How to supply nutrition that helps children improve their immune system during Covid-19 - Little Étoile
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How to supply nutrition that helps children improve their immune system during Covid-19


About Covid-19 in children

  • Covid-19 is a respiratory infection that affects all age groups, spread by the virus called “SARS-CoV2” (a member of the coronavirus family). During 2020-2022, it has become a pandemic, meaning that it has spread around the world, because it is highly contagious (catchy).
  • Note, the word “infection” refers to the symptoms that kids get after the virus has gotten into the body. The virus usually lives in the nose and throat first, before spreading to the rest of the body
  • Children can still carry the virus if they are vaccinated or not, but vaccination is considered protective them from getting symptoms of infection. Vaccination has its own set of side effects (read more at https://www.health.harvard.edu/diseases-and-conditions/coronavirus-outbreak-and-kids)
  • Some children get more symptoms than others, but it is possible that they test positive and not have any noticeable symptoms
  • The main symptoms are very similar to a flu, including fever (high temperature), sore throat, cough, runny nose, congestion, headaches etc.


How likely are kids to get covid-19?

  • Children have a much lower risk than adults of getting covid (about 1%) and they have a lower risk of testing positive for the virus (6%)[1] compared to adults, but they are more likely to catch it from adults than other kids [2]. The risk of getting covid or being positive is higher in infants <3months, then drops toward 5 years. The risk of testing positive goes up again after 18 years (>20%).
  • Children are less likely to get Covid-19 because their nose and throat are smaller than adults, and they can’t carry as much of the virus or absorb it as well as adults[3]
  • It is also thought that kids have a better resistance to other more common coronaviruses because they catch common colds a lot more [4], and this is because their immune system is less well developed than adults.


Which nutrients are especially important to improve their immune system?

Macronutrients

  • Protein: this is probably the most critical one, because it is needed to replace new immune system cells that die during infections. Protein deficiency is a major part of undernutrition that increases the risk of children catching any lung infections, and makes them more severe and life threatening [5]

Vitamins and minerals

  • Zinc: this is a critical nutrient for the immune system in children. It is known to prevent infections in the gut that cause diarrhea. One study showed that children with covid who have very low zinc in their bodies are 4 times more likely to need hospitalization [6]
  • Vitamin D: this vitamin is also very important in the immune system and can be low in children, especially kids who stay inside a lot, have inadequate diets, or who have allergies. Vitamin D in important in the part of the immune system that responds to virus infections. In one study by Molla et al. (2021) [7] , involving children with covid-19 werefound that 82% of them were low in vitamin D.
  • Vitamin C: this nutrient is involved in protecting the lungs and stopping tissues in the nose and throat from getting inflamed. It also helps with recovery. Vitamin C has been shown historically to prevent common colds caused by other viruses and reduces the length of a cold in children [8]. The study by Molla et al. (2021) (see below) also reported that 17% of covid-19 children were low in vitamin C.
  • Vitamin A & beta-carotene: both vitamin A and beta-carotene (which is used in the body to make vitamin A) are important immune system vitamins, especially in the mouth, nose, throat, skin and gut. It helps maintain and repair layers of tissues in these parts of the body that block viruses from getting in. The study by Molla et al. (2021) (see below) also reported that 13% of covid-19 children were low in vitamin C.
  • Iron: children with iron deficiency are often tired and lack energy. They are also more likely to get infections. The study by Molla et al. (2021) (see below) found that 16% of covid-19 children showed signs of low iron in their body. Infants with undernutrition and iron deficiency are more likely to get severe symptoms of covid-19 as well [9]
  • Folic acid and B-vitamins: folic acid and some B-vitamins work together with iron to support growth and new blood cell formation. The study by Molla et al. (2021) (see below) showed that 16% of children covid-19 children were low in folate.
  • Omega-3 fats (e.g. DHA, EPA): these are not just important in brain and eye health. In the immune system, they support parts that lower how inflamed tissues get, which helps with healing and recovery. Several studies have reported benefits of omega-3’s in helping to prevent lung infections in infants and children [10].

Other nutrients

  • Beta-glucan: is a special carbohydrate that comes from plants, that stimulates the immune system thru the gut. Studies have shown that 1-4 year old children given this nutrient showed more than 50% reduction in cold/flu symptoms and days of infection [11]. There is some new evidence that beta-glucans may even help to make Covid-19 vaccines work more effectively [12].
  • Lactoferrin: this iron containing factor is found in human and dairy milk and has been shown to support immune function in children [13]. Because of its antiviral effects, some researchers are suggesting that lactoferrin may be useful in helping with treating and preventing covid-19 [14].


Recommended foods which include micro & macro- nutrients for immunity

  • Dairy foods: contain lactoferrin and are an easily digested source of protein
  • Eggs: contain protein, all vitamins and minerals; good source of vitamin D
  • Fish: good source of omega-3’s and zinc
  • Colored fruit and veggies: contain zinc and beta-carotene
  • Orange juice or kiwifruit: good sources of vitamin C
  • Water: children with infections need to keep up their hydration, so they should maintain enough water in their diet

(Note: check that your children don’t have an allergy to any of these foods before you feed them)


Bad habits to avoid during this time?

  • For toddlers, try to avoid putting things they pick up from the ground in their mouth
  • Avoiding sharing adult food with children
  • Not washing hands and having bath frequently enough – good hygiene is very important
  • Sneezing into hands or in the open, and touching things
  • Picking the nose
  • Not preparing feed bottles by disinfecting them properly
  • Poor hygiene practices during childcare
  • For adults, to avoid coughing or sneezing around children without a mask or tissues

References

  1. Ladhani et al. Arch Dis Child 2020 105:1180–1185 https://adc.bmj.com/content/archdischild/105/12/1180.full.pdf
  2. Howard-Jones et al. J Paediatr Child Health. 2021 Oct 13: 10.1111/jpc.15791. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8662210/
  3. Patel & Verma. JAMA. 2020 Jun 16;323(23):2386-2387 https://jamanetwork.com/journals/jama/fullarticle/2766522
  4. Sette & Crotty. Nat Rev Immunol. 2020 Aug;20(8):457-458.  https://www.nature.com/articles/s41577-020-0389-z
  5. Schaible and Kaufman et al. PLoS Med. 2007 May; 4(5): e115.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1858706/
  6. Keles et al. Eur J Pediatr. 2022 Jan 22;1-10. https://pubmed.ncbi.nlm.nih.gov/35064310/
  7. Molla et al. Clin Nutr ESPEN. 2021 Aug; 44: 424–428.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8110330/
  8. Ludvigsson et al. Scand J Infect Dis. 1977;9(2):91-8.  https://pubmed.ncbi.nlm.nih.gov/897573/
  9. Kulkarni et al. J Trop Pediatr. 2021 Jan 29;67(1):fmaa084. https://pubmed.ncbi.nlm.nih.gov/33313926/
  10. Pecora et al. Nutrients. 2020 Oct; 12(10): 3198. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589163/
  11. Meng. J Nutr Food Sci 2016, 6:4 https://www.longdom.org/open-access-pdfs/bakers-yeast-betaglucan-decreases-episodes-of-common-childhood-illness-in-1-to-4-year-old-children-during-cold-season-in-china-2155-9600-1000519.pdf
  12. Cordova-Martinez 2021. Int J Environ Res Public Health. 2021 Dec; 18(23): 2636. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656611/
  13. Manzoni et al. J Pediatr. 2016 Jun;173 Suppl:S43-52.https://pubmed.ncbi.nlm.nih.gov/27234411/
  14. https://pubmed.ncbi.nlm.nih.gov/32738305/