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Winterize Your Immune System

chilly-womanThe relationship between vitamin D status and the strength of the immune system is a hot topic. Actually a steroid hormone more than a vitamin, vitamin D is made by the skin after exposure to the ultraviolet radiation of the sun. Because the sun’s angle of incidence outside the tropics is considerably lower in winter, the skin’s response is too weak to manufacture sufficient stores of this vital nutrient.

In the early 1980’s, British physician R. Edgar Hope-Simpson proposed a relationship between solar radiation and the seasonality of influenza.  Without sufficient sunlight, the skin does not produce vitamin D, deficiency of which is common in winter.  This steroid hormone has considerable influence on immunity, where it prevents excessive expression of inflammation and is able to, “…stimulate the expression of potent anti-microbial peptides, which exist in neutrophils, monocytes, natural killer cells, and in epithelial cells lining the respiratory tract where they play a major role in protecting the lung from infection.”   (Cannell. 2006)   This study, performed at California’s Atascadero State Hospital, states that deficiency of vitamin D predisposes children to respiratory infections.  UV radiation, either natural or artificial, increases vitamin D levels and thereby reduces the incidence of pulmonary infections.

Vitamin D deficiency has been associated with many of the diseases of modern society, but traditional medicine has been reluctant to address this concern, or even to recognize it.  This vitamin is the only known precursor to a potent steroid hormone that is able to regulate expression in a number of tissues.  It does not exist in appreciable amounts in the diet, not even in fortified foods like dairy.  People used to make enormous amounts of vitamin D until they were warned to stay out of the sun.  If not exposed to the sun, we need to get it from supplements.  The flu epidemic of 1918 took a great toll.  Autopsies on some of the fifty million people who died revealed destruction of the respiratory tract.  This is the inflammation that vitamin D has been found to prevent.

Randomized, double-blind, placebo-controlled studies done in Japan in 2010 found that vitamin D3 supplementation not only reduced incidence of influenza type A, but also reduced asthma attacks as a secondary outcome. (Urashima. 2010).  The elderly tend to have suboptimal levels of vitamin D, which is associated with an increased risk of falls as well as seasonal virus attacks.  Vitamin D supplementation in this group is a realistic intervention that can pay large dividends.  2000 IU a day has been suggested as a minimal dose also to help prevent osteoporosis, increased risk of certain cancers, aberrant glucose and lipid metabolism and to improve quality of life.  (Lawless. 2011)  (Cherniak.  2008). Solar activities of the sun have a cycle of about eleven years, and an interesting phenomenon is that flu epidemics seems to follow the pattern.  (Hayes.  2010).

Vitamin D is not the sole player in the winterizing game.  Viruses need to get into your cells to make copies of themselves, using your cellular materials.   Replication of the flu virus is interrupted by a standardized elderberry extract called Sambucol, the use of which brought improvement to more than 90% of the persons in a study group within two days.  Since there is no satisfactory medication to cure the flu, this natural substance is nearly miraculous because it’s also inexpensive, has no side effects, and works on both A and B strains of influenza.  (Zakay-Rones.  1995)  (Zakay-Rones.  2004). The anti-viral properties of elderberry are attributed to its flavonoids content, some of which are peculiar to that plant alone. (Roschek. 2009).

A considerable part of the immune system resides in the gut, where intestinal microflora work to maintain the status quo.  Keeping those bacteria happy and healthy makes sense, so probiotics have been examined as a support system.  In a controlled study in Wisconsin, scientists found that six months of supplementation with a probiotic resulted in reduced fever, runny nose, and cough incidence in youngsters aged 3 to 5 years.  Duration of prescription medications and missed school days also were reduced.  (Leyer. 2009)  Day care centers across the Atlantic also fared well in the reduction of childhood infections with probiotic use. In Finland, researchers saw a substantial reduction in respiratory infections and their severity among children under 6 years old, accompanied by a reduction in the need for antibiotic treatment in those who received probiotic dairy products.  (Hatakka.  2001)

Investigations of echinacea as treatment for flu were not as positive as those for prevention.  It was discovered that early intervention, at the fist symptoms, brought the best results using an echinacea compound tea, namely one called Echinacea Plus.  (Lindenmuth.  2000).  Because there are too many variables, including the part or parts of the plant used, the brewing times and techniques, the variety of the plant used, its cultivation conditions, and other factors, test results are likely to differ.  Even in trials with sound methodology, results may conflict.  (Melchart.  2000)  (Linde. 2006) Using echinacea as prevention or as treatment, then, may be an uncertain proposition.

