The Nutrition/Immune System Connection

Can what we eat really affect our immune system?  You bet it can! 

Don’t be fooled, however, by confusing and misleading claims about so-called ‘super foods’ and over-the-counter dietary supplements.   

Host Jonathan Fialkow, M.D. and his guest, Lucette Talamas, a registered dietitian with Baptist Health’s community health program, separate facts from myths when it comes to the nutrients we need to support a healthy immune system. 

Get factual information about health and nutrition topics with Baptist Health's free online classes. For more information, go to the community health website or email programs@baptisthealth.net.

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Announcer:

At Baptist Health South Florida, it's our mission to care for you when you're injured or sick and help you stay healthy and fit.

Announcer:

Welcome to the Baptist HealthTalk podcast, where our respected experts bring you timely practical health and wellness information to improve your family's quality of life.

Dr. Jonathan Fialkow:

Welcome, Baptist HealthTalk podcast listeners. I'm your host, Dr. Jonathan Fialkow. I'm a preventative cardiologist and lipidologist at Baptist Health's Miami Cardiac and Vascular Institute, where I'm also Chief of Cardiology and the Chief Population Health Officer at Baptist Health South Florida.

Dr. Jonathan Fialkow:

March is National Nutrition Month, which brings attention to what we eat and the way it impacts our health and wellness. In particular, we're going to look at how a healthy diet is key to supporting our body's immune system... Which nutrients help our immune system to fight off pathogens like bacteria and viruses, how we can make sure we're getting what we need.

Dr. Jonathan Fialkow:

We'll explore these answers with my guest, Lucette Talamas, a registered dietician with Baptist Health's community health team. Lucette holds Bachelor's and Master's Degrees in Food Science and Nutrition and has additional experience as a clinical dietician.

Dr. Jonathan Fialkow:

Welcome to the podcast, Lucette.

Lucette Talamas:

Thank you. Great to be here.

Dr. Jonathan Fialkow:

So Lucette, we know that during the COVID-19 pandemic, there's been a lot of uncertainty, and people try to control that uncertainty in any way they can. And there's a lot of stuff out there, both written and people's perceptions, regarding the role of nutrition in helping their immune system.

Dr. Jonathan Fialkow:

So first, does our nutrition really impact our immune system? Does what we eat make a difference in our ability to fight off viruses and bacteria?

Lucette Talamas:

Yes, definitely. What we eat makes a difference, not just with our immune system. Often we isolate the systems, right? We're just looking at the immune system, but what we eat affects all of our systems, including our immune system.

Lucette Talamas:

So there is a suggestion that when we have vitamin and mineral deficiencies, that can weaken the body's ability to fight infection.

Dr. Jonathan Fialkow:

So certainly, we know a bad diet, how we're able to define that, can be negatively impactful on our health, and there's certainly concerns regarding whether it be diabetes or high blood pressure and heart disease and even cancers.

Dr. Jonathan Fialkow:

But when we're talking about kind of the stuff that a good diet can do to help, what again, can it do? So let's start with, again, going back to that concept. Can we eat our way out of a bad lifestyle? What can't we expect if we eat healthier, or eat properly balanced nutrition?

Lucette Talamas:

Right. We definitely can't eat our way out of an unhealthy lifestyle and there's definitely no magic bullet either. There's no substitution for what a healthy diet can do. So that can also lead into the conversation about supplements.

Lucette Talamas:

At the end of the day, we definitely want a food first approach, which is trying to work on building that healthy dietary pattern. So that pattern is not restrictive. I like to say there's more of the good stuff and less of the other stuff.

Dr. Jonathan Fialkow:

That's actually a good comment. And even when I speak to my patients about nutrition, people tend to concentrate on the good stuff they eat and that's fine, but if you're eating a lot of the bad stuff too, that's not going to mitigate the consequences of the good stuff. So I appreciate that.

Dr. Jonathan Fialkow:

So let's get down and dirty to a couple of specifics now, because we want to be careful... Again, diet is important. Proper nutrition for a good immune system is important, but you can't be a three-pack a day smoker and then take a supplement and say, "Now I'm really healthy."

Dr. Jonathan Fialkow:

So let's talk about what a good diet can do. Let's talk a little bit about vitamins, minerals, antioxidants, phytochemicals. These are all terms that have been thrown out there regarding potential health benefits of certain foods. What is the benefit of these various nutrients on our immune system?

Lucette Talamas:

Right. So all of these are big words that can be difficult to digest for some people. So we'll start with the words like phytochemicals and phytonutrients. So they're essentially the same word. Phyto means plants. So it's just nutrients that come from plants and antioxidants are one of those hundreds of compounds that come from plants that are known to literally help fight and protect our body by protecting ourselves from the damage of free radicals.

