Malnutrition and infection in industrialized countries

  • Susanna Cunningham-Rundles
  • Deborah Ho Lin
Part of the Birkhäuser Advances in Infectious Diseases book series (BAID)


Malnutrition is a major cause of immune deficiency that directly affects the acute phase response and leads to greater frequency and severity of common infections. Primary malnutrition is not uncommon in wealthy industrialized societies due to poverty, lack of education, food allergies, inappropriate or limited diet, or eating disorders. Inadequate intake of micronutrients including vitamin A, E, calcium, iron and zinc are prevalent among children under 10 years of age and often unrecognized. Although chronic infectious diseases are less prevalent in industrialized countries, infections with HIV, Mycobacterium tuberculosis and hepatitis C virus are significant problems and parasitic infections may appear among immigrant populations. Obesity is becoming increasingly common in children and may enhance risk of serious complications of common infections. Adequate nutrition is critically important for the development of the immune system, immune response to environmental antigens and pathogens, and for the maintenance of host defense. In children with congenital anomalies or medical conditions affecting growth, poor nutrient status will have a disproportionate effect on development, immunity, and susceptibility to infection since nutrients are cofactors in immune response. Defects in T cell immunity lead to increased susceptibility to intracellular pathogens, reactivation of viral infections, and development of opportunistic infections. Zinc deficiency inhibits Th1 cytokine responses, thymic hormone activity, and lymphopoiesis. Vitamin A deficiency is associated with severity of many infections including measles, rotavirus, HIV, and bacterial infections. Selenium deficiency is associated with HIV progression. Nutrient cofactors of innate immune response include 1,25-dihydroxyvitamin D3, which is a direct regulator of antimicrobial responses. The overall impact of chronic subclinical malnutrition in children may determine the quality and duration of immune response to vaccines and may be an important topic for future research.


Celiac Disease Anorexia Nervosa Eating Disorder Food Allergy Zinc Deficiency 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Cunningham-Rundles S, McNeeley DF, Moon A (2005) Mechanisms of nutrient modulation of the immune response. J Allergy Clin Immunol 115: 1119–1128; quiz 1129CrossRefPubMedGoogle Scholar
  2. 2.
    Ganji V, Hampl JS, Betts NM (2003) Race-, gender-and age-specific differences in dietary micronutrient intakes of US children. Int J Food Sci Nutr 54: 485–490CrossRefPubMedGoogle Scholar
  3. 3.
    Fattal-Valevski A, Kesler A, Sela BA, Nitzan-Kaluski D, Rotstein M, Mesterman R, Toledano-Alhadef H, Stolovitch C, Hoffmann C, Globus O et al (2005) Outbreak of life-threatening thiamine deficiency in infants in Israel caused by a defective soy-based formula. Pediatrics 115: e233–238CrossRefPubMedGoogle Scholar
  4. 4.
    Obladen M, Loui A, Kampmann W, Renz H (1998) Zinc deficiency in rapidly growing preterm infants. Acta Paediatr 87: 685–691CrossRefPubMedGoogle Scholar
  5. 5.
    Stevens J, Lubitz L (1998) Symptomatic zinc deficiency in breast-fed term and premature infants. J Paediatr Child Health 34: 97–100CrossRefPubMedGoogle Scholar
  6. 6.
    Chatoor I, Surles J, Ganiban J, Beker L, Paez LM, Kerzner B (2004) Failure to thrive and cognitive development in toddlers with infantile anorexia. Pediatrics 113: e440–447CrossRefPubMedGoogle Scholar
  7. 7.
    Hackett A, Nathan I, Burgess L (1998) Is a vegetarian diet adequate for children. Nutr Health 12: 189–195PubMedGoogle Scholar
  8. 8.
    Sanders TA (1995) Vegetarian diets and children. Pediatr Clin North Am 42: 955–965PubMedGoogle Scholar
  9. 9.
    Accorsi S, Fabiani M, Nattabi B, Corrado B, Iriso R, Ayella EO, Pido B, Onek PA, Ogwang M, Declich S (2005) The disease profile of poverty: morbidity and mortality in northern Uganda in the context of war, population displacement and HIV/AIDS. Trans R Soc Trop Med Hyg 99: 226–233CrossRefPubMedGoogle Scholar
  10. 10.
    Carvalho NF, Kenney RD, Carrington PH, Hall DE (2001) Severe nutritional deficiencies in toddlers resulting from health food milk alternatives. Pediatrics 107: E46CrossRefPubMedGoogle Scholar
  11. 11.
    Eastlack JP, Grande KK, Levy ML, Nigro JF (1999) Dermatosis in a child with kwashiorkor secondary to food aversion. Pediatr Dermatol 16: 95–102CrossRefPubMedGoogle Scholar
  12. 12.
    Liu T, Howard RM, Mancini AJ, Weston WL, Paller AS, Drolet BA, Esterly NB, Levy ML, Schachner L, Frieden IJ (2001) Kwashiorkor in the United States: fad diets, perceived and true milk allergy, and nutritional ignorance. Arch Dermatol 137: 630–636PubMedGoogle Scholar
  13. 13.
    Juyal R, Osmamy M, Black RE, Dhingra U, Sarkar A, Dhingra P, Verma P, Marwah D, Saxsena R, Menon VP et al (2004) Efficacy of micronutrient fortification of milk on morbidity in pre-school children and growth — a double blind randomised controlled trial. Asia Pac J Clin Nutr 13: S44Google Scholar
  14. 14.