There is more to consider.  Garlic and onions have putative anti-bacterial and anti-viral properties. (Goncagul. 2010). (Harris. 2001)  Exercise, regardless of intensity or duration, and sound sleep of uninterrupted duration help the lymphatic system to clear impurities and to boost immunity.  One or all of these suggestions might be your ounce of prevention.  Oh, yeah, one last thing.  The higher the humidity in your house in the winter, the less likely viruses are to be transmitted.  (Lowen,. 2007)  (Yang. 2011)

References

MAIN ABSTRACT
Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, Garland CF, Giovannucci E. Epidemic influenza and vitamin D. Epidemiol Infect. 2006 Dec;134(6):1129-40.

SUPPORTING ABSTRACTS
Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H.
Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren.
Am J Clin Nutr. 2010 May;91(5):1255-60. Epub 2010 Mar 10.

Lawless S, White P, Murdoch P, Leitch S.
(Preventing) two birds with one stone: improving vitamin D levels in the elderly.
J Prim Health Care. 2011 Jun 1;3(2):150-2.

Cherniack EP, Levis S, Troen BR.
Hypovitaminosis D: a widespread epidemic.
Geriatrics. 2008 Apr;63(4):24-30.

Hayes DP.
Influenza pandemics, solar activity cycles, and vitamin D.
Med Hypotheses. 2010 May;74(5):831-4. Epub 2009 Dec 28.

Zakay-Rones Z, Varsano N, Zlotnik M, Manor O, Regev L, Schlesinger M, Mumcuoglu M.
Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama.
J Altern Complement Med. 1995 Winter;1(4):361-9.

Zakay-Rones Z, Thom E, Wollan T, Wadstein J.
Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections.
J Int Med Res. 2004 Mar-Apr;32(2):132-40.

Roschek B Jr, Fink RC, McMichael MD, Li D, Alberte RS.
Elderberry flavonoids bind to and prevent H1N1 infection in vitro.
Phytochemistry. 2009 Jul;70(10):1255-61.

Leyer GJ, Li S, Mubasher ME, Reifer C, Ouwehand AC
Probiotic effects on cold and influenza-like symptom incidence and duration in children.
Pediatrics. 2009 Aug;124(2):e172-9.

Hatakka K, Savilahti E, Pönkä A, Meurman JH, Poussa T, Näse L, Saxelin M, Korpela R.
Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial.
BMJ. 2001 Jun 2;322(7298):1327

Brinkeborn RM, Shah DV, Degenring FH.
Echinaforce and other Echinacea fresh plant preparations in the treatment of the common cold. A randomized, placebo controlled, double-blind clinical trial.
Phytomedicine. 1999 Mar;6(1):1-6.

Lindenmuth GF, Lindenmuth EB
The efficacy of echinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms: a randomized, double-blind placebo-controlled study.
J Altern Complement Med. 2000 Aug;6(4):327-34.

Melchart D, Linde K, Fischer P, Kaesmayr J.
Echinacea for preventing and treating the common cold.
Cochrane Database Syst Rev. 2000;(2):CD000530.

Linde K, Barrett B, Wölkart K, Bauer R, Melchart D.
Echinacea for preventing and treating the common cold.
Cochrane Database Syst Rev. 2006 Jan 25;(1):CD000530.

Goncagul G, Ayaz E.
Antimicrobial effect of garlic (Allium sativum).
Recent Pat Antiinfect Drug Discov. 2010 Jan;5(1):91-3.

Harris JC, Cottrell SL, Plummer S, Lloyd D.
Antimicrobial properties of Allium sativum (garlic).
Appl Microbiol Biotechnol. 2001 Oct;57(3):282-6.

Lowen AC, Mubareka S, Steel J, Palese P.
Influenza virus transmission is dependent on relative humidity and temperature.
PLoS Pathog. 2007 Oct 19;3(10):1470-6.

