Nutrition Unlocked // EP15 - Immunity

// Jackie Intro // 

[00:00:01] Jackie: Nutrition fuels our bodies and minds. Our strength, mobility, energy, and even mood rely on the right nutrition, and scientists are continually uncovering new secrets. 

Welcome to Nutrition Unlocked, the podcast celebrating innovations, advancing the role of nutrition and health, sponsored by Nestle Health Science.

In each episode, we'll talk to experts from around the world about the latest topics, and we'll bring you insights and discuss innovations that are unlocking healthier futures.

In today's episode, we'll be exploring the key role that nutrition plays in developing our immune system. Our host is Anna Moll. 

// Episode intro //

[00:00:39] Anna: Welcome back to Nutrition Unlocked. I'm Anna Mohl and in this episode I'm looking forward to discussing a very important topic relevant to us all, the role nutrition plays in shaping our immune systems. 

Today I'm delighted to be joined by Dr. Michael Roizen, an anesthesiologist, Chief Wellness Officer Emeritus at the Cleveland Clinic, and award winning author who will dive into the topic in great detail today. 

Dr. Roizen, a very warm welcome. I'm really thrilled to have you with us today. And I'm really looking forward to our conversation.

[00:01:12] Dr Roizen: My privilege Anna, I'm looking forward to it. 

// Main Chat // 

[00:01:16] Anna: Great, well we have a lot to uncover today to discuss what we can do to boost our immune system through nutrition.

This topic, I think, is particularly important around this time of year when we see cold, flu, and of course COVID again, starting to make an appearance. So maybe to get us started, I think it would be great to have an understanding, in a bit of detail, about the role of the immune system. Maybe just with the fundamentals of how it works? 

[00:01:40] Dr Roizen: Your immune system is your protection against invaders of all kinds, either self if you will, propagated such as cancers, viruses, bacteria, fungi parasites, etc that attack you from outside. 

So the initial defense is actually your skin and your mucous membranes of secretions that convey things to the outside without them getting in.

 But once something comes in, whether it is a cancer natively, or whether it is a virus such as COVID 19 was, or RSV, or any of the common cold viruses, you mount an attack against them, initially by signaling to your immune system that this is something that doesn't belong inside you and then by mounting an attack against that.

So one of the greatest parts of your immune system and a conveyor is your gut, because you take in a lot of things in the food you eat that can cause infections. You fight them off through both a barrier in your gut and through immune reactions. And there's a tight reaction in your gut between your immune system and your nervous system. So, it all seems to work together. Let me give you one example of where it is really demonstrated. When you exercise a little, you strengthen your immune reactions, you increase your ability to fight infections. But when you exhaust your immune system, or your muscles, if you will, through a marathon, for the next two to three weeks, you're at an increased vulnerability to infections.

By, some things such as in nutrition, getting enough vitamin D, getting enough sleep, and, eating appropriately, you can decrease that increase in infection rate, that over exercise. 

[00:04:03] Anna: Oh, that is absolutely fascinating. 

[00:04:05] Dr Roizen: So, as we talk about immunity, I've heard about there are two different kinds of immunity, if I understand correctly, innate and acquired. 

[00:04:13] Anna: Can you explain a little bit about the difference between those and the impact that has on our health and fighting infection as you described?

[00:04:21] Dr Roizen: Yeah, so, the innate is, if you will, something comes in and you shoot at it. That's the way you would think of it, or innate might be you develop initial cancer cells and your body roots it out really quickly. 

The acquired is when something invades and your immune system recognizes it as an invader and you develop antibodies to it that then coat it and allow your killer cells to kill it better.

So, rather than do it any other way, the innate, it's readily available. Bang, you shoot at something and knock it out, surround it, and you often have mucus with it. All those things, a scab around a skin infection, etc. Whereas, acquired is, for example, you get a vaccine, you get an immunization against polio, and if the polio virus came, you would immediately attack it before it could have set up shop in your house. So it's a reaction that you've acquired. 

Now, one of the things, just to go into it, we know that certain vaccines get a high enough, what we call acquired immunity, that they put their immunity into your bone marrow as a plasma cell. So they get to a high enough concentration, then 20 years later, if the polio vaccine attacked, you have a high enough immunity, those plasma cells come out and the antibodies coat the polio virus and make it a target of your, killer T cells.

[00:06:14] Anna: Wow, it's interesting, I always wondered how that worked, because some people get certain childhood vaccines, and then you never need to get one again. And then others you need to get like a flu shot, I know there are different strains, but there are certain shots that you have to get on a more regular basis, or you have multiple doses.

