hurrell, R. (2006). Food and Agricultural Organization of the United Nations. Part I. The role of food fortification in the control of micronutrient malnutrition. Guidelines on Food Fortification with Micronutrients, World Health Organization.Not checked yet

  Not checked in the free run.

• cites [83] Bailey, 2015, The epidemiology of global micronutrient deficiencies, Ann. Nutr. Metab. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

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.

“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].”

• cites [33] Chandra, 2002, Nutrition and the immune system from birth to old age, Eur. J. Clin. Nutr. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The available data suggest that, even in industrialized countries, some infants who are breastfed may not be receiving optimal amounts of certain micronutrients, as the levels found in breastmilk, maternal serum or urine did not always reach recommended levels in all women.

“The available data suggest that, even in industrialized countries, some infants who are breastfed may not be receiving optimal amounts of certain micronutrients, as the levels found in breastmilk, maternal serum or urine did not always reach recommended levels in all women [73,85,86,87,88,89,90,91,92,93,94,95].”

• cites [73] Vahter, 2012, Metals and trace element concentrations in breast milk of first time healthy mothers: A biological monitoring study, Environ. HealthNot checked yet

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• cites [85] Mackey, 1999, Maternal folate status during extended lactation and the effect of supplemental folic acid, Am. J. Clin. Nutr. sourceNot checked yet

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• cites [86] Houghton, 2007, How well do blood folate concentrations predict dietary folate intakes in a sample of Canadian lactating women exposed to high levels of folate? An observational study, BMC Pregnancy Childbirth sourceNot checked yet

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• cites [87] Gellert, 2017, Breastfeeding woman are at higher risk of vitamin D deficiency than nonbreastfeeding women - insights from the German VitaMinFemin study, Int. Breastfeed. J.Not checked yet

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• cites [88] Milman, 2012, Vitamin D status during normal pregnancy and postpartum. A longitudinal study in 141 Danish women, J. Perinat. Med. sourceNot checked yet

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• cites [89] Dawodu, 2014, Heightened attention to supplementation is needed to improve the vitamin D status of breastfeeding mothers and infants when sunshine exposure is restricted, Matern. Child HealthNot checked yet

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• cites [90] Hannan, 2009, Maternal milk concentration of zinc, iron, selenium, and iodine and its relationship to dietary intakes, Biol. Trace Elem. Res. sourceNot checked yet

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• cites [91] Charlton, 2012, Poor knowledge and practices related to iodine nutrition during pregnancy and lactation in australian women: Pre- and post-iodine fortification, Nutrients sourceNot checked yet

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• cites [92] Mulrine, 2010, Breast-milk iodine concentration declines over the first 6 mo postpartum in iodine-deficient women, Am. J. Clin. Nutr. sourceNot checked yet

  Not checked in the free run.

• cites [93] Valent, 2011, Maternal diet and selenium concentration in human milk from an Italian population, J. Epidemiol. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In young children, mainly in industrialized countries, deficiencies may occur because many micronutrients (e.g., vitamin C and B vitamins) are found in fruit and green, leafy vegetables and children are often fussy about what they eat.

“In young children, mainly in industrialized countries, deficiencies may occur because many micronutrients (e.g., vitamin C and B vitamins) are found in fruit and green, leafy vegetables and children are often fussy about what they eat.”

May combine two claims.

An insufficient intake of micronutrients in older people has been reported both in the community (vitamins A, B12, D and zinc) and at a higher prevalence in long-term care facilities (vitamins A, D, and E), while lower food intake has been associated with lower intakes of calcium, iron, zinc, B vitamins and vitamin E in older people.

“An insufficient intake of micronutrients in older people has been reported both in the community (vitamins A, B12, D and zinc) and at a higher prevalence in long-term care facilities (vitamins A, D, and E) [101], while lower food intake has been associated with lower intakes of calcium, iron, zinc, B vitamins and vitamin E in older people [100].”

• cites [101] High, 2001, Nutritional strategies to boost immunity and prevent infection in elderly individuals, Clin. Infect. Dis. sourceNot checked yet

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• cites [100] Drenowski, 2001, Impact of aging on eating behaviors, food choices, nutrition, and health status, J. Nutr. Health AgingNot checked yet

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May combine two claims.

Vitamin D intake is usually inadequate in most age groups worldwide, even in countries with mandatory food fortification, which can increase the risk of infection, especially respiratory tract infections.

“Vitamin D intake is usually inadequate in most age groups worldwide, even in countries with mandatory food fortification [98], which can increase the risk of infection, especially respiratory tract infections [71].”

• cites [98] Palacios, 2014, Is vitamin D deficiency a major global public health problem?, J. Steroid Biochem. Mol. Biol. sourceNot checked yet

  Not checked in the free run.

