“Taking better care of our own health at every stage of life is vital not only to help prevent disease and improve health outcomes but also to relieve the enormous pressure on health and social care systems,” the global team of researchers wrote in the journal BMJ Nutrition, Prevention & Health.
Lead author Prof Philip Calder, head of school at the University of Southampton, told NutraIngredients: "Our paper was aimed at raising awareness of a healthy diet in supporting the immune system and that the immune system is more than protection against pathogens[...]. Beyond that. the aim was to highlight that healthcare providers including pharmacists can play a role in helping people achieve a better diet and that sources of micronutrients (vitamins and minerals) need to be considered."
The review argued that primary healthcare providers (PCHPs), particularly pharmacists, represent a widely available, easily accessible and convenient resource that can be used to promote self-care strategies that could help to improve public health.
However, they noted a need to invest in training and provide succinct and reliable information about the immune system and the vital roles of nutrition—including the use of a multiple micronutrient supplements to help close any nutrient gaps that could impair immune function.
They emphasise that there is a particularly pressing need to educate on the importance of nutrition to support immune health, noting the many aspects of health that are impacted by the immune system.
“Immune support through nutrition is a high-priority self-care practice that can help to maximise the health and well-being of the population," the report stated, adding: "In situations of inadequate diet or challenging immune stressors, regular use of a micronutrient supplement in accordance with the manufacturers’ instructions seems likely to help support a well-functioning immune system.”
The immune-metabolic crosstalk
The report discussed the intertwined nature of metabolism and the immune system as metabolism involves sensing nutrient balance to allow the host to prioritise energy storage against the host’s requirements, and the immune system plays an important role in this sensing.
"This immuno-metabolic cross-talk is pivotal in promoting metabolic health throughout the entire life course and plays essential roles in the ability of a host to respond to external challenges and dynamic conditions within the body to maintain homeostasis," the researchers wrote.
They also noted a healthy immune system is essential in the maintenance of the brain as it provides "homeostatic support to the central nervous system (CNS) and helps to maintain the complex and delicate brain environment".
Next step: Educating PHCPs
The review highlighted lack of time and resources combined with lack of ongoing training as key barriers to the provision of nutrition education by PHCPs.
"In addition, the minimal exposure to nutritional knowledge during the training of all PHCPs is detrimental, particularly when combined with insufficient understanding of the broader roles of the immune system beyond host defence and how to communicate its importance," the researchers wrote.
"These issues must be addressed before PCHPs can safely and confidently advise the community about basic nutrition and know when they should refer to an expert. Integrating evidence-based nutrition courses into health professional education, using a range of delivery and communication options, can prompt greater competence and confidence when providing nutritional advice."
Improving education in medical professions
Given the lack of nutrition education in standard medical training, many medical professionals feel ill-equipped to advise their patients on preventative healthcare lifestyles. One challenge is knowing how to fit all this into the already sizeable educational courses, but some work is being done to improve nutrition education within medical courses.
The Association for Nutrition (AfN) developed a new undergraduate nutrition curriculum in 2022 designed to form future doctors who will understand and recognise the role of nutrition in health.
After assuming responsibility for the undergraduate nutrition curriculum for medical students in 2018, the AfN incorporated education in eight critical nutrition topic areas: Nutrition and Hydration in Health and Disease, Nutrition Screening and Assessment, Effect of Nutrition Status on Illness, Malnutrition (Undernourishment), Malnutrition (Obesity and Metabolic Syndrome), Specific Dietary Requirements, Hydration and Nutrition in Health Promotion and Illness Prevention.
Writing about the curriculum in BMJ Nutrition, Prevention & Health, the association stated: "Medical doctors do not need to become nutritionists or dietitians but should be equipped to confidently address malnutrition in all its forms. Doctors, who will see thousands of patients throughout their career, play a key role in helping to identify, treat and monitor nutrition-related conditions, as well as in delivering preventative medicine.”
Source: BMJ Nutrition, Prevention & Health
doi: 10.1136/bmjnph-2023-000755
“Vital role for primary healthcare providers: urgent need to educate the community about daily nutritional self-care to support immune function and maintain health”
Authors: Calder PC, Bach-Faig A, Bevacqua T, et al