Wan Yang, Linsey C. Marr
Dynamics of Airborne Influenza A Viruses Indoors and Dependence on Humidity
PLoS ONE: Research Article, published 24 Jun 2011 10.1371/journal.pone.0021481

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Exercise And The Common Cold

winter-runningSome things never come our way, no matter how hard we try. Wouldn’t it be really cool if you could win the trillion dollar lottery at least once? Or maybe twice? On the other hand, some things do come to us without trying, like the in-laws at holiday time, the IRS in April, and the common cold, also known as coryza. If you’re an adult—and if you’re reading this you probably are—you’ll get about two to four such viral infections a year. Your kids will get more than a half dozen. Then, again, you might be one of the fortunate few who get none. Collectively, colds, the flu and other upper respiratory infections are classed as influenza-like illnesses.

Some science people hold that viruses are not actually living things because they cannot reproduce on their own. They can’t go through cell division because they are acellular, not made of cells. That means they have to use your cellular material to make copies of themselves, and that means they have to get inside one of your cells, where they disguise themselves as part of the gang.  That’s when they start to sneak around, fooling other cells to accept them as friends, and then cloning themselves repeatedly. If your immune system is awake and on the job, it’ll recognize this fraud and take steps to halt it.  If it isn’t, you’ll get sick for as long a time as it takes to recoup your resources.

The rhinovirus is the most studied of the pathogens that cause upper respiratory infections (URI).  There are more than a hundred, and are most infectious in the first three days after the onset of symptoms. One of the things that separate a cold from the flu is that cold symptoms show up a couple of days after infection; with the flu, it’ll be sudden onset with extreme fatigue.  (Eccles. 2005)  Exposure to the cold weather has little to do with catching a cold, although it might compromise the immune system. Staying indoors and being in close proximity to other people is a more likely cause. All you have to do is to touch a doorknob turned by a sneeze-covered hand, or to breathe in the particles that already erupted from somebody’s nose or throat, and bingo, you’ve got it. Makes you want to stay home, doesn’t it?

There is not one thing on the market that can get rid of a cold. Nada. Nothing. Zip. You might be able to control symptoms, though, and for most of us, that’s enough. Vapor rubs for the chest, antihistamines for the runny nose, analgesics for physical discomfort, and chicken soup for the soul, which, by the way, might just be the last word in cold medicine. It’s kind of frustrating to find out that medical books don’t really address colds (at more than a few hundred dollars each), but that granny does. (Ibid.)

Whatever you do, don’t ask for an antibiotic. You can’t kill things that aren’t alive in the first place, but you can disrupt the whole immune system machinery and get the nasty side effects.  If you really and truly want to do something about your cold, exercise it away. Sounds goofy, especially because you don’t feel like it.

People who exercise seem to have fewer and milder colds, says a report from the Appalachian State University in North Carolina. Dr. David Nieman and colleagues collected data from more than a thousand subjects, ages 18 to 85, and tracked the number of URI’s they suffered.  Among the data were reports of the kinds and frequency of exercise, personal fitness evaluations, and dietary habits and lifestyle. It was found that those who exercised five or more days a week experienced 41% fewer days’ worth of cold symptoms. Also, colds were milder for those in better shape than for those who were sedentary. Dr. Nieman explained that exercise mobilizes the immune system at a higher rate than normal and causes immune cells to attack viruses. (Nieman. 2011)

As opposed to intense, strenuous workouts, moderate exercise reduces the number and severity of colds. Prolonged strenuous exercise opens a window for viral attack by exhausting the first responders of the immune system. Investigators at the Department of Exercise Science of the University of South Carolina learned of increased susceptibility to respiratory viral attack following exercise stress in lab animals that ran a treadmill to the point of fatigue. The animals subjected to such rigors were more likely to succumb to administered viruses than those that rested or were less taxed.  (Murphy. 2008)

When a geriatric populace was examined under the hypothesis that moderate exercise could promote resistance to upper respiratory tract infections, Polish researchers found that, not only was susceptibility to infection reduced, but also that symptoms of depression were ameliorated. In this cohort, there was a distinct negative association between physical activity and sickness.  (Kostka. 2007)

T-cells are a major source of messenger cytokines responsible for the biological effects of the immune system. They have antigen-specific receptors on their cell surfaces to allow them to identify invaders. Th1 cytokines produce the pro-inflammatory response that kills intracellular parasites and perpetuates autoimmune responses. Interferon gamma is the star player. If this gets out of hand, there can be excessive tissue damage, so there is a balancing mechanism in Th2 cytokines, which include interleukins 4, 5, and 13. These promote the IgE responses that are common to skin and mucus membranes. Interleukin 10, also a Th2, is seriously anti-inflammatory.  In the best case scenario, Th1 and Th2 will be balanced at the exact ratio needed to face an immune challenge. It was discovered at the University of Illinois that moderate exercise (pay attention to the word “moderate”) would shift immune response from the pro-inflammatory Th1 to the anti-inflammatory Th2 cytokines, thereby reducing lung pathology and influenza protein expression, thus improving survival after virus infection. (Lowder. 2006)

