Flu and Nutrition: Dr. Fuhrman Responds to Comments

Dr. Fuhrman's recommendations to families to avoid flu, including avian flu, stirred some interesting comments--especially the idea that those with the healthiest immune systems may be less protected from avian flu than those with average immune systems. Dr. Fuhrman responds:

Clearly, the concept that powerful and competent host defenses are enabled by nutritional excellence is not merely my opinion; rather it is the reality of human physiology supported by hundreds of scientific studies.

And because I have written books on nutrition to teach applied nutritional excellence does not make my viewpoints any more or less substantiated. However, keep in mind my books contain hundreds of references for all my points and likewise my opinions expressed here are not off the cuff but reflect a lifetime of devoted study to these issues.

The idea that a person eating a nutrient-rich diet is just as likely to develop and suffer the dangerous consequences from an influenza virus as a cheese burgers and soda eating American is simply wrong. Moe importantly such opinions are dangerous as they may lead to tragic outcomes for those mistaking authority for knowledge.

Let's review just a few articles from the scientific literature that further support this concept that nutritional.excellence can offer protection from viral attacks. I will show the reference and post some explanatory comments below each reference.

1. Bendich A. Antioxidant nutrients and immune functions--introduction Adv Exp Med Biol 1990;262:1-12
This short introduction encompasses only a small portion of the literature linking free radical production and consequent effects on immune functions. The role of essential dietary components in modulating these effects is an area of intense and expanding investigation. Each of the nutrients examined in the chapters has distinct functions to support immuno-competency, but in this volume they concentrate on their shared capacity to act as antioxidants

2. Fawzi W. Nutritional factors and vertical transmission of HIV-1. Epidemiology and potential mechanisms. Ann N Y Acad Sci 2000 Nov;918:99-114
This article shows that the transmission of the AIDS virus is significantly reduced and even made improbable when the host's nutrition is excellent.

3. Beck MA; Levander OA Dietary oxidative stress and the potentiation of viral infection. Annu Rev Nutr 1998;18:93-116. Beck MA Antioxidants and viral infections: host immune response and viral pathogenicity. J Am Coll Nutr 2001 Oct;20(5 Suppl):384S-388S; discussion 396S-397S. Beck MA; Levander OA; Handy J Selenium deficiency and viral infection. J Nutr 2003 May;133(5 Suppl 1):1463S-7S. Rayman MP; The argument for increasing selenium intake Proc Nutr Soc 2002 May;61(2):203-15
These articles above review the literature and studies showing nutritional deficiencies lead to more serious infections. They contain the interesting science that describes how a diet low in anti-oxidents and phytochemicals can enable genetic sequences in the pathogen to alter allowing more serious outcome. Oxidative stress is implicated in the pathogenesis of several viral infections, including hepatitis, influenza, and AIDS. Dietary oxidative stress due to either various nutritional deficiencies such as selenium or vitamin E increases cardiac damage in mice infected with a myocarditic strain of coxsackievirus B3. Poor diet allows a normally benign (i.e., amyocarditic) coxsackievirus B3 to convert to virulence and cause heart damage. These findings were then documented to occur in humans too. It was found that cardiomyapathy as well as viral induced neuropathy have a dual etiology involving a nutritional deficiency along with a enterovirus that now can create a serious outcome, not permitted in a more nutritionally adequate host. More recently research has shown that the influenza virus also exhibits increased virulence in a nutritional deficient host allowing multiple changes in the viral genome. Interestingly, the influenza virus causes more serious lung pathology and HIV infection progresses more rapidly to AIDS in the micronutrient poor host. Although it has been known for many years that poor nutrition can affect host response to infection, the finding that host nutrition affects the genetic sequence of a pathogen is an important field of future investigations.

4. Levander OA. Nutrition and newly emerging viral diseases: an overview. J Nutr 1997 May;127(5 Suppl):948S-950S. Amati L; Cirimele D; Pugliese V; Covelli V; Resta F; Jirillo E Nutrition and immunity: laboratory and clinical aspects. Curr Pharm Des 2003;9(24):1924-31 Irshad M; Chaudhuri PS Oxidant-antioxidant system: role and significance in human body. Indian J Exp Biol 2002 Nov;40(11):1233-9
Malnutrition has long been associated with increased susceptibility to infectious disease due to an impaired immune response. Now more data has emerged to substantiate the view that oxidants, anti-oxidants and nutritional factors have dramatic positive effect on host recovery, response, resistance and also to protect the virus from mutating into a more dangerous forms. When discussing interactions of nutrition and infection, nutritionists have traditionally considered only the effects of diet on the host. Recent data, however, indicate that host nutrition can influence the genetic make-up of the pathogen and thereby alter its virulence. These symposiums and articles were designed to alert the community of nutritional scientists to this discovery and possible implications for the improvement is public health.

