Nutrition

5 Immune Boosting Nutrients your Kids Need Today

November 25, 2020

I’m Dr. Lindsay
I'm a naturopathic pediatrician based in Colorado Springs offering primary care, chronic care & telemedicine appointments. I'm so glad you're here!
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After several months of being cooped up in the house, many of us are planning to brave the airports and highways this holiday season. Before you pack your bags, take a quick trip to your nearest health foods store and pick up a few extra things that just might salvage your holidays if someone falls ill.

It’s normal to get sick

Did you know it’s considered normal for children to be sick 6 times per year? That’s every eight weeks! That can really take a toll on your routine, not to mention the effect it has on your child to miss out on play dates, school, and sports events.

Getting sick this often doesn’t automatically mean your child has a poor immune system. On the contrary, this is a natural process of training the immune system through exposure. The name of the game is prevention, not avoidance. I’ll explain the difference.

Avoiding exposure to germs means our children won’t have the opportunity to gain immunity. The immune system learns how to respond to a virus by first being exposed to it, then building a healthy immune response follows. We should want our children to have a trained immune system.

Prevent prolonged infection

What we want to prevent is prolonged infection, severe symptoms, and residual damage. Let me give you some clarity around what this means. When your child gets the flu, you should expect them to have a fever, congestion, and aching. However, the fever should break and their symptoms should clear up after a couple of days. We should not see them become severely dehydrated, or have their congestion progress to their lungs and develop pneumonia. And we certainly do not want to see them develop post infectious symptoms like tics, tremors, or cardiovascular damage. Yes, these things can happen with certain infections, but they can be avoided if our children have a flourishing immune system.

How to build a strong immune system

The building blocks of a healthy immune system are the same pieces that make up a strong foundation of health: diet, exercise, sleep, and lifestyle. The diet is especially important. This is where our children get the vitamins and minerals – micronutrients – that do the heavy lifting when they’re exposed to a pathogen.

Children only require small doses of micronutrients to fulfill their needs, but deficiency is still extremely common. A growing number of infants and preschoolers have multiple micronutrient deficiencies. I have been a witness to this in my clinical practice through specialized nutrient testing. In addition, children under age 5 are more likely to develop bronchitis and pneumonia than any other age group. Of the long list of essential micronutrients, there are a few key players that pack the most punch against infection.

Vitamin C

Vitamin C is an essential micronutrient that we have come to recognize as a go-to immune booster. It is a potent antioxidant and is also required to help our immune cells respond to invaders. In fact, evidence suggests that vitamin C is responsible for helping immune cells migrate to the site of infection.

During flu season, it’s important for cells to be saturated with vitamin C by taking in adequate amounts (40-200mg) on a daily basis. When infection occurs, the cells rapidly utilize vitamin C to manage inflammation. Therefore, higher doses, usually in grams, are required during infection to help the body respond appropriately.

Vitamin C is also shown to help replenish other antioxidants, such as glutathione and vitamin E, which are also depleted during infection. We should continue dosing with extra vitamin C for a period after the infection resolves, in order to replenish those depleted reserves.

Vitamin D3

We often associate vitamin D with healthy skin, and forget the benefits it has on the immune system. Studies show that a deficiency of the vitamin makes us more susceptible to upper respiratory infections – i.e. the common cold. As for the flu, school-aged kids are 42% less likely to be infected with Influenza A when given increased doses of Vitamin D.

Vitamin D acts on immune cells to increase anti-inflammatory action. When inflammation is under control, airways stay clear, which prevents mucus and other infectious fluid from settling into the lungs and leading to more severe illness like pneumonia. Plus, if infections progress to the lungs, children are at high risk for airway restriction. As their small passages become inflamed, it is more difficult to breathe, which can lead to a panicked trip to the emergency room. All of this may be preventable with something as simple as Vitamin D3.

The required dose varies based on the child. What you need is a simple blood test and a doctor you trust. Individuals with blood levels below 30 ng/mL are more likely to develop upper respiratory infections.3  The typical RDA for children is 400 IU daily; however, a child who is deficient may need higher doses.

Vitamin A

Often overlooked, vitamin A is among the most common micronutrient deficiencies worldwide. It is essential for building, repairing, and maintaining the most delicate tissues in the body. This is why we commonly recognize vitamin A, or beta carotene, as an essential nutrient for improving our vision and keeping our skin wrinkle-free.