Current study is examining nutritional supplements as countermeasures to exercise-induced immune changes and infection risk.  Quercetin, beta-glucan, and curcumin are cited as being able to reduce the magnitude of such immune system insult and resultant risk of URI.  (Nieman.  2008)

Now we have another reason to get up from the couch and leave the remote behind.

References

Chubak J, McTiernan A, Sorensen B, Wener MH, Yasui Y, Velasquez M, Wood B, Rajan KB, Wetmore CM, Potter JD, Ulrich CM.
Moderate-intensity exercise reduces the incidence of colds among postmenopausal women.
Am J Med. 2006 Nov;119(11):937-42.

Douglas RM, Hemilä H, Chalker E, Treacy B.
Vitamin C for preventing and treating the common cold.
Cochrane Database Syst Rev. 2007 Jul 18;(3):CD000980.

Eccles R.
Understanding the symptoms of the common cold and influenza.
Lancet Infect Dis. 2005 Nov;5(11):718-25.

Friman G, Wesslén L.
Special feature for the Olympics: effects of exercise on the immune system: infections and exercise in high-performance athletes.
Immunol Cell Biol. 2000 Oct;78(5):510-22.

Kostka T, Praczko K.
Interrelationship between physical activity, symptomatology of upper respiratory tract infections, and depression in elderly people.
Gerontology. 2007;53(4):187-93. Epub 2007 Feb 21.

Lowder T, Padgett DA, Woods JA.
Moderate exercise early after influenza virus infection reduces the Th1 inflammatory response in lungs of mice.
Exerc Immunol Rev. 2006;12:97-111.

Martin SA, Pence BD, Woods JA.
Exercise and respiratory tract viral infections.
Exerc Sport Sci Rev. 2009 Oct;37(4):157-64.

Murphy EA, Davis JM, Carmichael MD, Gangemi JD, Ghaffar A, Mayer EP.
Exercise stress increases susceptibility to influenza infection.
Brain Behav Immun. 2008 Nov;22(8):1152-5. Epub 2008 Jun 21.

Nieman DC.
Immunonutrition support for athletes.
Nutr Rev. 2008 Jun;66(6):310-20.

D C Nieman, S J Stear, L M Castell, L M Burke
Nutritional supplement series
A–Z of nutritional supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance: part 15
Br J Sports Med 2010;44:1202-1205

David C Nieman, Dru A Henson, Melanie D Austin, Wei Sha
Upper respiratory tract infection is reduced in physically fit and active adults
Br J Sports Med. 2011 Sep;45(12):987-92. Epub 2010 Nov 1.

Woods JA, Keylock KT, Lowder T, Vieira VJ, Zelkovich W, Dumich S, Colantuano K, Lyons K, Leifheit K, Cook M, Chapman-Novakofski K, McAuley E.
Cardiovascular exercise training extends influenza vaccine seroprotection in sedentary older adults: the immune function intervention trial.
J Am Geriatr Soc. 2009 Dec;57(12):2183-91.

Wright PA, Innes KE, Alton J, Bovbjerg VE, Owens JE.
A pilot study of qigong practice and upper respiratory illness in elite swimmers.
Am J Chin Med. 2011;39(3):461-75.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Is Sugar Affecting Your Immunity?

sweet-drinkThere is a metabolic difference between simple and complex carbohydrates.  The simple ones become glucose soon after they are eaten.  The complex ones take longer to turn into sugar and are less apt to spike insulin and cause energy crashes down the line.  But that isn’t the only difference between the two.