• cites [71] Prentice, 2017, They are what you eat: Can nutritional factors during gestation and early infancy modulate the neonatal immune response?, Front. Immunol. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Marginal zinc deficiency is common in older people, as their dietary intakes are generally lower and plasma zinc concentrations decline with age, possibly connected to impaired absorption, alterations in cellular uptake, and epigenetic dysregulation of DNA methylation or the methionine/transsulfuration pathway.

“Marginal zinc deficiency is common in older people, as their dietary intakes are generally lower and plasma zinc concentrations decline with age, possibly connected to impaired absorption, alterations in cellular uptake, and epigenetic dysregulation of DNA methylation or the methionine/transsulfuration pathway, for example [14].”

• cites [14] Micronutrient Information Center (2018, April 17). Immunity in Depth. Available online: http://lpi.oregonstate.edu/mic/health-disease/immunity.Not checked yet

  Not checked in the free run.

May combine two claims.

Immunological benefits of zinc supplementation help to reduce the incidence of infections such as common cold, cold sores and influenza, as well as the incidence and morbidity of pneumonia.

“immunological benefits that help to reduce the incidence of infections such as common cold, cold sores and influenza [120], as well as the incidence and morbidity of pneumonia [121].”

• cites [120] Prasad, 2007, Zinc: Mechanisms of host defense, J. Nutr. sourceNot checked yet

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• cites [121] Meydani, 2007, Serum zinc and pneumonia in nursing home elderly, Am. J. Clin. Nutr. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

In young males with marginal vitamin C deficiency, supplementation was shown to reduce the incidence of common cold and the duration of cold symptoms compared with placebo, accompanied by improved activity levels.

“For example, in young males with marginal vitamin C deficiency, supplementation was shown to reduce the incidence of common cold and the duration of cold symptoms compared with placebo, accompanied by improved activity levels [109].”

• cites [109] Johnston, 2014, Vitamin C supplementation slightly improves physical activity levels and reduces cold incidence in men with marginal vitamin C status: A randomized controlled trial, Nutrients sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Micronutrient supplementation with higher levels of vitamins C, E and beta-carotene increased the number of various subsets of T-cells, enhanced lymphocyte response to mitogen, increased IL-2 production and NK-cell activity, increased the response to the influenza virus vaccine, and led to fewer days of infection.

“while micronutrient supplementation with higher levels of vitamins C, E and beta-carotene increased the number of various subsets of T-cells, enhanced lymphocyte response to mitogen, increased IL-2 production and NK-cell activity, increased the response to the influenza virus vaccine, and led to fewer days of infection [118].”

• cites [118] Chandra, 1992, Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects, Lancet sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Supplementation with a complex micronutrient formulation in older people increased the number of various types of immune cells, including total lymphocytes, and induced a shift from memory T cells to naïve T cells.

“Supplementation with a complex micronutrient formulation in older people increased the number of various types of immune cells, including total lymphocytes, and induced a shift from memory T cells to naïve T cells [119].”

• cites [119] Schmoranzer, 2009, Influence of a complex micronutrient supplement on the immune status of elderly individuals, Int. J. Vitam. Nutr. Res. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Supplementation with vitamin D can protect against respiratory tract infections and reduce the risk of acute respiratory illness and influenza, especially with once-daily dosing.

“Supplementation with vitamin D can protect against respiratory tract infections and reduce the risk of acute respiratory illness and influenza, especially with once-daily dosing [112,113,114,115].”

• cites [112] Yamshchikov, 2009, Vitamin D for treatment and prevention of infectious diseases: A systematic review of randomized controlled trials, Endocr. Pract. sourceNot checked yet

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• cites [113] Charan, 2012, Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis, J. Pharmacol. Pharmacother. sourceNot checked yet

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• cites [114] Bergman, P., Lindh, Å., Björkhem-Bergman, L., and Lindh, J. (2013). Vitamin D and respiratory tract infections: A systematic review and meta-analysis of randomized controlled trials. PLoS ONE, 8. sourceNot checked yet

  Not checked in the free run.

• cites [115] Martineau, 2017, Vitamin D supplementation to prevent acute respiratory infections: Systematic review and meta-analysis of individual participant data, BMJ sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

There is a rationale for micronutrient supplementation to restore concentrations to recommended levels, especially after an infection, and to support immune function and maintenance.

“Considering the importance of micronutrients in immunity, and the fact that many people of all ages have single or multiple micronutrient deficiencies that can have detrimental immunological effects, there is a rationale for micronutrient supplementation to restore concentrations to recommended levels, especially after an infection, and to support immune function and maintenance.”

May combine two claims.

Vitamin C shortened the duration of a cold in children (especially with higher doses) and reduced the severity of symptoms; a greater effect was observed in children compared with adults, including a greater prophylactic effect of vitamin C.

