Immunity

Question 1

What factors can depress our immune system?

Answer 1

Older age, environmental toxins, excess weight, poor diet, chronic diseases, chronic mental stress, lack of sleep and rest.

Question 2

What is the effect of chronic exposure to proinflammatory events?

Answer 2

Disturbed homeostasis / prolonged inflammation
Increased risk of chronic diseases

Question 3

Examples of nutrients that have been identified as critical for immune cells

Answer 3

Vitamin C
Vitamin D
Zinc
Selenium
Iron
Protein (amino acid glutamine)

Question 4

How do nutrients can help the immune system?

Answer 4

Working as antioxidants to protect healthy cells, support the growth and activity of immune cells, and produce antibodies.

Question 5

What are the high-risk populations (immunity)?

Answer 5

Low-income households
Pregnant and lactating women
Infants and toddlers
Critically ill
Elderly

Question 6

What diet is good for the growth and maintenance of beneficial microbes?

Answer 6

A high-fibre plant-rich diet with plenty of fruits, vegetables, whole grains, and legumes.
A diet containing probiotics and prebiotics foods.

Question 7

What is Dysbiosis?

Answer 7

Dysbiosis is defined by an imbalance in bacterial composition, changes in
bacterial metabolic activities, or changes in bacterial distribution within the gut.
* The three types of dysbiosis are:
1. Loss of beneficial bacteria
2. Overgrowth of potentially pathogenic bacteria
3. Loss of overall bacterial diversity

Question 8

Dysbiosis effects

Answer 8

Gut inflammations: leaky gut and systemic LPS
Infection/cancer susceptibility
Systemic inflammation
Allergy & Autoimmunity
Insulin resistance
Oxidative stress

Question 9

What is the Inflammatory bowel
disease (IBD)?

Answer 9

It is a chronic and relapsing inflammatory disorder of the gut

Question 10

IBD & Dysbiosis

Answer 10

• Functional changes in the gut microbiota resulting
  from dysbiosis may be involved in the pathophysiology
  of IBD.
• The number of genes harboured in the gut microbiota
  is 100 times greater than that in the human genome
• It remains controversial whether dysbiosis is a cause
  or consequence of intestinal inflammation in IBD

Question 11

What are the 2 forms of Inflammatory Bowel Disease?

Answer 11

Crohn’s disease CD: chronic
inflammatory bowel disease that
can affect the entire GIT, but most
commonly the ileum and colon.

Ulcerative colitis UC: chronic
inflammatory bowel disease primarily located in the colon and rectum

Question 12

Pathophysiology of Inflammatory Bowel Diseases

Answer 12

Exposure to specific triggers for those genetically susceptible will lead to an abnormal immune response.
Release of cytokines.
Exaggerated inflammatory reaction.
Destruction of mucosa.

Question 13

What is the onset of Inflammatory Bowel Diseases?

Answer 13

mainly in patients between 15 and 30 years of age

Question 14

Environmental Factors for Inflammatory Bowel Diseases

Answer 14

Smoking
Infection agents
Intestinal flora
Abnormal inflammatory response

Question 15

What are the clinical symptoms IBD

Answer 15

Food intolerance
Abdominal pain
Diarrhea
Blood stools
Fever
Weight loss
Malnutrition
Fatigue
Anaemia
Delayed sexual development and growth failure in children
Complicated IBD leads to ulcerations, abscesses, strictures and blockage of the intestine due to scar tissues

Question 16

Medical Nutrition Therapy for IBD

Answer 16

Primary goal: restore and maintain the nutrition status of the patient.
Intervention depends on the phase:
-Exacerbation: low residue diet
Remission: high calorie, high protein

Question 17

Exacerbation phase Nutrition (IBD)

Answer 17

Parental nutrition. Enteral nutrition or PO intake is the preferred potential to feed intestinal epithelium and alter GI flora
Inflammation results in malabsorption of:
-Fats: steatorrhea
-Lactose: Lactose intolerance
-Fibre may worsen obstruction
-Bouts of diarrhoea occur
-Restrict caffeine
-Restric gas-producing foods
-Small frequent meals

Question 18

Protein requirements for the Exacerbation phase in IBD

Answer 18

1.2-1.3 g/kg

Question 19

Remission phase Nutrition

Answer 19

-Fibre and lactose increased gradually (some patients may become permanent lactose intolerant)
-More food tolerated
-Weigh gain and physical activity
-Pro and prebiotics
-Omega-3 food choices and supplements for anti-inflammatory effect
IBD patients at higher risk for B12 deficiency
-Micronutrients: iron, zinc, calcium, magnesium and copper