    Lyons GH, Stangoulis JC, Graham RD (2004) Exploiting micronutrient interaction to optimize biofortification programs: the case for inclusion of selenium and iodine in the HarvestPlus program. Nutr Rev 62: 247–252CrossRefPubMedGoogle Scholar
  15. 15.
    Beck MA, Williams-Toone D, Levander OA (2003) Coxsackievirus B3-resistant mice become susceptible in Se/vitamin E deficiency. Free Radic Biol Med 34: 1263–1270CrossRefPubMedGoogle Scholar
  16. 16.
    van den Broek N (2003) Anaemia and micronutrient deficiencies. Br Med Bull 67: 149–160CrossRefPubMedGoogle Scholar
  17. 17.
    Klinger G, Shamir R, Singer P, Diamond EM, Josefsberg Z, Sirota L (1999) Parenteral selenium supplementation in extremely low birth weight infants: inadequate dosage but no correlation with hypothyroidism. J Perinatol 19: 568–572CrossRefPubMedGoogle Scholar
  18. 18.
    Viteri FE, Gonzalez H (2002) Adverse outcomes of poor micronutrient status in childhood and adolescence. Nutr Rev 60: S77–83CrossRefPubMedGoogle Scholar
  19. 19.
    Mangge H, Schauenstein K, Stroedter L, Griesl A, Maerz W, Borkenstein M (2004) Low grade inflammation in juvenile obesity and type 1 diabetes associated with early signs of atherosclerosis. Exp Clin Endocrinol Diabetes 112: 378–382CrossRefPubMedGoogle Scholar
  20. 20.
    Boeck MA, Chen C, Cunningham-Rundles S (1993) Altered immune function in a morbidly obese pediatric population. Ann NY Acad Sci 699: 253–256CrossRefPubMedGoogle Scholar
  21. 21.
    Dovio A, Caramello V, Masera RG, Sartori ML, Saba L, Tinivella M, Prolo P, Termine A, Avagnina P, Angeli A (2004) Natural killer cell activity and sensitivity to positive and negative modulation in uncomplicated obese subjects: relationships to leptin and diet composition. Int J Obes Relat Metab Disord 28: 894–901CrossRefPubMedGoogle Scholar
  22. 22.
    Tanaka S, Inoue S, Isoda F, Waseda M, Ishihara M, Yamakawa T, Sugiyama A, Takamura Y, Okuda K (1993) Impaired immunity in obesity: suppressed but reversible lymphocyte responsiveness. Int J Obes Relat Metab Disord 17: 631–636PubMedGoogle Scholar
  23. 23.
    Sanchez-Margalet V, Martin-Romero C, Santos-Alvarez J, Goberna R, Najib S, Gonzalez-Yanes C (2003) Role of leptin as an immunomodulator of blood mononuclear cells: mechanisms of action. Clin Exp Immunol 133: 11–19CrossRefPubMedGoogle Scholar
  24. 24.
    Faggioni R, Feingold KR, Grunfeld C (2001) Leptin regulation of the immune response and the immunodeficiency of malnutrition. FASEB J 15: 2565–2571CrossRefPubMedGoogle Scholar
  25. 25.
    Gibson WT, Farooqi IS, Moreau M, DePaoli AM, Lawrence E, O’Rahilly S, Trussell RA (2004) Congenital leptin deficiency due to homozygosity for the Delta133G mutation: report of another case and evaluation of response to four years of leptin therapy. J Clin Endocrinol Metab 89: 4821–4826CrossRefPubMedGoogle Scholar
  26. 26.
    Falagas ME, Kompoti M (2006) Obesity and infection. Lancet Infect Dis 6: 438–446CrossRefPubMedGoogle Scholar
  27. 27.
    Fernandez-Twinn DS, Ozanne SE (2006) Mechanisms by which poor early growth programs type-2 diabetes, obesity and the metabolic syndrome. Physiol Behav 88: 234–243CrossRefPubMedGoogle Scholar
  28. 28.
    Russell BJ, White AV, Newbury J, Hattch C, Thurley J, Chang AB (2004) Evaluation of hospitalisation for Indigenous children with malnutrition living in Central Australia. Aust J Rural Health 12: 187–191CrossRefPubMedGoogle Scholar
  29. 29.
    Schneider SM, Veyres P, Pivot X, Soummer AM, Jambou P, Filippi J, van Obberghen E, Hebuterne X (2004) Malnutrition is an independent factor associated with nosocomial infections. Br J Nutr 92: 105–111CrossRefPubMedGoogle Scholar
  30. 30.
    Najera O, Gonzalez C, Toledo G, Lopez L, Ortiz R (2004) Flow cytometry study of lymphocyte subsets in malnourished and well-nourished children with bacterial infections. Clin Diagn Lab Immunol 11: 577–580CrossRefPubMedGoogle Scholar
  31. 31.
    Anstead GM, Chandrasekar B, Zhao W, Yang J, Perez LE, Melby PC (2001) Malnutrition alters the innate immune response and increases early visceralization following Leishmania donovani infection. Infect Immun 69: 4709–4718CrossRefPubMedGoogle Scholar
  32. 32.
    Brewster DR, Manary MJ, Menzies IS, Henry RL, O’Loughlin EV (1997) Comparison of milk and maize based diets in kwashiorkor. Arch Dis Child 76: 242–248PubMedCrossRefGoogle Scholar
  33. 33.
