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Micronutrients: Immunological and Infection Effects on Nutritional Status and Impact on Health in Developing Countries

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Book cover Preventive Nutrition

Part of the book series: Nutrition and Health ((NH))

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Just under 10 million children under 5 years of age continue to die unnecessarily in countries of the developing world (1,2). Undernutrition is the direct cause of at least a third of these deaths (3). Although there has been a reduction in the numbers and proportion dying, and progress toward the child survival millennium development goal (MDG4) is positive in many countries, clearly this is an unacceptable figure—especially when compared with what is possible from the single digit figures of more affluent countries. Progress toward the goals for maternal health (MDG5) and the elimination of poverty and hunger and undernutrition (MDG1) is doing even less well. Undernutrition contributes to over 3.5 million child deaths (3) and micronutrient deficiencies (vitamin A and zinc deficiencies) have been estimated to account for 1 million of these deaths per year or 9% of global childhood burden of disease (under 5 years), while iron deficiency is a risk factor for maternal mortality, responsible for 115,000 deaths per year, or 20% of global maternal deaths (3).

Key Points

• Deficiencies of micronutrients (vitamins, minerals and trace elements) are common—up to a third of people in low-income countries are affected.

• Women and children, especially those living in poverty, are those most at risk because of increased metabolic demands of growth, pregnancy and lactation and repeated infections.

• A vicious cycle of undernutrition leads to reduced immunity that increases disease risk and then the disease itself causes further undernutrition and so on.

• Immune systems are impacted by micronutrient deficiencies:

– vitamin A deficiency impairs innate, cell-mediated and humoral antibody responses but probably not viral infection

– zinc deficiency affects both innate and cell-mediated immunity but effects of supplementation on antibody production in humans are less clear than in animals

– iron deficiency and overload impair both innate and cell-mediated immunity, with no effect on humoral antibody production

– vitamin C deficiency in humans impairs leukocyte functions and decreases overall NK cell activity and lymphocyte proliferation

– vitamins B6, B12, folate and E deficiencies impair Th1 cytokine-mediated immune response through insufficient production of pro-inflammatory cytokines, shifting to an anti-inflammatory Th2 cell-mediated immune response, thus increasing the risk of extracellular infections

– supplementation with micronutrients generally reverses these impaired immune responses

• Micronutrient deficiencies can also be addressed by dietary improvement (if available and accessible), and by fortification. It is important to also address other interventions such as immunization, water and sanitation, breastfeeding and the reduction of social inequities.

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Authors and Affiliations

  1. Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA

    Ian Darnton-Hill MD, MPH, MSC

  2. Special Adviser to the Executive Director on Ending Child Hunger & Undernutrition UNICEF, 3 United Nations Plaza, 10017, New York, USA

    Ian Darnton-Hill MD, MPH, MSC

  3. Department of Family Sciences, College for Women, Kuwait University, Safat, Kuwait

    Faruk Ahmed BSC (HONORS), MSC, PHD

  4. Senior Lecturer (Adjunct), School of Population Health, University of Queensland, Brisbane, Australia

    Faruk Ahmed BSC (HONORS), MSC, PHD

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    Adrianne Bendich

  2. Inst. Human Nutrition, Columbia University, West 168th St. 630 , New York, 10032, U.S.A.

    Richard J. Deckelbaum

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Darnton-Hill, I., Ahmed, F. (2010). Micronutrients: Immunological and Infection Effects on Nutritional Status and Impact on Health in Developing Countries. In: Bendich, A., Deckelbaum, R. (eds) Preventive Nutrition. Nutrition and Health. Humana Press. https://doi.org/10.1007/978-1-60327-542-2_23

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