However, there are other parts of the body that rely heavily on the vitamin. The intestines and respiratory system are lined with a thick mucous membrane that houses much of our immune activity.  This mucosal barrier relies on Vitamin A to keep it intact as it is constantly bombarded by things we eat and drink that break it down. We also know that Vitamin A has a direct role in the production of immunoglobulins, also known as antibodies. This explains why Vitamin A has been shown to be an effective treatment for pneumonia and hand, foot, and mouth disease. [, ]

During an active infection, we tend to lose more than normal amounts of vitamin A in the urine, so it becomes even more important to increase our intake when we’re sick. What’s more, vitamin A also plays a crucial role in the regulation of bone marrow activity, which is the production site of immune cells. Primary food sources of vitamin A include: liver, fish, carrots, broccoli, spinach and red bell peppers. The RDA for children is 1650 IU.

Zinc

Zinc deficiency is common in children because it is not stored in the body, and the foods containing high levels of the mineral are not high on kids’ favorite food list:

  • Pepitas (pumpkin seeds)
  • Lentils
  • Legumes
  • Beans
  • Whole grains

A lack of zinc has dire effects on the immune system. Antibodies rely on zinc in order to  recognize and clear pathogens as they are supposed to. Zinc is particularly important in detecting viruses. In fact, it’s quite an intelligent mineral, causing different reactions in the body depending on what virus it comes into contact with. For example, when dealing with the common cold, zinc reduces symptom severity, frequency, and duration. Compare to coronavirus, where zinc’s response is to act directly on the viral DNA to slow down replication. Zinc has also been proven to help the body fight pneumonia, influenza, herpes outbreaks, clearing warts, and reducing duration of hand, foot and mouth disease. Zinc supplementation of 10mg in children under age 1 and 20mg for children 1-10 has been shown to shorten severity and duration of pneumonia.

B12

Vitamin B-12, aka cobalamin, is a key player in producing immune cells that do the work of killing invaders. When a virus enters the body, it takes a healthy cell hostage, and uses the DNA replication tools within the cell to start replicating itself. As long as the virus is allowed to do this unchecked, more and more cells are taken hostage and the person becomes increasingly ill. Cobalamin helps produce cytotoxic cells, which essentially act as bouncers, seeking out the infected cells and killing them so the virus can’t continue to spread.

There are reports of a fatal COVID-19 case in a 13 month old girl who was malnourished, and deficient in vitamin B-12. According to the report, she did not have pre-existing conditions, and did not have a known COVID-19 exposure. Health professionals concluded that further research is warranted to investigate whether B-12 deficiency increases risk for contracting COVID-19.

Our bodies also rely on B-12 in order to effectively absorb and utilize other essential micronutrients, like the ones listed in this article. The very absence of B12 can lead to multiple micronutrient deficiencies. The RDA of B12 is 0.4-2.4 mcg daily for children and 2.4 mcg for adults. Most children consume an adequate amount by eating meat, poultry, eggs, and dairy products. Because cobalamin is water soluble, any excess supplementation will leave the body through urine, so overdosing is not as much of a concern as literally flushing your money down the toilet. However, it would be best to consult your physician before supplementing, as B-12 may interact with certain medications.

When supplementation is necessary 

While supplementation should not be the first resort, sometimes it is necessary to supplement for a period of time to replenish a depleted body. Our environment is full of insults that place heavy demand on our immune system, causing our nutrient stores to be used up more rapidly than we can restore them. Eating a healthy diet consisting of large quantities of colorful vegetables, nuts, seeds, and legumes helps to ensure that we are getting the micronutrients our body requires; however, many of us do not eat this way on a consistent basis. It is especially difficult to get our children to eat this way.

You might be wondering if children are really as deficient as adults. In my practice, I have observed that even infants can show surprising signs of nutrient deficiency. Digestive symptoms of constipation or diarrhea are common in infants, and both suggest malabsorption of nutrients. Skin irritations like eczema and dermatitis can be signs of gut damage, which also means immune system damage. Diaper rash, yeast infection, and urinary tract infections are common in young children and are all suggestive of immune imbalances. I have even seen toddlers develop arthritis, which is an autoimmune condition caused by immune system damage. The takeaway message is that these vital nutrients play a crucial role in overall health and wellbeing.

Other honorable mentions include: vitamin E, folate, iron, selenium, glutathione.