    Sakamoto M, Fujisawa Y, Nishioka K (1998) Physiologic role of the complement system in host defense, disease, and malnutrition. Nutrition 14: 391–398CrossRefPubMedGoogle Scholar
  34. 34.
    Peters-Golden M, Canetti C, Mancuso P, Coffey MJ (2005) Leukotrienes: underappreciated mediators of innate immune responses. J Immunol 174: 589–594PubMedGoogle Scholar
  35. 35.
    Wang TT, Nestel FP, Bourdeau V, Nagai Y, Wang Q, Liao J, Tavera-Mendoza L, Lin R, Hanrahan JW, Mader S et al (2004) Cutting edge: 1,25-dihydroxyvitamin D3 is a direct inducer of antimicrobial peptide gene expression. J Immunol 173: 2909–2912PubMedGoogle Scholar
  36. 36.
    Mancuso P, Gottschalk A, Phare SM, Peters-Golden M, Lukacs NW, Huffnagle GB (2002) Leptin-deficient mice exhibit impaired host defense in Gram-negative pneumonia. J Immunol 168: 4018–4024PubMedGoogle Scholar
  37. 37.
    Reid M, Badaloo A, Forrester T, Morlese JF, Heird WC, Jahoor F (2002) The acute-phase protein response to infection in edematous and nonedematous protein-energy malnutrition. Am J Clin Nutr 76: 1409–1415PubMedGoogle Scholar
  38. 38.
    Ekiz C, Agaoglu L, Karakas Z, Gurel N, Yalcin I (2005) The effect of iron deficiency anemia on the function of the immune system. Hematol J 5: 579–583CrossRefPubMedGoogle Scholar
  39. 39.
    Stephensen CB (2001) Vitamin A, infection, and immune function. Annu Rev Nutr 21: 167–192CrossRefPubMedGoogle Scholar
  40. 40.
    Piemonti L, Monti P, Sironi M, Fraticelli P, Leone BE, Dal Cin E, Allavena P, Di Carlo V (2000) Vitamin D3 affects differentiation, maturation, and function of human monocyte-derived dendritic cells. J Immunol 164: 4443–4451PubMedGoogle Scholar
  41. 41.
    Coutant F, Agaugue S, Perrin-Cocon L, Andre P, Lotteau V (2004) Sensing environmental lipids by dendritic cell modulates its function. J Immunol 172: 54–60PubMedGoogle Scholar
  42. 42.
    Ravaglia G, Forti P, Maioli F, Bastagli L, Facchini A, Mariani E, Savarino L, Sassi S, Cucinotta D, Lenaz G (2000) Effect of micronutrient status on natural killer cell immune function in healthy free-living subjects aged ≥90 y. Am J Clin Nutr 71: 590–598PubMedGoogle Scholar
  43. 43.
    Rikimaru T, Taniguchi K, Yartey JE, Kennedy DO, Nkrumah FK (1998) Humoral and cell-mediated immunity in malnourished children in Ghana. Eur J Clin Nutr 52: 344–350CrossRefPubMedGoogle Scholar
  44. 44.
    Dylewski ML, Mastro AM, Picciano MF (2002) Maternal selenium nutrition and neonatal immune system development. Biol Neonate 82: 122–127CrossRefPubMedGoogle Scholar
  45. 45.
    Vasquez-Garibay E, Campollo-Rivas O, Romero-Velarde E, Mendez-Estrada C, Garcia-Iglesias T, Alvizo-Mora JG, Vizmanos-Lamotte B (2002) Effect of renutrition on natural and cell-mediated immune response in infants with severe malnutrition. J Pediatr Gastroenterol Nutr 34: 296–301CrossRefPubMedGoogle Scholar
  46. 46.
    Marodi L (2006) Innate cellular immune responses in newborns. Clin Immunol 118: 137–144CrossRefPubMedGoogle Scholar
  47. 47.
    Carneiro-Filho BA, Bushen OY, Brito GA, Lima AA, Guerrant RL (2003) Glutamine analogues as adjunctive therapy for infectious diarrhea. Curr Infect Dis Rep 5: 114–119CrossRefPubMedGoogle Scholar
  48. 48.
    Cano PG, Aguero G, Perdigon G (2002) Immunological effects of yogurt addition to a re-nutrition diet in a malnutrition experimental model. J Dairy Res 69: 303–316CrossRefPubMedGoogle Scholar
  49. 49.
    Vandenbulcke L, Bachert C, Van Cauwenberge P, Claeys S (2006) The innate immune system and its role in allergic disorders. Int Arch Allergy Immunol 139: 159–165CrossRefPubMedGoogle Scholar
  50. 50.
    Savino W (2002) The thymus gland is a target in malnutrition. Eur J Clin Nutr 56Suppl 3: S46–49CrossRefPubMedGoogle Scholar
  51. 51.
    Palacio A, Lopez M, Perez-Bravo F, Monkeberg F, Schlesinger L (2002) Leptin levels are associated with immune response in malnourished infants. J Clin Endocrinol Metab 87: 3040–3046CrossRefPubMedGoogle Scholar
  52. 52.
    Zaman K, Baqui AH, Yunus M, Sack RB, Chowdhury HR, Black RE (1997) Malnutrition, cell-mediated immune deficiency and acute upper respiratory infections in rural Bangladeshi children. Acta Paediatr 86: 923–927PubMedGoogle Scholar
  53. 53.
    Perl A, Gergely P Jr, Puskas F, Banki K (2002) Metabolic switches of T cell activation and apoptosis. Antioxid Redox Signal 4: 427–443CrossRefPubMedGoogle Scholar
  54. 54.