Lucette Talamas:

Now, free radicals are a normal by-product of all the chemical processes in our body that happen that's known as metabolism, right? And antioxidants, when they're supplied through their diet are there to combat. So it's a normal process that's happening.

Lucette Talamas:

Now, when it gets out of control with either too much oxidative stress or poor diet not contributing the antioxidants, the fighters, that's where we can see a disbalance that can lead to maybe some problems.

Dr. Jonathan Fialkow:

So again, going back to the original premise, our body has some metabolism. There are negative things that can happen in our body and certain balanced foods and healthy foods can help mitigate the negative consequences. Like you said, oxidative stress is not a good thing when it's overwhelming. It can lead to inflammation and various other things.

Dr. Jonathan Fialkow:

So are you advocating a plant-based diet? Are you advocating eat things in a natural forms? Are you eating... Is it about eat the rainbow or is all of these things?

Dr. Jonathan Fialkow:

How would you basically... You made some comments regarding a well-balanced diet. Let's talk about what you would generally recommend people concentrate on when it comes to proper nutrition.

Lucette Talamas:

Yes. So a healthy dietary pattern is definitely a plant-based pattern. Now there tends to be confusion of what the term plant-based means. And the thing is there's actually no formal definition in literature.

Lucette Talamas:

Plant-based is a spectrum of different dietary patterns from vegan to vegetarianism all the way to the other side of the spectrum, which is actually the Mediterranean diet pattern.

Lucette Talamas:

So we know the Mediterranean dietary pattern includes lots of plant-based nuts, seeds, fruits, and veggies, whole grains. And then you start to see the animal, the seafood, more like the topping off of your dishes versus as instead of the main course.

Lucette Talamas:

So that's the spectrum of plant-based diets. Usually we can find somewhere in the spectrum for people to start taking those baby steps. You can start with adding more vegetables to some meals, starting to change the proportions of animal versus plants on their plates to truly reflect more of a Mediterranean dietary pattern.

Dr. Jonathan Fialkow:

So before we get again, to some details, let's talk about the concept of processed foods and maybe more importantly, ultra processed foods and how we've taken foods in a natural form and done something to them and how our bodies react negatively to that. Can you speak a little bit to those concepts?

Lucette Talamas:

Yes. So foods can come in different amounts of processing and there's a spectrum of how processed these foods are. So there's foods that can be processed very simply such as some of our vegetables that are already pre-cut and washed. And then maybe some of them are more processed and they are canned, and they're exposed to some heat and maybe even some preservatives.

Lucette Talamas:

Now, ultra processed foods on the spectrum, it lies far from these fresh cut vegetables that are lightly processed, but the ultra processed foods are the ones that we're really concerned about for our health, and the ones that we want to keep an eye on and see how much we're eating and reduce our intake of them.

Lucette Talamas:

The ultra processed foods are usually the ones that are on shelves and they last for a long time. They're usually higher in added sugars and also different types of oils that are usually not as good for our health because they tend to be hydrogenated oils, which are a source of saturated fat, which we know is not good for our health either.

Dr. Jonathan Fialkow:

So I've heard it said that people should shop the periphery of the supermarkets, meaning don't go down the aisles where you have all your processed and unprocessed foods. And if you get food in the most natural form, of course, you're going to be more likely to avoid health-related concerns from nutrition. So I think that's great information.

Dr. Jonathan Fialkow:

So we talked about some bad things, especially in the form of ultra processed and less natural type forms of food. Let's talk about the good stuff. When we're talking about various nutrients, and you mentioned before phytochemicals and antioxidants, big words.

Dr. Jonathan Fialkow:

What about things like, let's go through a couple. Beta carotene. What is beta carotene? Why is it good for us and where can people find it?

Lucette Talamas:

Yeah. So when we talk about the good stuff, before we talk about the detail. A very simple recommendation is to eat the rainbow, which just means eat fruits and vegetables, especially on different colors.

Lucette Talamas:

So beta carotene, for example, that's one of the natural pigments that actually reflects... It's actually a vitamin as well, beta carotene or antioxidant as well.

Lucette Talamas:

It's associated with our deep orange, deep yellow fruits and vegetables. Now, if you just follow the eat the rainbow and choose different colored fruits and vegetables, you'll be getting a mixture of vitamins, minerals, antioxidants, and phytonutrients from all of these plant-based pigments.

Lucette Talamas:

So beta carotene, like I said, it's an antioxidant, it's a precursor to vitamin A. Specifically for our immune health, it's really important as well. It has a role in enhancing our immune function, especially if you're not getting enough, for example, beta carotene or vitamin A. If you have insufficient or deficient levels, that's where we start to see your immune system maybe not working as well.