[00:06:29] Dr Roizen: Right. And that's because, with COVID, we have not... gotten to the point where the immunity from the vaccines or the immunity, as far as we know, from infection gets to the point where it predictably causes plasma cell, if you will, propagation. It is, in some people, about 20 percent now, we think get that propagation from prior infections, but it's not consistent.

[00:07:02] Anna: Yeah, obviously a lot more for us to learn there.

So if I follow your point around, if our immune systems can get stronger through, call it learning, what can we do to help our immune system? I'll call it learn more and recognize potential threats. And I don't know if this differs with age, if your immune system has more experience as you get older, how does that work? What can we do, really?

[00:07:28] Dr Roizen: So, what we've learned is that when you get a flu shot, the take rate, the success rate of a flu shot, the success rate against RSV immunization, so the success rate in learning is due to both sleep, that is getting more sleep for the three days before you get the flu shot and getting a multivitamin for about two weeks beforehand. So presumably that multivitamin is because you have all the nutrients you need to create the antibodies and for your immune system to function optimally. 

We think one of the keys in that is vitamin D. We know that getting foods with vitamin D and getting vitamin D supplements and multivitamin and sleep are important. 

So we also think that, if you will, certain foods are important in helping clear the infection, such as chicken soup. It increases secretions, so you clear it naturally. And we think other things such as cruciferous vegetables are important in activating your immune system through some of the compounds they have, the sulfur compounds they have, that help your immune system. 

One of the great studies in people with breast cancer, the recurrence rate of breast cancer goes down 50 percent if you do 30 minutes of physical activity a day and have 5 fruits or vegetables a day. So, simple thing to decrease long term is walk 30 minutes and walk to a fruit and vegetable stand and have 5 fruits and vegetables a day decreases recurrence rates. Randomized controlled studies, repeatable studies that are repeated twice. 

So there's some simple things we think help your immune system function and we think the optimal fruits and vegetables is vegetables in the cruciferous category.

[00:09:42] Anna: When you explain it that way, it almost seems too simple and too good to be true. Although I know, it's not always so easy for everybody to eat five fruits and vegetables a day. But I think that's some pretty clear and actionable advice, in terms of 30 minutes of exercise, as well as eat your fruits and veggies, like you were told to growing up. 

And it's also interesting what you say about chicken soup, because I always thought that was just something that my mom told us, and the minute we got sick, she'd run off to the kitchen and start making chicken soup, which I was always happy to eat. I didn't know that it actually was helping something physiologically in my body.

[00:10:18] Dr Roizen: It shortens the cold cycle. Now, I'm going to go over, now there's some fats that also help. So, we have no idea why, but extra virgin olive oil, or walnuts in the large Spanish study where a tablespoon and a half and now it's actually in other studies it's a half a tablespoon of extra virgin olive oil a day. Whether on something or taken as just fat, just swallowed, I like it on bread obviously, on whole wheat bread, but whether it is, or you can cook the cruciferous vegetables in it, but whatever method you get it. in seems to decrease breast cancer by over 30 percent. And so what's usually found for breast cancer is usually found for prostate cancer. So it's probably good for both men and women. It's also good for preventing heart disease and stroke. But in any case in that randomized, large randomized study, both the fat in walnuts and fat or protein, it was whole walnuts or extra virgin olive oil were beneficial for what we perceive as your immune response.

So, we're not sure the mix in the multivitamin that I mentioned before… 

[00:11:36] Anna: I was going to ask you more about that. 

[00:11:37] Dr Roizen: Everyone thinks it's vitamin C and vitamin D. We don't really know. No one's, to my knowledge, separated it out. But we do know that, the foods I've mentioned, fruits and vegetables, especially cruciferous, some would say lycopene in cooked tomatoes also, it basically is a little exercise, a lot of sleep and a multivitamin, and then fruits and vegetables are what we know. Plus a little bit of extra virgin olive oil and omega 3s. 

The omega 3s are important for cleaning up infection, what we call the resolvins. So you need both vitamin D and omega 3 to produce what we call resolvins, which clean up infections. That is, get rid of them, so, you don't have the pus and the other stuff coming out longer.

[00:12:33] Anna: That's great advice and very clear.

