Diätetische Wirksamkeit einer Mikronährstoffkombination bei rezidivierenden Atemwegsinfekten
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Zusammenfassung
Hintergrund und Zielsetzung: Eine optimale Versorgung mit Vitaminen und Mineralstoffen kann dazu beitragen, die Immunabwehr zu verbessern, und so den Verlauf und die Intensität rezidivierender Atemwegsinfekte positiv beeinflussen. In der vorliegenden Studie wurden die diätetische Wirksamkeit und der Nutzen einer Mikronährstoffkombination bei rezidivierenden Atemwegsinfekten untersucht.
Methodik: An der multizentrischen, randomisierten, placebokontrollierten Doppelblindstudie nahmen 192 Patienten mit rezidivierenden Atemwegsinfekten teil. Die Beobachtungsdauer betrug 16 Wochen. Wirksamkeitsparameter waren Anzahl, Stärke und Verlauf der Atemwegsinfekte (ermittelt anhand des Erkältungs-Gesamtsummenwerts [GSW]) sowie die Veränderung der Mikronährstoffversorgung (Vitamin C und D3, Folsäure und Selen) im Studienverlauf.
Ergebnis: Bei Probanden, die zu Beginn mindestens zwei erkältungstypische Symptome zeigten (n = 107), verbesserten sich die Symptome in der Verumgruppe (VG) signifikant stärker als in der Placebogruppe (PG) (ΔGSW: VG -6,9 ± 4,8; PG -5,4 ± 4,5; p = 0,034). Bei initial schweren Erkaltungsepisoden verbesserten sich die Symptome in der VG statistisch signifikant (ΔGSW: VG -93,8%, PG -91,2%, p = 0,043). In der Altersgruppe der unter 45-Jährigen wurden während der zweiten oder dritten Erkältungsepisode signifikant weniger VG- als PG-Patienten krankgeschrieben (VG: 14,3%, PG: 47,8%, p = 0,038). Patienten mit einem Vitamin-D-Mangel bzw. einer unzureichenden Vitamin-C-Versorgung zeigten in der VG signifikant weniger Erkältungsepisoden als in der PG. Im Studienverlauf erhöhten sich in der VG im Gegensatz zur PG die Serumspiegel von Vitamin C, Folsäure und Selen (p ≤ 0,001). Der 25(OH)D3-Spiegel sank in beiden Gruppen, in der VG jedoch deutlich weniger (VG -8,8%; PG -14%; p = 0,001).
Schlussfolgerung: Die Ergebnisse der Studie zeigen die Wirksamkeit einer ernährungsmedizinischen Therapie in Form einer speziellen Mikronährstoffkombination bei infektanfälligen Patienten mit rezidivierenden Atemwegsinfekten.
Schlüsselwörter
Erkältungskrankheiten Rezidivierende Atemwegsinfekte Vitamin C Vitamin D Mikronährstoffkombination ImmunsystemDietary efficacy of a micronutrient combination in patients with recurrent upper respiratory tract infections. Results of a placebo-controlled doubleblind study.
Abstract
Background and objectives: An optimal vitamin and mineral supply may contribute to the enhancement of immune defenses and thus favorably influence the course and intensity of recurrent upper respiratory tract infections (URIs). In the present study the dietary efficacy and benefits of a micronutrient combination in patients with recurrent URIs was evaluated.
Methods: 192 patients with recurrent URIs were enrolled in this randomized, placebo-controlled, double-blind multicenter trial for a study duration of 16 weeks. Efficacy variables were number, intensity and course of URIs (as assessed using a total common cold score [CCS]) and the alterations in micronutrient supply (vitamins C and D3, folic acid and selenium) during the study.
Results: In subjects who initially had at least two common cold symptoms (N = 107) the symptoms improved in the active group (AG) significantly more than in the placebo group (PG; ΔCCS: AG -6.9 ± 4.8; PG -5.4 ± 4.5; p = 0.034). In patients with initially severe common cold (CC) episodes the symptoms improved in the AG to a statistically significant extent (ΔCCS: AG -93.8%, PG -91.2%, p = 0.043). In the age group below 45 years significantly fewer AG than PG patients were absent from their job during the second or third CC episode (AG: 14.3%, PG: 47.8%, p = 0.038). Patients with vitamin-D deficiency and/or insufficient vitamin-C supply reported significantly fewer CC episodes in AG than in PG. In the course of the trial, in AG vs. PG the serum vitamin C, folic acid and selenium levels increased (p ? 0.001). The concentration of 25(OH)D3 decreased in both groups, but less so in the AG (AG -8.8%; PG -14%; p = 0.001).