    McDade TW, Beck MA, Kuzawa C, Adair LS (2001) Prenatal undernutrition, postnatal environments, and antibody response to vaccination in adolescence. Am J Clin Nutr 74: 543–548PubMedGoogle Scholar
  55. 55.
    Walrand S, Moreau K, Caldefie F, Tridon A, Chassagne J, Portefaix G, Cynober L, Beaufrere B, Vasson MP, Boirie Y (2001) Specific and nonspecific immune responses to fasting and refeeding differ in healthy young adult and elderly persons. Am J Clin Nutr 74: 670–678PubMedGoogle Scholar
  56. 56.
    Prentice AM (1999) The thymus: a barometer of malnutrition. Br J Nutr 81: 345–347PubMedGoogle Scholar
  57. 57.
    Hosea HJ, Rector ES, Taylor CG (2004) Dietary repletion can replenish reduced T cell subset numbers and lymphoid organ weight in zinc-deficient and energy-restricted rats. Br J Nutr 91: 741–747CrossRefPubMedGoogle Scholar
  58. 58.
    Fraker PJ, King LE (2004) Reprogramming of the immune system during zinc deficiency. Annu Rev Nutr 24: 277–298CrossRefPubMedGoogle Scholar
  59. 59.
    Forte WC, Santos de Menezes MC, Horta C, Carneiro Leao Bach R (2003) Serum IgE level in malnutrition. Allergol Immunopathol (Madr) 31: 83–86CrossRefGoogle Scholar
  60. 60.
    Moore SE, Goldblatt D, Bates CJ, Prentice AM (2003) Impact of nutritional status on antibody responses to different vaccines in undernourished Gambian children. Acta Paediatr 92: 170–176PubMedCrossRefGoogle Scholar
  61. 61.
    Udani PM (1994) BCG vaccination in India and tuberculosis in children: newer facets. Indian J Pediatr 61: 451–462PubMedGoogle Scholar
  62. 62.
    Chadha VK, Suryanarayana L, Suryanarayan HV, Srikantaramu N, Kumar P (2004) Protective effect of BCG among children vaccinated under universal immunization programme. Indian J Pediatr 71: 1069–1074PubMedGoogle Scholar
  63. 63.
    Dawar M, Clark M, Deeks SL, Walop W, Ahmadipour N (2004) A fresh look at an old vaccine: does BCG have a role in 21st century Canada? Int J Circumpolar Health 63(Suppl 2): 230–236PubMedGoogle Scholar
  64. 64.
    Goth SR, Chu RA, Gregg JP, Cherednichenko G, Pessah IN (2006) Uncoupling of ATP-mediated calcium signaling and dysregulated interleukin-6 secretion in dendritic cells by nanomolar thimerosal. Environ Health Perspect 114: 1083–1091PubMedCrossRefGoogle Scholar
  65. 65.
    Thibault H, Galan P, Selz F, Preziosi P, Olivier C, Badoual J, Hercberg S (1993) The immune response in iron-deficient young children: effect of iron supplementation on cell-mediated immunity. Eur J Pediatr 152: 120–124CrossRefPubMedGoogle Scholar
  66. 66.
    Mattsson N, Kilander A, Bjornsson E (2004) [Helicobacter pylori can in rare cases be the cause of iron and vitamin B 12 deficiency. No increased risk of iron and vitamin B 12 deficiency due to proton pump inhibitors.] Lakartidningen 101: 2014–2015PubMedGoogle Scholar
  67. 67.
    Baysoy G, Ertem D, Ademoglu E, Kotiloglu E, Keskin S, Pehlivanoglu E (2004) Gastric histopathology, iron status and iron deficiency anemia in children with Helicobacter pylori infection. J Pediatr Gastroenterol Nutr 38: 146–151CrossRefPubMedGoogle Scholar
  68. 68.
    Dardenne M (2002) Zinc and immune function. Eur J Clin Nutr 56(Suppl 3): S20–23CrossRefPubMedGoogle Scholar
  69. 69.
    Botash AS, Nasca J, Dubowy R, Weinberger HL, Oliphant M (1992) Zincinduced copper deficiency in an infant. Am J Dis Child 146: 709–711PubMedGoogle Scholar
  70. 70.
    Rayman MP (2000) The importance of selenium to human health. Lancet 356: 233–241CrossRefPubMedGoogle Scholar
  71. 71.
    Thorling EB, Overvad K, Geboers J (1986) Selenium status in Europe — human data. A multicenter study. Ann Clin Res 18: 3–7PubMedGoogle Scholar
  72. 72.
    Stec A, Mochol J, Kurek L, Walkuska G, Chalabis-Mazurek A (2005) The influence of different factors on selenium levels in dairy cow herds in the centraleastern region of Poland. Pol J Vet Sci 8: 225–229PubMedGoogle Scholar
  73. 73.
    Roekens EJ, Robberecht HJ, Deelstra HA (1986) Dietary selenium intake in Belgium for different population groups at risk for deficiency. Z Lebensm Unters Forsch 182: 8–13CrossRefPubMedGoogle Scholar
  74. 74.
    Thomson CD (2004) Selenium and iodine intakes and status in New Zealand and Australia. Br J Nutr 91: 661–672CrossRefPubMedGoogle Scholar
  75. 75.
    Salonen JT, Alfthan G, Huttunen JK, Puska P (1984) Association between serum selenium and the risk of cancer. Am J Epidemiol 120: 342–349PubMedGoogle Scholar
  76. 76.