Almost forty years ago scientists had an interest in the relationship of diet to health, specifically of sugar intake to immunity.   But their curiosity went past simple sugar to include carbohydrates other than glucose.  The cells that are the backbone of the immune system are supposed to kill, swallow, and dispose of alien bodies, including bacteria, viruses and cancer cells.  Scientists at Loma Linda University in California examined the activity of neutrophilic phagocytes (cells that dissolve the enemy) after subjects ingested glucose, fructose, sucrose, honey, or orange juice and found that “…all significantly decreased the capacity of neutrophils to engulf bacteria…”  (Sanchez, Reeser, et al. 1973)  Looking more closely, the researchers also discovered that the greatest effects occurred within the first two hours after eating, but “…the effects last for at least 5 hours.”  (Ibid.)  If there is any promise, it’s that the effects can be undone by fasting from added sugars for the next two or three days.

At the start of the twentieth century, Americans consumed only about five pounds of sugar a year.  By the fifties, that had grown to almost 110 pounds a year, and to more than 152 by the year 2000.  Corn sweeteners account for 85 of those pounds.
(USDA Economic Research Service, http://www.usda.gov/factbook/chapter2.pdf )  America’s sweet tooth increased 39% between 1950 and 2000 as the use of corn sweetener octupled.

Although the cited study is decades old, its message is contemporary. HFCS began replacing sugar in soft drinks in the 1980’s, after it was portrayed by marketers as a healthful replacement for demon sugar.  It didn’t hurt the industry that it cost less, either.  The biological effects of sugar and HFCS are the same, however.  Neither has any food value—no vitamins, protein, minerals, antioxidants, or fiber—but they do displace the more nutritious elements of one’s diet, and we tend to consume more than we need to maintain our weight, so we gain.

Even though the number of calories from the glucose in a slice of bread or other starch is the same as that from table sugar (half fructose and half glucose), they are metabolized differently and have different effects on the body.  While fructose is metabolized by the liver, glucose is metabolized by every cell in the body.  When fructose reaches the liver, especially in liquid form (as in soda), it overwhelms the organ and is almost immediately converted to fat.  (Taubes. 2011)

Innate immunity is that which occurs as part of your natural makeup and defends you against infection by other organisms.  Short-term hyperglycemia, which might come from a pint of vanilla, has been found to affect all the major components of the innate immune system and to impair its ability to combat infection.  Reduced neutrophil activity, but not necessarily reduced neutrophil numbers, is one of several reactions to high sugar intake.  (Turina. 2005)  Way back in the early 1900’s, researchers noted a relationship between glucose levels and infection frequency among diabetes sufferers, but it wasn’t until the 1940’s that scientists found that diabetics’ white cells were sluggish. (Challem. 1997)  More recent study has corroborated the diabetes-infection connection, agreeing that neutrophil phagocytosis is impaired when glucose control is less than adequate.  (Lin. 2006)  Impaired immune activity is not limited to those with diabetes.  As soon as glucose goes up, immune function goes down.

Some folks think they’re doing themselves a favor by using artificial sweeteners.  Once the brain is fooled into thinking a sweet has been swallowed, it directs the pancreas to make insulin to carry the “sugar” to the cells for energy.  After the insulin finds out it’s been cheated of real sugar, it tells the body to eat in order to get some, and that creates artificial hunger, which causes weight increase from overeating.   Even environmental scientists have a concern with fake sweeteners in that they appear in the public’s drinking water after use.  You can guess how that works. (Mawhinney. 2011)

Mineral deficiencies, especially prevalent in a fast-food world, contribute to immune dysfunction by inhibiting all aspects of the system, from immune cell adherence to antibody activity.  Paramount among minerals is magnesium, which is part of both the innate and acquired immune responses.  (Tam. 2003)  Epidemiological studies have connected magnesium intake to decreased incidence of respiratory infections, and intravenous administration has shown effective in treating asthma. (PDR. 2000)  But sugar pushes magnesium—and other minerals—out of the body.  (Milne. 2000)  This will compromise not only immune function, but also bone integrity.  (Tjäderhane. 1998)

Zinc has been touted for its ability to shorten the duration of the common cold.  Like magnesium, zinc levels decrease with age, and even tiny deficiencies can have a large effect on immune health, particularly in the function of the thymus gland, which makes the T-cells of the immune system.  Zinc supplementation improves immune response in both the young and the old.  (Haase. 2009)  (Bogden. 2004)  (Bondestam. 1985)  All the microminerals, in fact, are needed in minute amounts for optimal growth and development…and physiology.  Low intakes suppress immune function by affecting T-cell and antibody response. Thus begins a cycle whereby infection prevents uptake of the minerals that could prevent infection in the first place.  Adequate intakes of selenium, zinc, copper, iron plus vitamins B6, folate, C, D, A, and E have been found to counteract potential damage by reactive oxygen species and to enhance immune function.  (Wintergest. 2007)

Who would have viewed something as sweet as sugar as being so hostile? It taste great to eat but has a nasty habit of pushing everything else out.