“Similar results have been observed with vitamin C, which shortened the duration of a cold in children (especially with higher doses) and reduced the severity of symptoms; a greater effect was observed in children compared with adults, including a greater prophylactic effect of vitamin C [105].”

• cites [105] Hemilä, H., and Chalker, E. (2013). Vitamin C for preventing and treating the common cold. Cochrane Database Syst. Rev., Available online: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000980.pub4/full. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Both zinc and vitamin C may also improve the outcome of pneumonia, malaria and diarrheal infections in children.

“Both zinc and vitamin C may also improve the outcome of pneumonia, malaria and diarrheal infections in children [9].”

• cites [9] Wintergerst, 2006, Immune-enhancing role of vitamin C and zinc and effect on clinical conditions, Ann. Nutr. Metab. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Zinc can reduce both the risk and duration of pneumonia in children, help to manage infantile diarrhea, lead to fewer episodes of malaria, and reduce the duration of diarrhea.

“Zinc can also reduce both the risk and duration of pneumonia in children, help to manage infantile diarrhea, lead to fewer episodes of malaria, and reduce the duration of diarrhea [3,17,71].”

• cites [3] Maggini, 2017, Vitamins C., D and zinc: Synergistic roles in immune function and infections, Vitam. Miner. sourceNot checked yet

  Not checked in the free run.

• cites [17] World Health Organization, and Food and Agricultural Organization of the United Nations (2006). Part 2. Evaluating the public health significance of micronutrient malnutrition. Guidelines on Food Fortification with Micronutrients, World Health Organization.Not checked yet

  Not checked in the free run.

• cites [71] Prentice, 2017, They are what you eat: Can nutritional factors during gestation and early infancy modulate the neonatal immune response?, Front. Immunol. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Multiple micronutrient supplementation in older people may also reduce antibiotic usage and lead to higher post-vaccination immune responses.

“Multiple micronutrient supplementation in older people may also reduce antibiotic usage and lead to higher post-vaccination immune responses [33].”

• cites [33] Chandra, 2002, Nutrition and the immune system from birth to old age, Eur. J. Clin. Nutr. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

In those under physical stress (e.g., at work, during sports, and under extreme temperatures), or in cases where vitamin C levels are slightly below recommended levels, vitamin C supplementation reduces common cold incidence.

“In those under physical stress (e.g., at work, during sports, and under extreme temperatures) [104], or in cases where vitamin C levels are slightly below recommended levels, vitamin C supplementation reduces common cold incidence.”

• cites [104] Hemilä, H. (2017). Vitamin C and infections. Nutrients, 9. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Vitamin D deficiency increases the risk of infection and autoimmune diseases such as multiple sclerosis and diabetes, probably related to activity of vitamin D receptors, which are found throughout the immune system.

“Vitamin D deficiency increases the risk of infection and autoimmune diseases such as multiple sclerosis and diabetes, probably related to activity of vitamin D receptors, which are found throughout the immune system [106,107].”

• cites [106] Aranow, 2011, Vitamin D and the immune system, J. Investig. Med. sourceNot checked yet

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• cites [107] Mangin, 2014, Inflammation and vitamin D: The infection connection, Inflamm. Res. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

In children with vitamin A deficiency, supplementation can decrease the risk of morbidity and mortality from infectious diseases, and reduce the incidence of diarrhea and measles.

“In children with vitamin A deficiency, supplementation can decrease the risk of morbidity and mortality from infectious diseases [77], and reduce the incidence of diarrhea and measles [14,71].”

• cites [77] Pettifor, J., and Zlotkin, S. (2004). Impact of micronutrient deficiencies on immune function. Micronutrient Deficiencies during the Weaning Period and the First Years of Life, Proceedings of the 54th Nestlé Nutrition Workshop, Pediatric Program, São Paulo, Brazil, 26–30 October 2003, Nestlé Nutrition Institute Workshop Series. sourceNot checked yet

  Not checked in the free run.

• cites [14] Micronutrient Information Center (2018, April 17). Immunity in Depth. Available online: http://lpi.oregonstate.edu/mic/health-disease/immunity.Not checked yet

  Not checked in the free run.

• cites [71] Prentice, 2017, They are what you eat: Can nutritional factors during gestation and early infancy modulate the neonatal immune response?, Front. Immunol. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Distinct immune features are present during each life stage, and specific factors differentially affect immune function, with a resulting difference in the type, prevalence and severity of infections with age.

“Distinct immune features are present during each life stage, and specific factors differentially affect immune function, with a resulting difference in the type, prevalence and severity of infections with age.”

May combine two claims.

Supplementation with vitamin E in older people has been shown to significantly improve NK cytotoxic activity, neutrophil chemotaxis and the phagocytic response, and enhance mitogen-induced lymphocyte proliferation and IL-2 production.

“Supplementation with vitamin E in older people has been shown to significantly improve NK cytotoxic activity, neutrophil chemotaxis and the phagocytic response, and enhance mitogen-induced lymphocyte proliferation and IL-2 production [123].”