One of the other things I wanted to ask you about is, the link between the gut microbiome and immunity. And you touched upon this a little bit, in the beginning. We previously had an episode about the microbiome and how it affects everything from digestion to mood. Can you talk a little bit about this and maybe just remind our listeners what the microbiome is and its link to nutrition and immunity specifically?

[00:13:02] Dr Roizen: Yes, so your microbiome includes not only bacteria, viruses, fungi, parasites, etc, that are inside your gut, but also what's on your skin and what's in the other areas of your body, hair, etc that are facing the outside world. 

And what we're learning now,and we're really in what I would call the second inning of learning, we're just getting to learn that the type of bacteria both inside you and on you are important at preventing diseases.

So, preventing acne, preventing skin aging, apparently there are certain bacteria that are much better than others at that. And we're not quite at the point where we can definitely say this is the right bacteria. We do know that, both Lactobacillus, some specific species and Bifidobacteria together decrease depression. Together they decrease if you will, osteoporosis, and together they decrease some skin infections. We don't quite know everything. 

The take home for me on microbiome is we don't quite know enough. I'm going to hope that I'm doing what's right because we aren't sure yet.

[00:14:29] Anna: No, it's a fascinating area. It'll be interesting to see what we learn. As you say, if we're in the first five minutes of the game or the second inning over the next 5, 10, 15, 20 years, I think it's going to be fascinating. 

So we've talked about eating habits, we've talked about exercise, what to eat, what to avoid, different supplementation. We talked about the importance of sleep.

Let's talk a little bit also about stress and mental health, which of course is a very hot topic these days. And in your book, Great Age Reboot, you talk about how stress contributes to weakening our immune system. How does that work? And then what are some tips and tricks that you could share that could help us, address the stresses impact on our immune system?

[00:15:15] Dr Roizen: There's some simple things about stress and there's a lot we don't understand. But stress is the greatest ager. It is the greatest risk to our immune system. It's the greatest risk to causing cancer and it's the greatest risk for infections, propagating, etc. So, managing stress is key, so I'm awful gladwe're getting to cover that.

The key and stress is posse, purpose, and play, and with purpose I talk about passion. So having friends, this is really from the Whitehall studies in Great Britain, and the Berkman studies in the US, both in the 40s through 70s. So we've known this a huge amount of time. There have been a record essence of knowledge on it recently, but it is stress shortens the villi in the gut, makes those fingers shorter. So that's maybe one cause. 

A second thing stress does by producing cortisol, it inhibits the immune system directly and it increases sugar levels which feed bacteria and make them more potent, it actually decreases sugar, it's almost like after a Thanksgiving meal, right? When you take sugar in, your white cells stop fighting as well.

Normally what white cells will do is engulf bacteria and then digest the bacteria through a series of processes. When you have sugar in your blood, that is a high blood sugar, your white cells stop engulfing as well and don't digest them as well. So they spit them out whole after they've duplicated. So in fact the, the simple thing is we know that cortisol rises in stress and it causes that increase in sugar and at the same time surpresses immune functioning. It suppresses the immune duplication of cells needed for gathering and functioning. 

So that's a simple explanation, but we think there's probably, unfortunately, a more complex one that works through your nervous system that says, you're stressed deal with this and don't deal with the infections, don't deal with something else.

So we think there's a more complex, part to this, but we know that there's an easy solution for stress. Maybe not so easy, but it is calling friends. It is being vulnerable to people. It is having friends around you and discussing it. So that's why, we think men are more vulnerable at this, because men don't friend and befriend as well as women do usually.

[00:18:18] Anna: That's really interesting. So you mentioned three things. You said posse, there were two other Ps you

[00:18:23] Dr Roizen: Posse, purpose, and play. 

[00:18:25] Anna: Posse, purpose and play.

[00:18:27] Dr Roizen: The purpose is not only purpose, but it is passion for that purpose. So, why do you get up in the morning? What's fun for you? So, one of the reasons I got up so avidly this morning is getting to talk to you is fun and passion, because my passion is actually helping people understand how to live younger longer.

[00:18:47] Anna: No, that's fantastic. Thank you. 

Yeah, I've read a couple of different books that talk about the importance of that and sometimes, it's almost seems so basic, right? Because, if you think about it on a personal level, you may be busy and crazy and running around, but if you just take a few minutes to catch up with a friend or your spouse or a relative or someone you're close with, you can just have a very short conversation that can completely change your outlook on things. So, that's great reminder. Thank you for that. 

