Immune-Enhancing Diets: What is the Final Answer?

Abstract

Supplementation of certain micronutrients to standard nutrition therapy in pharmacological doses can modulate the host immunologic response. The three most extensively studied: arginine, glutamine, and omega-3 fatty acids (Bfish oils^). While animal studies are encouraging, human clinical trials arrive at conflicting conclusions for multiple reasons, mainly related to heterogeneity in patient selection, concentration and combination of agents, dose, route, and timing and administration. Glutamine should not be given to patients with multi-organ (especially renal) failure and arginine should be avoided in septic shock. Enteral glutamine may be beneficial in burn and trauma patients. Larger, higher-quality studies are required before strong recommendations can be made.

Enteral feeding and the microbiome in critically ill children: a narrative review

“…Most of these studies have been conducted in adults. Arginine and glutamine have shown some immunomodulatory effects in animal studies; however, no evidence of significant clinical improvement in humans has been demonstrated (129)(130)(131)(132). The use of omega-3 PUFA, on the other hand, has been associated with clinical benefit with reduction in mortality, risk of developing new organ failure, and duration of mechanical ventilation and ICU stay (133).…”