Deficiencies

Many feel that in our western society there is no true malnutrition or dietary deficiencies. Studies and observations have consistently shown this belief to be unfounded. We know that 13 vitamins, 22 minerals, 6 co-factors, 8 amino acids and 2 essential fatty acids are needed for normal body function.

Deficiencies of folic acid, vitamin A, vitamin C and vitamin E result in damaged immunity. Vitamin B6 deficiency results in a decreased response time to an invasion into the body by our T cell lymphocytes, a key component of the immune system. A moderate increase in development of certain tumors. Zinc deficiency leads to shrinking or atrophy of the lymph glands and impaired wound healing as well as a reduction of antibody forming cells in the spleen and impaired T killer cell activity.

 

 

Nutritional Assessment

The key to identifying a person's nutritional deficiencies is the comprehensive nutritional assessment. This must include a detailed history and physical examination, various laboratory studies and anthropometric measurements. Serum albumin, prealbumin, retinal binding protein, transferring concentrations, as well as lymphocyte count and subpopulation are included in most nutrional assessment.

 

 

The need to meet calorie requirements is essential. Under-eating leads to poor healing, protein wasting, and ultimately, organ failure. Over-eating can cause hyperglycemia, liver problems and excess fluid overload. The best nutritional goal remains providing the appropriate amount of calories required to meet energy demands protein to reduce nitrogen loss.

Dietary amino acids are fuel for energy in addition to being irreplaceable for the maintenance of organ integrity and immuno- competence and as the building blocks for wound healing. Lack of power amounts of protein can lead to organ failure, and an excess of protein can damage the kidneys. Normally, we need 1.5 to 2.0 grams of protein per kilo of body weight per day.

Glucose is the preferred fuel for many active organs including the central nervous system (our brain) and the immune system. Whenever we have increased stress or injury, this need for glucose is magnified. However, excess carbohydrates in our diet can cause liver dysfunction, exacerbate hyperglycemia and increase the production of carbon dioxide. Hyperglycemia has been shown to affect immune function and has profound effects on wound healing and infection rates.

In general lipids (or fats) supply 30 to 40% of required calories. Usually, triglycerides are the fat the our body uses most effectively and has been associated with immune abnormalities such as impaired ability by our white blood cells to engulf bacteria (phagocytosis) and increase infections by Gram-negative bacteria. Omega-6 polyunsaturated fatty acids can cause immunologic dysfunction, while omega-3 polyunsaturated fatty, such as fish oils, augment immune functions and also have unique anti-inflammatory properties.

Conclusion
The close interdependence of our immune system and of our nutritional status is quite clear. Specific nutrients can be utilized together with basic nutritional support to increase or modify the immune response in order to improve our health. The evaluation and correction of nutritional deficiencies is an essential and important part of our patient's treatment and return to well-being.