    Virtamo J, Valkeila E, Alfthan G, Punsar S, Huttunen JK, Karvonen MJ (1987) Serum selenium and risk of cancer. A prospective follow-up of nine years. Cancer 60: 145–148CrossRefPubMedGoogle Scholar
  77. 77.
    Ferencik M, Ebringer L (2003) Modulatory effects of selenium and zinc on the immune system. Folia Microbiol (Praha) 48: 417–426CrossRefGoogle Scholar
  78. 78.
    Baum MK, Shor-Posner G, Lai S, Zhang G, Lai H, Fletcher MA, Sauberlich H, Page JB (1997) High risk of HIV-related mortality is associated with selenium deficiency. J Acquir Immune Defic Syndr Hum Retrovirol 15: 370–374PubMedGoogle Scholar
  79. 79.
    Baeten JM, Mostad SB, Hughes MP, Overbaugh J, Bankson DD, Mandaliya K, Ndinya-Achola JO, Bwayo JJ, Kreiss JK (2001) Selenium deficiency is associated with shedding of HIV-1—infected cells in the female genital tract. J Acquir Immune Defic Syndr 26: 360–364PubMedGoogle Scholar
  80. 80.
    Fawzi WW, Chalmers TC, Herrera MG, Mosteller F (1993) Vitamin A supplementation and child mortality. A meta-analysis. JAMA 269: 898–903CrossRefPubMedGoogle Scholar
  81. 81.
    Sommer A, Davidson FR (2002) Assessment and control of vitamin A deficiency: the Annecy Accords. J Nutr 132: 2845S–2850SPubMedGoogle Scholar
  82. 82.
    Aukrust P, Muller F, Ueland T, Svardal AM, Berge RK, Froland SS (2000) Decreased vitamin A levels in common variable immunodeficiency: vitamin A supplementation in vivo enhances immunoglobulin production and downregulates inflammatory responses. Eur J Clin Invest 30: 252–259CrossRefPubMedGoogle Scholar
  83. 83.
    Ahmed J, Zaman MM, Ali SM (2004) Immunological response to antioxidant vitamin supplementation in rural Bangladeshi school children with group A streptococcal infection. Asia Pac J Clin Nutr 13: 226–230PubMedGoogle Scholar
  84. 84.
    Wintergerst ES, Maggini S, Hornig DH (2006) Immune-enhancing role of vitamin C and zinc and effect on clinical conditions. Ann Nutr Metab 50: 85–94CrossRefPubMedGoogle Scholar
  85. 85.
    Akyon Y (2002) Effect of antioxidants on the immune response of Helicobacter pylori. Clin Microbiol Infect 8: 438–441CrossRefPubMedGoogle Scholar
  86. 86.
    Fischer CP, Hiscock NJ, Penkowa M, Basu S, Vessby B, Kallner A, Sjoberg LB, Pedersen BK (2004) Supplementation with vitamins C and E inhibits the release of interleukin-6 from contracting human skeletal muscle. J Physiol 558: 633–645CrossRefPubMedGoogle Scholar
  87. 87.
    Hartel C, Strunk T, Bucsky P, Schultz C (2004) Effects of vitamin C on intracytoplasmic cytokine production in human whole blood monocytes and lymphocytes. Cytokine 27: 101–106CrossRefPubMedGoogle Scholar
  88. 88.
    Devaney B, Ziegler P, Pac S, Karwe V, Barr SI (2004) Nutrient intakes of infants and toddlers. J Am Diet Assoc 104: s14–21CrossRefPubMedGoogle Scholar
  89. 89.
    Lee CY, Man-Fan Wan J (2000) Vitamin E supplementation improves cell-mediated immunity and oxidative stress of Asian men and women. J Nutr 130: 2932–2937PubMedGoogle Scholar
  90. 90.
    Malmberg KJ, Lenkei R, Petersson M, Ohlum T, Ichihara F, Glimelius B, Frodin JE, Masucci G, Kiessling R (2002) A short-term dietary supplementation of high doses of vitamin E increases T helper 1 cytokine production in patients with advanced colorectal cancer. Clin Cancer Res 8: 1772–1778PubMedGoogle Scholar
  91. 91.
    Pighetti GM, Eskew ML, Reddy CC, Sordillo LM (1998) Selenium and vitamin E deficiency impair transferrin receptor internalization but not IL-2, IL-2 receptor, or transferrin receptor expression. J Leukoc Biol 63: 131–137PubMedGoogle Scholar
  92. 92.
    Tsoureli-Nikita E, Hercogova J, Lotti T, Menchini G (2002) Evaluation of dietary intake of vitamin E in the treatment of atopic dermatitis: a study of the clinical course and evaluation of the immunoglobulin E serum levels. Int J Dermatol 41: 146–150CrossRefPubMedGoogle Scholar
  93. 93.
    Lagrange-Puget M, Durieu I, Ecochard R, Abbas-Chorfa F, Drai J, Steghens JP, Pacheco Y, Vital-Durand D, Bellon G (2004) Longitudinal study of oxidative status in 312 cystic fibrosis patients in stable state and during bronchial exacerbation. Pediatr Pulmonol 38: 43–49CrossRefPubMedGoogle Scholar
  94. 94.
    Marodi L (2002) Deficient interferon-gamma receptor-mediated signaling in neonatal macrophages. Acta Paediatr (Suppl) 91: 117–119CrossRefGoogle Scholar
  95. 95.