References

Albert Sanchez, J. L. Reeser, H. S. Lau, P. Y. Yahiku, et al
Role of sugars in human neutrophilic phagocytosis
American Journal of Clinical Nutrition, Nov 1973; Vol 26, 1180-1184

Profiling Food Consumption in America
USDA
http://www.usda.gov/factbook/chapter2.pdf

Taubes G.
“Is Sugar Toxic?”
in New York times Magazine, 13 April, 2011

Turina M, Fry DE, Polk HC Jr.
Acute hyperglycemia and the innate immune system: clinical, cellular, and molecular aspects.
Crit Care Med. 2005 Jul;33(7):1624-33.

Challem J and Heumer RP.
The Natural health Guide to Beating the Supergerms.
1997. Simon and Schuster Inc. New York.  Pp. 124-125

Lin JC, Siu LK, Fung CP, Tsou HH, Wang JJ, Chen CT, Wang SC, Chang FY.
Impaired phagocytosis of capsular serotypes K1 or K2 Klebsiella pneumoniae in type 2 diabetes mellitus patients with poor glycemic control.
J Clin Endocrinol Metab. 2006 Aug;91(8):3084-7.

Mawhinney DB, Young RB, Vanderford BJ, Borch T, Snyder SA.
Artificial sweetener sucralose in U.S. drinking water systems.
Environ Sci Technol. 2011 Oct 15;45(20):8716-22.

Tam M, Gómez S, González-Gross M, Marcos A.
Possible roles of magnesium on the immune system.
Eur J Clin Nutr. 2003 Oct;57(10):1193-7.

PDR:  Physicians’ Desk reference for Herbal Medicines.  Magnesium.  2nd edition.  Mintvale NJ: Medical Economics Company; 2000:  5340540

Milne David B, PhD and Forrest H. Nielsen, PhD
The Interaction Between Dietary Fructose and Magnesium Adversely Affects Macromineral Homeostasis in Men
J Am Coll Nutr February 2000 vol. 19 no. 1 31-37

Tjäderhane Leo, and Markku Larmas
A High Sucrose Diet Decreases the Mechanical Strength of Bones in Growing Rats
J. Nutr. October 1, 1998 vol. 128 no. 10 1807-1810

Fuchs, Nan Kathryn Ph.D.
Magnesium: A Key to Calcium Absorption
The Magnesium Web Site on November 22, 2002
http://www.mgwater.com/calmagab.shtml

Haase H, Rink L.
The immune system and the impact of zinc during aging.
Immun Ageing. 2009 Jun 12;6:9.

Bogden JD.
Influence of zinc on immunity in the elderly.
J Nutr Health Aging. 2004;8(1):48-54.

Bondestam M, Foucard T, Gebre-Medhin M.
Subclinical trace element deficiency in children with undue susceptibility to infections.
Acta Paediatr Scand. 1985 Jul;74(4):515-20.

Wintergerst ES, Maggini S, Hornig DH.
Contribution of selected vitamins and trace elements to immune function.
Ann Nutr Metab. 2007;51(4):301-23. Epub 2007 Aug 28.

Smolders I, Loo JV, Sarre S, Ebinger G, Michotte Y.
Effects of dietary sucrose on hippocampal serotonin release: a microdialysis study in the freely-moving rat.
Br J Nutr. 2001 Aug;86(2):151-5.

Jack Challem, Burton Berkson, M.D., Ph.D., Melissa Diane Smith
Glucose and Immunity
http://www.diabeteslibrary.org/View.aspx?url=Article638
Accessed 11/2011

Van Oss CJ.
Influence of glucose levels on the in vitro phagocytosis of bacteria by human neutrophils.
Infect Immun. 1971 Jul;4(1):54-9.

Bernstein J, Alpert S, et al
Depression of lymphocyte transformation following oral glucose ingestion
Am J Clin Nutr. 1977; 30: 613

Robert A. Good, Ellen Lorenz
Nutrition and cellular immunity
International Journal of Immunopharmacology. Vol 14, Iss 3, Apr 1992, Pp. 361-366

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.