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Title:   Author  item
                                            Stephensen, Charlesitem
                                            Dawson, Harryitem
                                            Larson, Kate
  Submitted to: Journal of Nutrition
                                    Publication Type: Peer Reviewed Journal
                                    Publication Acceptance Date: 10/29/2014
                                    Publication  Date: 4/1/2015
                                    Publication URL: http://www.ncbi.nlm.nih.gov/pubmed/25833893Citation: Stephensen, C.B., Dawson, H.D., Claycombe, K.J. 2015. Impact of nutrition on immune function and the inflammatory response. Journal of Nutrition. 145(5):1039S-1108S. DOI: 10.3945/jn.114.194571.Interpretive Summary: The review utilizes data on three micronutrients (vitamin A, zinc and iron), anthropometrically defined undernutrition (stunting, wasting and underweight) and obesity to evaluate the effect on immune function, recovery of immune function in response to nutritional interventions, related health outcomes (e.g., risk of infection) and markers of inflammation.  In brief, the review concludes that malnutrition in all forms impairs both innate and adaptive immunity resulting in changes that can impair resistance to or recovery from infections.  It also concludes that nutritional supplementation can have benefits (e.g., reducing mortality and some types of morbidity in the case of VA and Zn but may also increase risk of adverse outcomes in selected populations as has been seen for both VA and Fe, but that adverse outcomes may result from supplementation to non-deficient individuals in population-based programs.  Thus the underlying mechanisms accounting for both benefit and potential adverse effects require further research in order to appropriately target intervention programs.   In summary, nutrition for optimal health and immune function appears to require balance, without stunting, wasting, and underweight on one hand, and without obesity on the other hand.  Similarly, micronutrient deficiencies impair immunity but supplementation of at least some micronutrients to non-deficient individuals may cause harm under some circumstances.
                                Technical Abstract: The review utilizes data on three micronutrients (vitamin A, zinc and iron), anthropometrically defined undernutrition (stunting, wasting and underweight) and obesity to evaluate the effect on immune function, recovery of immune function in response to nutritional interventions, related health outcomes (e.g., risk of infection) and markers of inflammation.  In brief, the review concludes that malnutrition in all forms impairs both innate and adaptive immunity resulting in changes that can impair resistance to or recovery from infections.  It also concludes that nutritional supplementation can have benefits (e.g., reducing mortality and some types of morbidity in the case of VA and Zn but may also increase risk of adverse outcomes in selected populations as has been seen for both VA and Fe, but that adverse outcomes may result from supplementation to non-deficient individuals in population-based programs.  Thus the underlying mechanisms accounting for both benefit and potential adverse effects require further research in order to appropriately target intervention programs.   In summary, nutrition for optimal health and immune function appears to require balance, without stunting, wasting, and underweight on one hand, and without obesity on the other hand.  Similarly, micronutrient deficiencies impair immunity but supplementation of at least some micronutrients to non-deficient individuals may cause harm under some circumstances.


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