    Nesin M, Cunningham-Rundles S (2000) Cytokines and neonates. Am J Perinatol 17: 393–404CrossRefPubMedGoogle Scholar
  96. 96.
    Marodi L, Kaposzta R, Nemes E (2000) Survival of group B streptococcus type III in mononuclear phagocytes: differential regulation of bacterial killing in cord macrophages by human recombinant gamma interferon and granulocytemacrophage colony-stimulating factor. Infect Immun 68: 2167–2170CrossRefPubMedGoogle Scholar
  97. 97.
    Shah D, Sachdev HP (2001) Effect of gestational zinc deficiency on pregnancy outcomes: summary of observation studies and zinc supplementation trials. Br J Nutr 85(Suppl 2): S101–108PubMedCrossRefGoogle Scholar
  98. 98.
    Kaur S, Thami GP, Kanwar AJ (2002) Acrodermatitis enteropathica in a full-term breast-fed infant. Indian J Pediatr 69: 631–633PubMedGoogle Scholar
  99. 99.
    Kraus TA, Toy L, Chan L, Childs J, Cheifetz A, Mayer L (2004) Failure to induce oral tolerance in Crohn’s and ulcerative colitis patients: possible genetic risk. Ann NY Acad Sci 1029: 225–238CrossRefPubMedGoogle Scholar
  100. 100.
    Maeda S, Hsu LC, Liu H, Bankston LA, Iimura M, Kagnoff MF, Eckmann L, Karin M (2005) Nod2 mutation in Crohn’s disease potentiates NF-kappaB activity and IL-1beta processing. Science 307: 734–738CrossRefPubMedGoogle Scholar
  101. 101.
    Catassi C, Fasano A (2004) Celiac disease as a cause of growth retardation in childhood. Curr Opin Pediatr 16: 445–449CrossRefPubMedGoogle Scholar
  102. 102.
    Hozyasz KK, Chelchowska M, Laskowska-Klita T (2003) [Vitamin E levels in patients with celiac disease.] Med Wieku Rozwoj 7: 593–604PubMedGoogle Scholar
  103. 103.
    D’Amico MA, Holmes J, Stavropoulos SN, Frederick M, Levy J, DeFelice AR, Kazlow PG, Green PH (2005) Presentation of pediatric celiac disease in the United States: prominent effect of breastfeeding. Clin Pediatr (Phila) 44: 249–258CrossRefGoogle Scholar
  104. 104.
    Steinkamp G, Wiedemann B (2002) Relationship between nutritional status and lung function in cystic fibrosis: cross sectional and longitudinal analyses from the German CF quality assurance (CFQA) project. Thorax 57: 596–601CrossRefPubMedGoogle Scholar
  105. 105.
    Best K, McCoy K, Gemma S, Disilvestro RA (2004) Copper enzyme activities in cystic fibrosis before and after copper supplementation plus or minus zinc. Metabolism 53: 37–41CrossRefPubMedGoogle Scholar
  106. 106.
    Akanli L, Lowenthal DB, Gjonaj S, Dozor AJ (2003) Plasma and red blood cell zinc in cystic fibrosis. Pediatr Pulmonol 35: 2–7CrossRefPubMedGoogle Scholar
  107. 107.
    Zhang Z, Lai HJ (2004) Comparison of the use of body mass index percentiles and percentage of ideal body weight to screen for malnutrition in children with cystic fibrosis. Am J Clin Nutr 80: 982–991PubMedGoogle Scholar
  108. 108.
    Bjorksten B, Sepp E, Julge K, Voor T, Mikelsaar M (2001) Allergy development and the intestinal microflora during the first year of life. J Allergy Clin Immunol 108: 516–520CrossRefPubMedGoogle Scholar
  109. 109.
    Kalliomaki M, Kirjavainen P, Eerola E, Kero P, Salminen S, Isolauri E (2001) Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing. J Allergy Clin Immunol 107: 129–134CrossRefPubMedGoogle Scholar
  110. 110.
    Prescott SL, Macaubas C, Holt BJ, Smallacombe TB, Loh R, Sly PD, Holt PG (1998) Transplacental priming of the human immune system to environmental allergens: universal skewing of initial T cell responses toward the Th2 cytokine profile. J Immunol 160: 4730–4737PubMedGoogle Scholar
  111. 111.
    Karlsson MR, Rugtveit J, Brandtzaeg P (2004) Allergen-responsive CD4+CD25+ regulatory T cells in children who have outgrown cow’s milk allergy. J Exp Med 199: 1679–1688CrossRefPubMedGoogle Scholar
  112. 112.
    Capano G, Guandalini S, Guarino A, Caprioli A, Falbo V, Giraldi V, Ruggeri FM, Vairano P, Vegnente A, Vairo U et al (1984) Enteric infections, cow’s milk intolerance and parenteral infections in 118 consecutive cases of acute diarrhoea in children. Eur J Pediatr 142: 281–285CrossRefPubMedGoogle Scholar
  113. 113.
    Donnet-Hughes A, Duc N, Serrant P, Vidal K, Schiffrin EJ (2000) Bioactive molecules in milk and their role in health and disease: the role of transforming growth factor-beta. Immunol Cell Biol 78: 74–79CrossRefPubMedGoogle Scholar
  114. 114.
    Euler AR, Mitchell DK, Kline R, Pickering LK (2005) Prebiotic effect of fructo-oligosaccharide supplemented term infant formula at two concentrations compared with unsupplemented formula and human milk. J Pediatr Gastroenterol Nutr 40: 157–164CrossRefPubMedGoogle Scholar
  115. 115.