Conclusion: Study results show the efficacy of a nutritional medical treatment with a special micronutrient combination in patients susceptible to infections and suffering from recurrent respiratory tract infections.
Keywords:
Common cold disease Recurrent respiratory tract infections Vitamin C Vitamin D Micro nutrient combination Immune systemLiteratur
- 1.Agarwal, R.: Nonhematological benefits of iron. Am. J. Nephrol. 27 (2007), 565–571.CrossRefPubMedGoogle Scholar
- 2.Aloia, J. F., Li-Ng, M.: Re: Epidemic influenza and vitamin D. Epidemiol. Infect. 135 (2007), 1095–1096; author reply 135 (2007), 1097-1098.Google Scholar
- 3.Alvares, O., Altman, L. C., Springmeyer, S., Ensign, W.; Jacobson, K.: The effect of subclinical ascorbate deficiency on periodontal health in nonhuman primates. J. Periodontal. Res. 16 (1981), 628–636.CrossRefPubMedGoogle Scholar
- 4.Barringer, T. A., Kirk, J. K., Santaniello, A. C., et al.: Effect of a multivitamin and mineral supplement on infection and quality of life. Ann. Intern. Med. 138 (2003), 365–371.CrossRefPubMedGoogle Scholar
- 5.Bartley, J.: Vitamin D, innate immunity and upper respiratory tract infection. J. Laryngol. Otol. 124 (2010), 465–469.CrossRefPubMedGoogle Scholar
- 6.Bikle, D. D.: Vitamin D and the immune system: role in protection against bacterial infection. Curr. Opin. Nephrol. Hypertens. 17 (2008), 348–352.CrossRefPubMedGoogle Scholar
- 7.Dhonukshe-Rutten, R. A., de Vries, J. H., de Bree, A., et al.: Dietary intake and status of folate and vitamin B12 and their association with homocysteine and cardiovascular disease in European populations. Eur. J. Clin. Nutr. 63 (2009), 18–30.CrossRefPubMedGoogle Scholar
- 8.Dhur, A., Galan, P., Hercberg, S.: Folate status and the immune system. Prog. Food. Nutr. Sci. 15 (1991), 43–60.Google Scholar
- 9.Drogan D., Klipstein-Grobusch K., Dierkes J., Weikert, C.; Boeing, H.: Dietary intake of folate equivalents and risk of myocardial infarction in the European Prospective Investigation into Cancer and Nutrition (EPIC) Potsdam study. Publ. Health Nutr. 9 (2006), (4), 465–471.CrossRefGoogle Scholar
- 10.Ganguly, R., Waldman, R.H.: Macrophage functions in aging: effects of vitamin C deficiency. Allerg. Immunol. 31 (1985), 37–43.Google Scholar
- 11.Ginde, A. A., Mansbach, J. M., Camargo, C. A. Jr.: Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch. Intern. Med. 169 (2009), 384–390.CrossRefPubMedPubMedCentralGoogle Scholar
- 12.Goldschmidt, M. C., Masin, W. J., Brown, L. R., Wyde, P. R.: The effect of ascorbic acid deficiency on leukocyte phagocytosis and killing of Actinomyces viscosus. Int. J. Vitam. Nutr. Res. 58 (1988), 326–334.PubMedGoogle Scholar
- 13.Haase, H., Rink, L.: Functional significance of zincrelated signaling pathways in immune cells. Annu. Rev. Nutr. 29 (2009), 133–152.CrossRefPubMedGoogle Scholar
- 14.Hartard, M., Kleinmond, C., Weissenbacher, E. R., Erben, R. G.: High prevalence of vitamin D insufficiency during late winter and spring in healthy young women in Germany. J. Endocrinol. Invest. 32 (2009), 291–292CrossRefPubMedGoogle Scholar
- 15.Hemilä, H.: Vitamin C and Infectious Diseases. In: Packer, L., Fuchs, J. (eds.): Vitamin C in Health and Disease. Marcel Dekker, New York (1997), 471–503.Google Scholar
- 16.Hintzpeter, B., Scheidt-Nave, C., Müller, M. J., Schenk, L.; Mensink, G. B.: Higher prevalence of vitamin D deficiency is associated with immigrant background among children and adolescents in Germany. J. Nutr. 138 (2008a) 1482–1490.PubMedGoogle Scholar
- 17.Hintzpeter, B., Mensink, G. B., Thierfelder, W., Müller, M. J., Scheidt-Nave, C.: Vitamin D status and health correlates among German adults. Eur. J. Clin. Nutr. 62 (2008b), 1079–1089.CrossRefPubMedGoogle Scholar