Dr. Jonathan Fialkow:

Some of the other things that we see again, a lot of patients coming in taking vitamin D, vitamin C. Maybe you could talk about the zinc a little bit, especially in the COVID environment.

Dr. Jonathan Fialkow:

I think your point though is well said, which is not to concentrate on a micronutrient, a particular vitamin, but eat foods that are rich in these generally helpful nutrients and minerals and vitamins and you'll be good to go, like eat the rainbow, as you said.

Dr. Jonathan Fialkow:

So just a couple of things. Vitamin D, vitamin C, zinc... Just mention those quickly because again, I think these are the more common supplements, if you will, that I see people taking and coming into my practice on.

Lucette Talamas:

Right. So these are all important vitamins for our overall health and also our immune function. Now the first line of approach would be to make sure if you can get them in your diet before we talk about supplements, because when we mass dose on any one of these, well, I can talk a little more specifics about each of them.

Lucette Talamas:

We never want to mega dose, especially without the consent of a physician. Just because it's good for you in one amount, doesn't mean that a mega dose will be good for you. So for example, in the case of zinc, we just want to make sure you're meeting the RDA, the recommended dietary allowance.

Lucette Talamas:

You know, if you're having trouble meeting that through the diet, that's where you can look at a supplement but just to put some numbers to it because people, sometimes the numbers work.

Lucette Talamas:

So your RDA is for men 11 milligrams, for women, eight milligrams per day for zinc. The upper limit is what we want to be mindful of. We don't want to pass the upper limit unless there's advice from a physician and under medical supervision to supplement above upper limits.

Lucette Talamas:

The upper limit for zinc is 40 milligrams. This one's really interesting because in the case of zinc supplementing and taking 150 or up to 450 milligrams of zinc per day can actually reduce your immune function.

Lucette Talamas:

So that's why, especially in this era of the pandemic, we've been hearing about specific micronutrients to support the immune system, which it's great we're putting this attention to nutrition, but the question is, can we get this through the diet? And if you're supplementing, are you getting just the right amount and not overdoing it?

Dr. Jonathan Fialkow:

So, we brought up a few specific types of vitamins and minerals. Specifically talk to me about vitamin C... It's widely taken, a lot of thoughts as to health benefits. What would you tell people about the benefits of vitamin C, both in its natural form and as a supplement?

Lucette Talamas:

Yeah. So vitamin C, whether it comes from food or supplements, tends to be one of the most common vitamins that gets all the attention when it comes to nutrition and immunity. As we've been talking about, what's more important to maintain a healthy immune system is focusing on your overall diet, choosing plenty of fruits and vegetables.

Lucette Talamas:

Now, plenty of fruits and vegetables also contains different amounts of vitamin C. Citrus foods like oranges and lemons tend to have the highest amounts of vitamin C, but so do strawberries and bell peppers and even broccoli. So by choosing your fruits and your vegetables as part of your daily healthy diet, you are getting enough vitamin C through your diet.

Lucette Talamas:

Now, again, as soon as someone starts maybe sneezing, there tends to be a tendency to go towards supplementing with vitamin C. And it's usually not as necessary, especially when you're getting it from your diet. But these mass doses of vitamin C are not necessarily always the answer to necessarily boosting your immune system.

Lucette Talamas:

So often, again, it tends to get a lot of attention, but vitamin C is not the only player here when it comes to nutrition and immune health. It's all of our other vitamins and minerals, too.

Dr. Jonathan Fialkow:

I agree with that. And the other thing I would caution and I'm speaking with my cardiometabolic role, is an orange may contain vitamin C as could other fruits and vegetables, but orange juice also contains a lot of sugar. So try to get your vitamins again, in the most natural form. I said, "It's an orange tree. There's no orange juice tree."

Dr. Jonathan Fialkow:

So keep in mind also other things that might be in the form of nutrition you're getting when you're looking for something with a benefit.

Lucette Talamas:

So eat your orange for sure instead of drinking the juice.

Dr. Jonathan Fialkow:

Well, I think actually I'm going to pause a little bit and I really want to emphasize this and maybe get into this a little more deeply because we try to expose the listeners to a couple of things they hear and articulate them. But the reality is our diet, especially if we eat a balanced diet and it's hard to be really nutritionally deficient from a vitamin standpoint in the United States, that we're able to get the regular needs of our body for these vitamins and minerals.