References:

  1. Bailey, R.; West, K.J.; Black, R. The epidemiology of global micronutrient deficiencies. Ann. Nutr. Metab. 2015, 66, 22–33.
  2. Gombart, A.F.; Pierre, A.; Maggini, S. A review of micronutrients and the immune system–working in harmony to reduce the risk of infection. Nutrients 2020, 12, 236. [Google Scholar] [CrossRef]
  3. Carr, A.C.; Maggini, S. Vitamin C and immune function. Nutrients 2017, 9, 1211.
  4.  Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey.
  5.  Martineau, A.R.; Jolliffe, D.A.; Hooper, R.L.; Greenberg, L.; Aloia, J.F.; Bergman, P.; Dubnov-Raz, G.; Esposito, S.; Ganmaa, D.; Ginde, A.A.; et al. Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data. BMJ 2017, 356, i6583. [Google Scholar] [CrossRef]
  6.  World Health Organization. Food and Agricultural Organization of the United Nations. Part I. The role of food fortification in the control of micronutrient malnutrition. In Guidelines on Food Fortification with Micronutrients; Allen, L., de Benoist, B., Dary, O., Hurrell, R., Eds.; World Health Organization: Geneva, Switzerland, 2006.
  7.  Mccullough, F.S.; Northropclewes, C.A.; Thurnham, D.I. The effect of vitamin A on epithelial integrity. Proc. Nutr. Soc. 1999, 58, 289.
  8.  Ghodratizadeh, S.; Kanbak, G.; Beyramzadeh, M.; Dikmen, Z.G.; Memarzadeh, S.; Habibian, R. Effect of carotenoid β-cryptoxanthin on cellular and humoral immune response in rabbit. Vet. Res. Commun. 2014, 38, 59–62.
  9.  Nan, H.U.; Qu-Bei, L.I.; Zou, S.Y. Effect of vitamin A as an adjuvant therapy for pneumonia in children: A meta analysis. Chin. J. Contemp. Pediatr. 2018, 20, 146–153.
  10.  Chen, S.; Yang, Y.; Yan, X.; Chen, J.; Yu, H.; Wang, W. Influence of vitamin A status on the antiviral immunity of children with hand, foot and mouth disease. Clin. Nutr. 2012, 31, 543–548.
  11. Kuwata, T.; Wang, I.M.; Tamura, T.; Ponnamperuma, R.M.; Levine, R.; Holmes, K.L.; Morse, H.C.; De Luca, L.M.; Ozato, K. Vitamin A deficiency in mice causes a systemic expansion of myeloid cells. Blood 2000, 95, 3349.
  12.  Beare-Rogers, J.L. Recommended Nutrient Intakes for Canadians. Dept. Natl. Health Welf. 1983, 48–50.
  13.  Micronutrient Information Center. Immunity in Depth. Available online: http://lpi.oregonstate.edu/mic/health-disease/immunity (accessed on 13 October 2020)
  14.  Zinc Supplementation Promotes a Th1 Response and Improves Clinical Symptoms in Fewer Hours in Children With Pneumonia Younger Than 5 Years Old. A Randomized Controlled Clinical Trial. Frontiers in Pediatrics. VOL 7. 2019. Pg 431. 10.3389/fped.2019.00431
  15.  Scott A Read, Stephanie Obeid, Chantelle Ahlenstiel, Golo Ahlenstiel, The Role of Zinc in Antiviral Immunity, Advances in Nutrition, Volume 10, Issue 4, July 2019, Pages 696–710, https://doi.org/10.1093/advances/nmz013
  16.  Maggini S, Maldonado P, Cardim P, Fernandez Newball C, Sota Latino ER (2017) Vitamins C, D and Zinc: Synergistic Roles in Immune Function and Infections. Vitam Miner 6: 167. doi:10.4172/2376-1318.1000167
  17.  Acevedo-Murillo Jorge Alberto, García León Miguel Leonardo, Firo-Reyes Verónica, Santiago-Cordova Jorge Luis, Gonzalez-Rodriguez Alejandra Pamela, Wong-Chew Rosa María
  18.  Wishart, K. (2017). Increased micronutrient requirements during physiologically demanding situations: Review of the current evidence. Vitamin. Miner, 6, 1-16.
  19.  Kulkarni, R.K., Kinikar, A.A. & Jadhav, T. Fatal Covid-19 in a Malnourished Child with Megaloblastic Anemia. Indian J Pediatr 87, 757–758 (2020). https://doi.org/10.1007/s12098-020-03408-7
  20. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy Press, 1998.
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