- 18.Hofmeister, M.: Auswirkungen von alimentären Ergänzungsmitteln auf die Gesundheit. Ernähr. Med. 20 (2005), 115–122.CrossRefGoogle Scholar
- 19.Jain, A. L. Influence of vitamins and trace-elements on the incidence of respiratory infection in the elderly. Nutr. Res. 22 (2002), 85–87.CrossRefGoogle Scholar
- 20.Maggini, S., Wenzlaff, S., Hornig, D.: Essential role of vitamin C and zinc in child immunity and health. J. Int. Med. Res. 38 (2010), 386–414.CrossRefPubMedGoogle Scholar
- 21.Maggini, S., Wintergerst, E. S., Beveridge, S., Hornig, D. H.: Selected vitamins and trace elements support immune function by strengthening epithelial barriers and cellular and humoral immune responses. Br. J. Nutr. 98 (2007), (Suppl. 1), S29–S35.PubMedGoogle Scholar
- 22.Marian, M., Sacks, G.: Micronutrients and older adults. Nutr. Clin. Pract. 24 (2009), 179–195.CrossRefPubMedGoogle Scholar
- 23.Maruotti, N., Cantatore, F. P.: Vitamin D and the immune system. J. Rheumatol. 37 (2010), 491–495.CrossRefPubMedGoogle Scholar
- 24.Max-Rubner-Institut (Hrsg.): Nationale Verzehrsstudie II. Ergebnisbericht Teil 2 (2008). Verfügbar unter: http://www.was-esse-ich.de/uploads/media/NVSII_Abschlussbericht_Teil_2.pdf [17.05.2011]
- 25.Mensink, G., Burger, M., Beitz, R., et al.: Beiträge zur Gesundheitsberichterstattung des Bundes. Was essen wir heute? Ernährungsverhalten in Deutschland. Robert-Koch-Institut, Berlin 2002.Google Scholar
- 26.Muhe, L., Lulseged, S., Mason, K. E., Simoes, E. A.: Case-control study of the role of nutritional rickets in the risk of developing pneumonia in Ethiopian children. Lancet 349 (1997), (9068), 1801–1804.CrossRefPubMedGoogle Scholar
- 27.Muñoz, C., Rios, E., Olivos, J., Brunser, O., Olivares, M.: Iron, copper and immunocompetence. Br. J. Nutr. 98 (2007), (Suppl. 1), S24–S28.PubMedGoogle Scholar
- 28.Shenkin, A.: Micronutrients in health and disease. Postgrad. Med. J. 82 (2006), 559–567.CrossRefPubMedPubMedCentralGoogle Scholar
- 29.Shilotri, P. G.: Phagocytosis and leukocyte enzymes in ascorbic acid deficient guinea pigs. J. Nutr. 107 (1977a), 1513–1516.PubMedGoogle Scholar
- 30.Shilotri, P.G.: Glycolytic, hexose monophosphate shunt and bactericidal activities of leukocytes in ascorbic acid deficient guinea pigs. J. Nutr. 107 (1977b), 1507–1512.PubMedGoogle Scholar
- 31.Ströhle, A., Hahn, A.: Vitamin C und Immunfunktion. Med. Monatsschr Pharm. 32 (2009), 49–54.PubMedGoogle Scholar
- 32.Ströhle, A., Wolters, M., Hahn, A.: Micronutrients at the interface between inflammation and infection — ascorbic acid and calciferol: part 1, general overview with a focus on ascorbic acid. Inflamm. Allergy Drug Targets 10 (2011a), 54–63.CrossRefPubMedGoogle Scholar
- 33.Ströhle, A., Wolters, M., Hahn, A.: Micronutrients at the interface between inflammation and infection -ascorbic acid and calciferol: part 2, calciferol and the significance of nutrient supplements. Inflamm. Allergy Drug Targets 10 (2011b), 64–74.CrossRefPubMedGoogle Scholar
- 34.Urashima, M., Segawa, T., Okazaki, M., Kurihara, M., Wada, Y., Ida, H.: Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am. J. Clin. Nutr. 91 (2010), 1255–1260.CrossRefPubMedGoogle Scholar
- 35.Watzl, B., Hänsch, G. M., P ool-Zobel B. L., et al.: Ernährung und Immunsystem. Ernahr. Umsch. 41 (1994), (10), 368–377.Google Scholar
- 36.Die Autoren erklären, dass kein Interessenkonflikt besteht.CrossRefPubMedGoogle Scholar
- a.Wayse, V., Yousafzai, A., Mogale, K., Filteau, S: Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 y. Eur. J. Clin. Nutr. 58 (2004), 563–567.Google Scholar