• cites [123] Hernanz, 2008, Vitamin E ingestion improves several immune functions in elderly men and women, Free Radic. Res. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

There are some reports that an adequate zinc supply could prevent degenerative age-related diseases including infection and cancer.

“There are some reports that an adequate zinc supply could prevent degenerative age-related diseases including infection and cancer [122].”

• cites [122] Mocchegiani, 2013, Zinc: Dietary intake and impact of supplementation on immune function in elderly, Age (Dordr.) sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Vitamin E can also improve T-cell-mediated immunity and increase the production of antibodies in response to the hepatitis B and tetanus vaccines.

“Vitamin E can also improve T-cell-mediated immunity and increase the production of antibodies in response to the hepatitis B and tetanus vaccines [124].”

• cites [124] Meydani, 1997, Vitamin E supplementation and in vivo immune response in healthy elderly subjects. A randomized controlled trial, JAMA sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The available clinical data suggest that micronutrient supplementation can reduce the risk and severity of infection and support a faster recovery.

“The available clinical data suggest that micronutrient supplementation can reduce the risk and severity of infection and support a faster recovery.”

Probably not a substantial claim: may not pass S2 (checkable).

Current knowledge regarding the importance of micronutrients in immunity, the effects of micronutrient deficiencies on the risk and severity of infection, and the worldwide prevalence of an inadequate micronutrient status form a sound basis for the use of a targeted multiple micronutrient supplement to support immunity over a person's lifetime.

“Nevertheless, current knowledge regarding the importance of micronutrients in immunity, the effects of micronutrient deficiencies on the risk and severity of infection, and the worldwide prevalence of an inadequate micronutrient status form a sound basis for the use of a targeted multiple micronutrient supplement to support immunity over a person’s lifetime.”

May combine two claims.

Adequate vitamin C intakes can optimize cell and tissue levels and help to protect against respiratory and systemic infections (e.g., reduced duration and severity of pneumonia).

“Adequate vitamin C intakes can optimize cell and tissue levels and help to protect against respiratory and systemic infections (e.g., reduced duration and severity of pneumonia [71]), while higher levels are required during infection to compensate for the increased inflammatory response and metabolic demand induced by the pathogen, and thus help to reduce the duration and severity of symptoms [12]”

• cites [71] Prentice, 2017, They are what you eat: Can nutritional factors during gestation and early infancy modulate the neonatal immune response?, Front. Immunol. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S2 (checkable).

Tailored supplementation based on the specific needs of each age group may help to provide an adequate basis for optimal immune function.

“Tailored supplementation based on the specific needs of each age group may help to provide an adequate basis for optimal immune function.”

May combine two claims.

The risk of upper respiratory tract infections, especially common cold, was significantly lower after vitamin E supplementation in nursing home residents, although there was no apparent effect on lower respiratory tract infections.

“The risk of upper respiratory tract infections, especially common cold, was significantly lower after vitamin E supplementation in nursing home residents, although there was no apparent effect on lower respiratory tract infections [125].”

• cites [125] Meydani, 2004, Vitamin E and respiratory tract infections in elderly nursing home residents: A randomized controlled trial, JAMA sourceNot checked yet

  Not checked in the free run.

May combine two claims.

A common factor throughout life is the need for an adequate supply of micronutrients, which play key roles in supporting immune function.

“A common factor throughout life is the need for an adequate supply of micronutrients, which play key roles in supporting immune function.”

May combine two claims.

Sufficient vitamin C is also important in older people, who are at risk of vitamin C deficiency, especially females.

“Sufficient vitamin C is also important in older people, who are at risk of vitamin C deficiency, especially females [96].”

• cites [96] Elmadfa, 2009, European Nutrition and Health Report, Forum Nutr. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Multiple micronutrient deficiencies are common throughout the world, with the likelihood increasing with age.

“Multiple micronutrient deficiencies are common throughout the world, with the likelihood increasing with age.”

May combine two claims.

The immune system undergoes many changes over the life course-developing and maturing during childhood, potentially achieving peak function in early adulthood, and gradually declining in most people in older age.

“The immune system undergoes many changes over the life course—developing and maturing during childhood, potentially achieving peak function in early adulthood, and gradually declining in most people in older age (Figure 3).”

May combine two claims.

Higher levels of vitamin C are required during infection to compensate for the increased inflammatory response and metabolic demand induced by the pathogen, and thus help to reduce the duration and severity of symptoms.

“while higher levels are required during infection to compensate for the increased inflammatory response and metabolic demand induced by the pathogen, and thus help to reduce the duration and severity of symptoms [12].”

• cites [12] Carr, A., and Maggini, S. (2017). Vitamin C and immune function. Nutrients, 9. sourceNot checked yet

  Not checked in the free run.