Dr. Jonathan Fialkow:

So thinking that something's good for me, so taking more of it is really good for me, is kind of the mindset behind the supplement industry. And it's really not validated by science. There really is not any kind of really good medical study saying taking extra of these minerals and supplements will provide some kind of benefit. I and others call it magical thinking.

Dr. Jonathan Fialkow:

So I do want to make sure that the listeners understand. You're advocating a helpful, balanced diet, eat the rainbow, as you say, and getting these essential nutrients, vitamins and minerals that way, not necessarily eating poorly or eating a diet and take extra by these pills.

Dr. Jonathan Fialkow:

Thinking that a little is okay, so a lot is better is a fallacy. Is that a fair statement? Does that go along with your thinking?

Lucette Talamas:

Yes. That's exactly a great conclusion to what I've been saying. Yeah.

Dr. Jonathan Fialkow:

Okay, there we go. So again, we're not advocating supplements. We're explaining what the concepts behind some of them are, but eat that balanced diet, eat that rainbow, avoid the ultra processed foods, and hopefully you'll be okay.

Dr. Jonathan Fialkow:

So a couple of other things that I think are worth exploring, given your expertise. Probiotics... I mean, a lot of stuff going on with a microbiome where synergistic relationship with the billions of bacteria in our intestines, the food we gets digested, the metabolism, we absorb it.

Dr. Jonathan Fialkow:

Speak a little bit about the concept of probiotics where you, in your clinical role, might use or debunk the concept of probiotics. So what are probiotics and where would we use them?

Lucette Talamas:

Right. So gut health is important for our overall health and also a healthy immune system. So when we refer to gut health, how can we assure that you have a healthy gut?

Lucette Talamas:

So the main way is by encouraging to eat foods that are rich in probiotics. So probiotics are actually healthy bacteria that live in our gut, and they do a whole bunch of wonderful stuff for our overall health, not just maintain a healthy digestive track.

Lucette Talamas:

So probiotics are found in fermented foods, the most common and easy fermented food there is, is probably yogurt. But then there's other fermented foods, also cultural foods that that can be fermented, and all of these can be sources of probiotics.

Lucette Talamas:

Now, the healthy bacteria, which are the probiotics, they feed off of prebiotics. So that's the difference between the probiotic and the prebiotics. Prebiotics are found in our fiber rich foods, especially our whole grains, fruits, and vegetables. And it's a certain type of fiber that actually feeds the probiotic and helps keep them healthy.

Dr. Jonathan Fialkow:

I know that there's things like sauerkraut and kimchi and other type of fermented foods. Those would be considered in that category of helpful foods as well for gut health?

Lucette Talamas:

Right? Yeah. So sauerkraut, kimchi, tempe is also fermented soy. So any fermented food, fermented dairy are great sources of probiotics. You don't need to buy a special brand of yogurt, for example. All yogurts have probiotics.

Dr. Jonathan Fialkow:

But having said that, and I've used this actually as a slide in a presentation I gave about how the food industry fools. A Greek plain yogurt, very healthy, very low in sugars, but you can get a processed yogurt with fruit in it, and that could be dessert, right? That could be poison. So when you talk about yogurt, you're talking about a plain, arguably Greek yogurt. Is that fair to say?

Lucette Talamas:

Definitely. Definitely. So if possible to buy plain yogurt because that way it's free of added sugars and yes, there could be a lot of marketing tied to certain brands that may have more probiotics, for example. But at the end of the day, in order for it to be yogurt, it has to be fermented. So all yogurts have probiotics and the plain Greek would a great choice.

Dr. Jonathan Fialkow:

As I say, go back to eating healthy foods, natural form. I would tell my patients if the food makes a health claim, run away from it. You're eating food for the balanced, nutritional benefit and the energy.

Dr. Jonathan Fialkow:

So a couple of other things. So we did talk about a little bit, we touched on... But going back to vitamins and supplements and the concept of taking something extra to provide health, is it generally your recommendation to avoid them, or are there scenarios where you might tell someone you're evaluating or a patient that, "Hey, listen, this is a circumstance where you might benefit from this."

Lucette Talamas:

Definitely food first approach, inserting cases with supplements. So there are certain populations that will benefit from supplements, such as prenatals for pregnant women, right? People that have the recommendation from their physicians to take calcium for osteopenia, osteoporosis. So there are some cases where it's physician recommended at that point for meeting a health goal, right?

Lucette Talamas:

But for the general population, that's just buying the supplements over the counter because a friend or social media, or they saw something on the news about a certain nutrient or vitamin or mineral is good for our health. And then instead of interpreting that as, "I should eat more foods from that category," right? They go buy the supplement. That's something we definitely want to pump the brakes on and ask yourself, "Why are you buying that supplement?"