You know, I look out the window here and I have these beautiful snow capped mountains behind me. So reminding me that we're really getting into the cold winter months now, We're probably in some regions, outside a little bit less, maybe we're getting less sunshine and people are going to be traveling, particularly as we come into the holidays.

What advice can you give us as we prepare, or as we're into the winter months, you've already given us some great advice around nutrition, around sleep, around stress, around exercise, but as we are in the winter months, is there anything specific or different we should be doing?

[00:19:48] Dr Roizen: I think there are probably, two, maybe three things, I think of differently. 

One is I now know that probably an N95 mask is probably a good thing to wear when you're just boarding a plane and on a plane, and then in tight circumstances, I don't wear it once everyone's settled, but while a huge number of people walking by, I tend to do that. So the close gatherings are a problem, but the combating that is having a fan. That is, a lot of airflow around you seems to get rid of viruses and bacteria. 

The second thing is, I don't stop from going to parties, because that's where you have friends. 

[00:20:43] Anna: Yep. Good advice. 

[00:20:44] Dr Roizen: ...but what I do is I try and get to the vegetable tray rather than anything else.

And, I suppose the other thing is, I'm meticulous about taking a vitamin D supplement, and my multivitamin anyway, but I probably am even more meticulous in the winter, small particulates, also cause inflammation, making things a little worse for your immune system. So I try and make sure that I keep the particulate level down in closed spaces, and when outside, much as I enjoy a fire, I'm pretty good about making sure I'm on the side that the wind isn't blowing the particulates into. 

[00:21:30] Anna: Well, I think that's all good advice. You mentioned vitamin D in particular in the multivitamin, but are there any specific foods or supplements that you recommend specifically for the winter months other than being meticulous as you described?

[00:21:44] Dr Roizen: Yeah, as I said, with the other things I've mentioned, sleep, friendship, vitamin D, not much risk, but again, it is fruits and vegetables, avoiding sugars and hydration is another key. 

The other thing is you don't want to force your immune system to fight two things at once. So, although we like raw food and sushi a lot, you don't want to have a double whammy. That is having to fight off a cold and fight off a parasite at the same time. So, I'm pretty good about avoiding raw food in winter. And then the other things, just to reiterate, are Omega 3 and extra virgin olive oil. It seems all common sense, right? And if you do get a cold, chicken soup is what your mom did and it's probably the best thing.

[00:22:44] Anna: Yep. I'll make sure I let her know that. I'll make sure she listens to this podcast so that she knows that you're advising in favor of her fantastic chicken soup. 

// Final Question // 

[00:22:52] Anna: So you have shared with us a tremendous wealth of insight and knowledge. Is there any one key takeaway that you want our listeners to really hang on to from this conversation?

[00:23:06] Dr Roizen: The key takeaway is posse, purpose and play. 

So don't forget those, that even if you've got a cold and don't want to see people, call them. So calling, having friends, doing things that increase friendship and increase your contact with others is probably the most important thing we can do.

[00:23:32] Anna: Oh, fantastic advice. Thank you. You have shared with us amazing insight and understanding into, what really helps, drive our immune system and a lot of practical tips and advice for us to take away. So I really appreciate your time, joining us today to speak with me, Dr. Roizen. It has really just been a pleasure and a privilege. I've been a fan of your books and your podcast, so it's great to have the opportunity to talk to you live. 

And I know that we could all take away at least one, if not many, things from what you've said today. 

I also want to mention a great piece of advice from your book, The Great Age Reboot, which touches upon something that you just said, which is, "Do not get hung up on the past. Your life is made up of the present and the future and your past helps us navigate." And I think that's great advice, because it tells us it's never too late to make changes to live more healthfully. And there's always just one or two things that we can do to incrementally improve our health and certainly to incrementally improve our immune system.

So thank you for that advice as well.

[00:24:33] Dr Roizen: Thank you Anna, it's a privilege to be with you today, and I love the quote you did get from the book, because it is so true, so thank you.

// Outro // 

[00:24:43] Anna: Great. And thank you. And to all our listeners, I hope you've enjoyed this episode of Nutrition Unlocked. 

Thank you so much, Dr. Roizen, for sharing your expertise and giving us a greater understanding of how nutrition can play a role in boosting our immunity. If you haven't already done so, please subscribe to Nutrition Unlocked so you don't miss an episode.

And we'd love to hear from you, so please use hashtag Nutrition Unlocked on social media to let us know your thoughts about this episode. We look forward to sharing more insights on the science of nutrition with you soon. And we look forward to seeing you next time on Nutrition Unlocked. 

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