    Koskinen S (1996) Long-term follow-up of health in blood donors with primary selective IgA deficiency. J Clin Immunol 16: 165–170CrossRefPubMedGoogle Scholar
  116. 116.
    Jarvinen KM, Laine ST, Jarvenpaa AL, Suomalainen HK (2000) Does low IgA in human milk predispose the infant to development of cow’s milk allergy? Pediatr Res 48: 457–462CrossRefPubMedGoogle Scholar
  117. 117.
    Rautava S, Isolauri E (2004) Cow’s milk allergy in infants with atopic eczema is associated with aberrant production of interleukin-4 during oral cow’s milk challenge. J Pediatr Gastroenterol Nutr 39: 529–535CrossRefPubMedGoogle Scholar
  118. 118.
    Munoz P, Sanchez-Somolinos M, Alcala L, Rodriguez-Creixems M, Pelaez T, Bouza E (2005) Candida krusei fungaemia: antifungal susceptibility and clinical presentation of an uncommon entity during 15 years in a single general hospital. J Antimicrob Chemother 55: 188–193CrossRefPubMedGoogle Scholar
  119. 119.
    Corazza GR, Ginaldi L, Furia N, Marani-Toro G, Di Giammartino D, Quaglino D (1997) The impact of HIV infection on lactose absorptive capacity. J Infect 35: 31–35CrossRefPubMedGoogle Scholar
  120. 120.
    Stephenson LS (1994) Helminth parasites, a major factor in malnutrition. World Health Forum 15: 169–172PubMedGoogle Scholar
  121. 121.
    Gendrel D, Richard-Lenoble D, Kombila M, Dupont C, Moreno JL, Gendrel C, Nardou M, Chaussain M (1992) Influence of intestinal parasitism on lactose absorption in well-nourished African children. Am J Trop Med Hyg 46: 137–140PubMedGoogle Scholar
  122. 122.
    Nova E, Samartin S, Gomez S, Morande G, Marcos A (2002) The adaptive response of the immune system to the particular malnutrition of eating disorders. Eur J Clin Nutr 56(Suppl 3): S34–37PubMedGoogle Scholar
  123. 123.
    Monteleone P, Martiadis V, Colurcio B, Maj M (2002) Leptin secretion is related to chronicity and severity of the illness in bulimia nervosa. Psychosom Med 64: 874–879CrossRefPubMedGoogle Scholar
  124. 124.
    Dagogo-Jack S, Tykodi G, Umamaheswaran I (2005) Inhibition of cortisol biosynthesis decreases circulating leptin levels in obese humans. J Clin Endocrinol Metab 90: 5333–5335CrossRefPubMedGoogle Scholar
  125. 125.
    Levin BE (2005) Factors promoting and ameliorating the development of obesity. Physiol Behav 86: 633–639CrossRefPubMedGoogle Scholar
  126. 126.
    Wernstedt I, Eriksson AL, Berndtsson A, Hoffstedt J, Skrtic S, Hedner T, Hulten LM, Wiklund O, Ohlsson C, Jansson JO (2004) A common polymorphism in the interleukin-6 gene promoter is associated with overweight. Int J Obes Relat Metab Disord 28: 1272–1279CrossRefPubMedGoogle Scholar
  127. 127.
    Backhed F, Ding H, Wang T, Hooper LV, Koh GY, Nagy A, Semenkovich CF, Gordon JI (2004) The gut microbiota as an environmental factor that regulates fat storage. Proc Natl Acad Sci USA 101: 15718–15723CrossRefPubMedGoogle Scholar
  128. 128.
    Bornstein SR, Licinio J, Tauchnitz R, Engelmann L, Negrao AB, Gold P, Chrousos GP (1998) Plasma leptin levels are increased in survivors of acute sepsis: associated loss of diurnal rhythm, in cortisol and leptin secretion. J Clin Endocrinol Metab 83: 280–283CrossRefPubMedGoogle Scholar
  129. 129.
    Otero M, Lago R, Gomez R, Dieguez C, Lago F, Gomez-Reino J, Gualillo O (2006) Towards a pro-inflammatory and immunomodulatory emerging role of leptin. Rheumatology (Oxford) 45: 944–950CrossRefGoogle Scholar
  130. 130.
    Dhurandhar NV (2004) Contribution of pathogens in human obesity. Drug News Perspect 17: 307–313CrossRefPubMedGoogle Scholar
  131. 131.
    Schwarzwald H (2005) Illnesses among recently immigrated children. Semin Pediatr Infect Dis 16: 78–83CrossRefPubMedGoogle Scholar
  132. 132.
    Salas SD, Heifetz R, Barrett-Connor E (1990) Intestinal parasites in Central American immigrants in the United States. Arch Intern Med 150: 1514–1516CrossRefPubMedGoogle Scholar
  133. 133.
    Barker D, Younger N, MooSang M, McKenzie CA (2004) HIV serostatus and recovery from severe childhood malnutrition. A retrospective matched casecontrol study. West Indian Med J 53: 89–94PubMedGoogle Scholar
  134. 134.
    Guarino A, Spagnuolo MI, Giacomet V, Canani RB, Bruzzese E, Giaquinto C, Roggero P, Plebani A, Gattinara GC (2002) Effects of nutritional rehabilitation on intestinal function and on CD4 cell number in children with HIV. J Pediatr Gastroenterol Nutr 34: 366–371CrossRefPubMedGoogle Scholar
  135. 135.