When derived of anti-oxidant nutrients viral infections can cause serious even fatal diseases, that don't occur when deficiency is not present. Immunity when optimized can ward off infection and when infected is more likely to have harmless outcome. It is well known that inappropriate nutrient intake accounts for the maintenance of the immunological equilibrium, in humans and animals. Vitamins, elements, lipids, proteins. phytonutrients, and nucleic acids play an important role in the regulation of cellular and humoral immune responses since single or multiple deficits of these food components have been shown to cause immune abnormalities.

5. Reid AH; Taubenberger JK; Fanning TG. The 1918 Spanish influenza: integrating history and biology. Microbes Infect 2001 Jan;3(1):81-7. Afkhami A Compromised constitutions: the Iranian experience with the 1918 influenza pandemic. Bull Hist Med 2003 Summer;77(2):367-92
The global demographic impact of the 1918-19 influenza pandemic continues to fascinate researchers and scholars. These papers examine the social and demographic effects of this outbreak on society, through a comprehensive investigation of the modes of transmission and propagation, mortality rates, and other distinctive features of various regions, and reveals the importance of taking a country's unique settings into account. For example, Iran was one of the regions hit hardest by the pandemic, with mortality rates significantly higher than in most regions of the world. Contrary to the prevailing notion that the 1918 influenza targeted the young and healthy, this paper suggests that famine, opium, malaria, and anemia were fundamentally responsible for the high mortality in Iran. Clearly those with compromised immunity suffered the most damage.

The touted concept that the pandemic flu of 1918 target the "young and healthy" is not quite accurate. First of all, like today the diet in Western Europe in those days was largely meat, bread, potato, lard, butter and cheese with minimal fresh produce. The so-called, "young and healthy" back then, like today could not be used as an example of those eating a diet to assure nutritional adequacy. The diets of yore were grossly deficient. Today most industrialized nations eat less than five percent of total calories from fresh produce: fruit, vegetables, seeds, nuts and beans. In spite of the fact that we have new science pointing to the impressive disease protection against heart disease, strokes, dementia, cancer and yes, serous infections, our society still consumes a diet assuring nutritional compromise and tragic medical outcomes..

Those of you naysayers who would like to stay on your chicken and pasta "low fat diet" or your cheeseburger and cokes with your heads buried deeply in the French fries, I say that is your prerogative. As for me, I will use and apply the science of today that shows the protection offered by cruciferous vegetables, raw vegetables and fruits, nuts and seeds and beans to give myself, my family and my patients the greatest potential to live a live a long, healthy life. This is not alternative medicine, it is good medicine.

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Comments (8) Read through and enter the discussion with the form at the end
Joe Murphy - November 11, 2005 10:10 AM

Given that H5N1, much like H1N1 in 1918 appears to kill via overwhelming immune system response, and therefore disproportionally is likely to kill those with the strongest immune systems, how does boosting your immune system protect you?


> *************************
> Bird flu causes fatal immune storm
> - study
> Reuters Nov. 11, 2005
> *************************
> Scientists in Hong Kong have found
> that the H5N1 virus apparently
> causes a "storm" of immune system
> chemicals that overwhelms the
> patient. The H5N1 virus caused
> proteins known as cytokines to rush
> to infected lung tissue -- evidence
> of a so-called cytokine storm, an
> immune system overreaction that can
> be fatal. The finding may mean the
> virus...
> http://www.kurzweilai.net/email/newsRedirect.html?newsID=5018&m=11940

Henry Abbott - November 11, 2005 10:21 AM


Can you point me to an expert who recommends preparing to fight the flu by depleting your immune system with poor nutrition? Because that seems to be what you're recommending, and it's certainly not a common line of reasoning among the experts I have seen quoted.

Joe Murphy - November 15, 2005 9:48 AM

That's not what I meant, my point is that there is no evidence that boosting ones own immune system will help them fight off H5N1. If you look at the 1918 strain, those with the strongest immune systems were the ones most likely to die.

