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interferon-gamma secretion in response to tumor cells. dysfunction, including adiposity and ability to gain weight,
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In general, probiotic microorganisms within the insulin resistance, and dyslipidemia. Another clinical
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Lactobacillus and Bifidobacterium species have been trial in overweight and obese individuals indicated that
demonstrated to exhibit numerous beneficial effects on less microbial gene diversity (40% lower) was associated
immunity through their interactions with macrophages, with increased metabolic dysfunction and inflammation.
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enterocytes, and dendritic cells, as well as Th1, Th2, and The researchers suggested that dietary intervention may
regulatory T (Treg) cells. 30 be helpful for improving microbial gene richness. 34
Unfortunately, our exposure to plant varieties has
A Note About Plant-Derived Compounds And significantly decreased over time from several thousand to
Immunity mere hundreds, with most of the food in the world coming
from fewer than twenty plant and animal species
Polyphenols combined. As is typically advised with food intolerance
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As discussed above, a common thread throughout the and/or allergy, rotating plant foods in the diet every three
mechanisms related to immunity relates to the anti- to four days may be important in ultimately conferring
inflammatory, antioxidant, and gut-balancing effects of greater immune resilience. Having greater dietary diversity
plant-based foods. Specifically, plant foods contain may also ensure better nutrient status 35,36 and lower rates
thousands of phytonutrients, which have been categorized of allergic disease, as has been demonstrated in children. 37,38
into phytonutrient families. One of the groups of plant Moreover, some may contend that meeting daily
compounds shown to be helpful for immunity is servings of fruits and vegetables is sufficient; however, a
polyphenols, a category consisting of more than 8,000 study in healthy women suggests that diversity is a major
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different compounds such as flavonoids (e.g., isoflavones factor. The women were divided into two arms, each
and anthocyanins) and non-flavonoids (e.g., phenolic consuming 8-10 servings of fruits and vegetables but with
acids and stilbenes). These phenolic compounds are different levels of botanical diversity, with one group
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ubiquitously found in plant foods like fruits, vegetables, having five botanical families and the other group having
nuts, seeds, legumes, and whole grains. On a physiological selections from eighteen botanical families. While both
level, they can serve as foodstuff for the gut microbiome, diets were helpful in reducing lipid peroxidation, the
resulting in the metabolic production of favorable higher diversity diet resulted in a significant decrease in
metabolites for immune enhancement. At the molecular DNA oxidation specifically. As a general guideline, it has
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level, they are thought to regulate immune function been suggested to encourage patients to aim for 50 unique,
through several mechanisms, including favorably plant-based foods in a week.
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modifying proinflammatory pathways involving nuclear
factor-kappa beta (NF-kB), mitogen-activated protein Download Patient Education Tools: Lifestyle Practices for
kinase (MAPK), and arachidonic acid, along with Strengthening Host Defense i
suppressing TLR. Coupled with their anti-inflammatory
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properties, they can inhibit oxidative enzymes responsible Stress Reduction/Management
for free radical generation, such as xanthine oxidase and
NADPH oxidase, while stimulating the endogenous Overall Recommendations: Both acute and chronic
production of helpful antioxidant enzymes like superoxide stress can result in dysregulated, suppressed immune
dismutase. Examples of food-based polyphenols with function. Under these conditions, susceptibility to illness is
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immune-regulating activity include quercetin (e.g., apples more likely. Monitoring stress levels through biofeedback
and onions), resveratrol (e.g., grapes), epigallocatechin-3- markers such as heart rate variability (HRV) may assist in
gallate (green tea), and curcumin (turmeric). 31 knowing when to implement stress management strategies
and in having a means to assess their efficacy, as well in
Plant Dietary Diversity helping to track resilience-building approaches. Practicing
What is key for immunity is not just ensuring the stress-modifying techniques on a regular basis using HRV
intake of plant-based foods in the diet but getting a diverse and other modalities can result in greater resilience when
blend of plant compounds for the gut microbiome. As confronted with stressors.
stated by Heiman and Greenway, “The more diverse the
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diet, the more diverse the microbiome and the more In 1936, Hans Selye defined stress as the nonspecific
adaptable it will be to perturbations.” The gut microflora response to change. Some degree of stress may be
can be modified through dietary components and, healthy for normal functioning and even beneficial for
ultimately, significantly impact markers of metabolic immunity (referred to as ‘hormesis’), while chronic,
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health that relate to inflammation. For example, in one low-level stress without resolution or coping behaviors
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clinical trial with Danish adults, it was found that those may suppress immune function. Hence, the field of
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who had a less diverse gut microbiome also had an
inflammatory phenotype and greater metabolic i. https://info.ifm.org/covid-19#patientEducation

56 Integrative Medicine • Vol. 19, No. S1 • Epub Ahead of Print Minich—Nutrition & Lifestyle Practices for Strengthening Host Defense