Lucette Talamas:

So definitely a food first approach when it comes to dietary supplements. There's a lot of concerns, I can say with the dietary supplement industry, that people should know about. It's unregulated, so these supplements are not going through FDA approval before they hit the shelves.

Lucette Talamas:

That means that they're innocent until proven guilty. So don't assume that just because it's sold in a pharmacy or sold on a shelf, that they are "safe to take."

Dr. Jonathan Fialkow:

That's an incredible point. I mean, the FDA is a safety organization that does not regulate things that are considered supplements unless they hurt someone. I mean, you and I, in my backyard could concoct something in a bowl and put it in a little capsule and sell it, and it's perfectly legal unless it starts killing someone; unlike pharmaceutical industry, which is highly regulated from a safety standpoint. So people don't know what they're getting in the supplements, which is very valid.

Dr. Jonathan Fialkow:

A couple of final points if we could. So going back to COVID, we've seen that a lot of the patients who get COVID or have a worse experience, there's an age component, but there's also an obesity component and might relate to some kind of underlying inflammation.

Dr. Jonathan Fialkow:

Are you seeing in the literature or do you read any particular dietary trends that might determine who's at a higher risk for a bad COVID outcome, or is it just general health and general nutrition and general weight? Are you seeing any particular components of a diet that might place someone at an increased risk?

Lucette Talamas:

Right. When it comes to COVID, I think we're in the midst of all the research and still learning, but obesity has been identified as a key area of potential risk and maybe more of the negative side effects from COVID.

Lucette Talamas:

I think when it comes to obesity, there could be an assumption that because someone is overweight or obese that they are nourished, but I think one thing I've consistently seen and read about is that just because you're overweight or obese does not mean you are necessarily well nourished. You could definitely not be getting enough high quality nutritious foods in your diet. So there could be vitamin and mineral insufficiency and deficiencies in the state of obesity.

Lucette Talamas:

So it's more of the malnourishment components, whether the person is overweight or not overweight, malnourishment it's usually on the inside, it's not just on the outside that we see it. So that would be the risk.

Dr. Jonathan Fialkow:

Another great concept. I mean, obesity is the abnormal deposition of energy in a form of fat that you're storing. It's fat that you're storing. Not necessarily dietary fat, that's a whole nother conversation, but it doesn't mean that you're absolutely well balanced in your vitamins and other nutrients.

Dr. Jonathan Fialkow:

So again, final points would be stick with that. I like that food first philosophy, not looking for other external sources of particular micronutrients and vitamins and minerals. Eat that healthy diet, eat the rainbow, eat the colors of the rainbow in the forms of vegetables and vital foods that have good health benefits.

Dr. Jonathan Fialkow:

What else can you tell us in final comments? What efforts are out there for you and others to help the community learn more about nutrition, very complicated, lots of wrong information out there. Lots of industry-led information that might not be always accurate. What links or other resources would you recommend to listeners to really get true information about nutrition?

Lucette Talamas:

Right. So Baptist Health has the Community Health Department, which is where I work in and we provide free health and nutrition classes. So currently we have gone virtual. So all of our health and nutrition classes are virtual.

Lucette Talamas:

I encourage people if they would like to learn more about the nutrition, always make sure your information is coming from someone that's qualified, such as a registered dietician when it comes to the world of nutrition.

Lucette Talamas:

I'll speak more about nutrition through these virtual classes. You can check out our website, so events.baptisthealth.net, or you can also email programs, which is plural, programs@baptisthealth.net if you'd like to be added to our email Listserv to receive the updates of our virtual classes.

Dr. Jonathan Fialkow:

That's great, and we'll have those links in the podcast notes. Any final comments, any final thoughts, anything you want to emphasize that we addressed or anything we missed?

Lucette Talamas:

So thanks again for having me here and keep it a simple food first approach. Eat your fruits and your vegetables. Choose less processed foods. I love how you pointed that out in the beginning of this podcast and just taking step at a time, right? So one step towards that healthy dietary pattern to support, not just our immune system, but our overall health.

Dr. Jonathan Fialkow:

Great. Eat the periphery of the supermarket, stay away from the aisles. That's the simple one. So this is great.

Dr. Jonathan Fialkow:

To our listeners, as we wrap up this episode, we encourage you all to please take a moment to give this podcast a five star rating on whichever platform you're listening to us on. And if you have any comments or suggestions for future topics, you can please email us at BaptistHealthTalk@baptisthealth.net. That's BaptistHealthTalk@baptisthealth.net. We'd love to hear from you.

Dr. Jonathan Fialkow:

Thanks for listening. Until next time, stay safe and mask up.

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