    Johann-Liang R, O’Neill L, Cervia J, Haller I, Giunta Y, Licholai T, Noel GJ (2000) Energy balance, viral burden, insulin-like growth factor-1, interleukin-6 and growth impairment in children infected with human immunodeficiency virus. AIDS 14: 683–690CrossRefPubMedGoogle Scholar
  136. 136.
    Baum MK, Miguez-Burbano MJ, Campa A, Shor-Posner G (2000) Selenium and interleukins in persons infected with human immunodeficiency virus type 1. J Infect Dis 182(Suppl 1): S69–73CrossRefPubMedGoogle Scholar
  137. 137.
    Fawzi WW, Msamanga GI, Hunter D, Renjifo B, Antelman G, Bang H, Manji K, Kapiga S, Mwakagile D, Essex M et al (2002) Randomized trial of vitamin supplements in relation to transmission of HIV-1 through breastfeeding and early child mortality. AIDS 16: 1935–1944CrossRefPubMedGoogle Scholar
  138. 138.
    Hotta M, Nagashima E, Takagi S, Itoda I, Numata T, Kobayashi N, Takano K (2004) Two young female patients with anorexia nervosa complicated by Mycobacterium tuberculosis infection. Intern Med 43: 440–444CrossRefPubMedGoogle Scholar
  139. 139.
    Miller LC (2005) International adoption: infectious diseases issues. Clin Infect Dis 40: 286–293CrossRefPubMedGoogle Scholar
  140. 140.
    Starke JR, Correa AG (1995) Management of mycobacterial infection and disease in children. Pediatr Infect Dis J 14: 455–469; quiz 469—470PubMedCrossRefGoogle Scholar
  141. 141.
    Waters WR, Palmer MV, Nonnecke BJ, Whipple DL, Horst RL (2004) Mycobacterium bovis infection of vitamin D-deficient NOS2-/- mice. Microb Pathog 36: 11–17CrossRefPubMedGoogle Scholar
  142. 142.
    Boelaert JR, Gordeuk VR (2002) Protein energy malnutrition and risk of tuberculosis infection. Lancet 360: 1102CrossRefPubMedGoogle Scholar
  143. 143.
    Chan J, Tian Y, Tanaka KE, Tsang MS, Yu K, Salgame P, Carroll D, Kress Y, Teitelbaum R, Bloom BR (1996) Effects of protein calorie malnutrition on tuberculosis in mice. Proc Natl Acad Sci USA 93: 14857–14861CrossRefPubMedGoogle Scholar
  144. 144.
    Cliffe LJ, Humphreys NE, Lane TE, Potten CS, Booth C, Grencis RK (2005) Accelerated intestinal epithelial cell turnover: a new mechanism of parasite expulsion. Science 308: 1463–1465CrossRefPubMedGoogle Scholar
  145. 145.
    Rivera MT, De Souza AP, Araujo-Jorge TC, De Castro SL, Vanderpas J (2003) Trace elements, innate immune response and parasites. Clin Chem Lab Med 41: 1020–1025CrossRefPubMedGoogle Scholar
  146. 146.
    Hagel I, Lynch NR, Puccio F, Rodriguez O, Luzondo R, Rodriguez P, Sanchez P, Cabrera CM, Di Prisco MC (2003) Defective regulation of the protective IgE response against intestinal helminth Ascaris lumbricoides in malnourished children. J Trop Pediatr 49: 136–142CrossRefPubMedGoogle Scholar
  147. 147.
    Nussenblatt V, Semba RD (2002) Micronutrient malnutrition and the pathogenesis of malarial anemia. Acta Trop 82: 321–337CrossRefPubMedGoogle Scholar
  148. 148.
    Slowik MK, Jhaveri R (2005) Hepatitis B and C viruses in infants and young children. Semin Pediatr Infect Dis 16: 296–305CrossRefPubMedGoogle Scholar
  149. 149.
    England K, Pembrey L, Tovo PA, Newell ML (2005) Growth in the first 5 years of life is unaffected in children with perinatally-acquired hepatitis C infection. J Pediatr 147: 227–232CrossRefPubMedGoogle Scholar
  150. 150.
    Palomba E, Manzini P, Fiammengo P, Maderni P, Saracco G, Tovo PA (1996) Natural history of perinatal hepatitis C virus infection. Clin Infect Dis 23: 47–50PubMedGoogle Scholar
  151. 151.
    Gonzalez-Peralta RP, Kelly DA, Haber B, Molleston J, Murray KF, Jonas MM, Shelton M, Mieli-Vergani G, Lurie Y, Martin S et al (2005) Interferon alfa-2b in combination with ribavirin for the treatment of chronic hepatitis C in children: efficacy, safety, and pharmacokinetics. Hepatology 42: 1010–1018CrossRefPubMedGoogle Scholar
  152. 152.
    Manguso F, D’Ambra G, Menchise A, Sollazzo R, D’Agostino L (2005) Effects of an appropriate oral diet on the nutritional status of patients with HCV-related liver cirrhosis: a prospective study. Clin Nutr 24: 751–759CrossRefPubMedGoogle Scholar

Copyright information

© Birkhäuser Verlag Basel/Switzerland 2007

Authors and Affiliations

  • Susanna Cunningham-Rundles
    • 1
  • Deborah Ho Lin
    • 1
  1. 1.Department of Pediatrics Host Defenses ProgramWeill Medical College of Cornell UniversityNew YorkUSA

Personalised recommendations