I don't want to give false hope to individuals that there are easy ways to avoid the horrors of an H5N1 pandemic. This is a truly serious issue, and vitamins and nutritional supplements aren't going to fix it.

Henry Abbott - November 15, 2005 2:00 PM

Joe--Dr. Fuhrman already addressed your "those with the strongest immune systems point," and let me add that no one is making the case that vitamins and supplements are all that's necessary, and it's reckless of you to say so. (Dr. Fuhrman's advice to prevent flu is here: http://tinyurl.com/advul)

With a tip of the hat to MedPundit (http://tinyurl.com/8w692) for making me aware of it, I direct anyone who's interested in learning more about the bird flu to read this Weekly Standard article by Michael Fumento: http://tinyurl.com/7g5uv.

Yes, he's a little smarmy--so I'm sure almost everyone (even Dr. Fuhrman) could find something to disagree with. But credit Mr. Fumento with some valuable information-gathering and perspective.

For instance, it seems many of the deaths from the 1918 epidemic were from secondary infections (he cites this source at Stanford: http://tinyurl.com/7v7dv), which we now can treat much better than they could in 1918.

Another important factor: Fumento reports that the H5N1 virus has been around since the 1970s--when it was infecting Scottish poultry--and has yet to mutate to become devestating to humans. (In the 1980s a similar virus was in Pennsylvania's chickens.)

1992 blood tests showed that at that time millions of Chinese had already been infected with the virus, without any reported human outbreak of the disease.

And he also says this, which sounds familiar:
"Washing your hands frequently with soap and hot water (or better yet, with alcohol) probably helps, as may keeping your immune system strong with a good diet and enough sleep. And for goodness' sake, don't shake hands with people who sneeze into their own. In other words, practice ordinary good hygiene."

It's well worth a read. Here's the link again: http://tinyurl.com/7g5uv.

Elijah - November 6, 2006 11:16 PM

Just because you are age 20 something DOES NOT mean you have a strong immune system. I know a ton of 20 year olds who are sick on what seems like a monthly basis. Allergies included.

John Gilpin - November 13, 2006 8:45 PM

The missing factor in this discussion is the role of vitamin D. It not only acts to strongly increase the effectiveness of the immune system, it also serves crucially as an immune system modulator that prevents a strong immune system from overreacting in a way that can drastically harm, even kill, the patient. See following.

Epidemic influenza and vitamin D


"In 1981, R. Edgar Hope-Simpson proposed that a 'seasonal stimulus' intimately associated with solar radiation explained the remarkable seasonality of epidemic influenza. Solar radiation triggers robust seasonal vitamin D production in the skin; vitamin D deficiency is common in the winter, and activated vitamin D, 1,25(OH)2D, a steroid hormone, has profound effects on human immunity. 1,25(OH)2D acts as an immune system modulator, preventing excessive expression of inflammatory cytokines and increasing the 'oxidative burst' potential of macrophages. Perhaps most importantly, it dramatically stimulates 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. Volunteers inoculated with live attenuated influenza virus are more likely to develop fever and serological evidence of an immune response in the winter. Vitamin D deficiency predisposes children to respiratory infections. Ultraviolet radiation (either from artificial sources or from sunlight) reduces the incidence of viral respiratory infections, as does cod liver oil (which contains vitamin D). An interventional study showed that vitamin D reduces the incidence of respiratory infections in children. We conclude that vitamin D, or lack of it, may be Hope-Simpson's 'seasonal stimulus'."

John Gilpin - November 13, 2006 9:13 PM

Here is a related source that confirms directly the point advanced by Joe Murphy above, and explains it. Young people with strong immune systems but insufficient vitamin D are killed by their own defense systems.


"In 1918, when medical scientists did autopsies on some of the fifty million people who died during the 1918 flu pandemic, they were amazed to find destroyed respiratory tracts; sometimes these inflammatory cytokines had triggered the complete destruction of the normal epithelial cells lining the respiratory tract. It was as if the flu victims had been attacked and killed by their own immune systems. This is the severe inflammatory reaction that vitamin D has recently been found to prevent."

Jenne Griffin - July 25, 2012 6:07 PM

Hello I was looking at your site to find liver and Hepatitis C information and can not find anything on it. I was always wondering if your diet or way of eating is an inflammatory way of eating , which is what I am interested in. I am lucky to be a great shape and want to stay that way but my gut needs to be cleansed and built back up. I would get your book if you have some idea on how to do this.

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