Nutrition and Infectious Diseases. Shifting the Clinical Paradigm

Foreword
Preface
	Part I: The Foundations of the Nutrition-Infection Nexus
	Part II: Types of Infectious Diseases and Influences of Nutrition
	Part III: Nutrition Issues During Major Infections: Case Studies of Nutrition and Infectious Disease
	Part IV: Integration of Cross-Cutting Issues in Nutrition/Infection Interactions
	References
Series Editor Page
Editors
Objectives and Organization of the Volume
	Part I – The Foundations of the Nutrition-Infection Nexus
	Part II: Types of Infectious Diseases and Influences of Nutrition
	Part III: Nutrition Issues During Major Infections: Case Studies of Nutrition and Infectious Disease
	Part IV: Integration of Cross-Cutting Issues in Nutrition/Infection Interactions
	Conclusions
Acknowledgments
Contents
About the Series Editors
About the Editors
Contributors
Part I: The Foundations of the Nutrition-Infection Nexus
	Chapter 1: Pathways Linking Nutritional Status and Infectious Disease: Causal and Conceptual Frameworks
		Background: Definitions and Tools for Understanding Relationships Between Nutrition and Infection
			Definitions
				Nutritional Status
				Infection
			Theories of Causality
			Criteria for Assessing Relationships Between Infections and Malnutrition
			Types of Relationships
				Synergistic Relationships Between Nutrition and Infection
				Antagonistic Relationships Between Nutrition and Infection
				No Relationship Between Nutrition and Infection
		A Conceptual Framework for the Infection-Malnutrition Interface
			Exposure (Spatial and Temporal Overlap of Host and Pathogen)
			Establishment of Infection (Pathogen Successfully Crosses Host Barriers, Establishes at Appropriate Tissue Location, and Matures)
				Breaching the Barriers
				Migration to Target Tissues
			Pathogen Proliferation (Pathogen Reproduction and Release of Infectious Stages)
			Immune Responses to Natural Infection and to Vaccines Lead to Resolution of Infection
			Disease Severity (Pathogen Leads to Symptoms and/or Immunopathology)
			Response to Treatment (Pathogen Cleared or Symptoms Reduced)
			Pathogen Affects Nutritional Status
		Challenges in Investigating Nutrition and Infectious Disease
		Conclusions
		References
	Chapter 2: Core Principles in Nutrition: Nutrient Needs, Metabolism, and Potential Influences on Infectious Diseases
		Introduction
		Macronutrients
			Carbohydrates
				Carbohydrate and Sugar Needs, Sources, and Risk of Deficiency
				Carbohydrate and Sugar Metabolism
				Carbohydrate and Sugar Pathways to Infections
			Proteins
				Protein Needs, Sources, and Risk of Deficiency
				Protein Metabolism
				Potential Pathways to Infections: Protein
			Lipids
				Lipid Needs, Sources, and Risk of Deficiency
				Lipid Metabolism
				Potential Pathways to Infections: Lipids
		Essential Minerals and Trace Elements
			Iron
				Iron Needs, Sources, and Risk of Deficiency
				Iron Metabolism
				Potential Pathways to Infections: Iron
			Calcium
				Calcium Needs, Sources, and Risk of Deficiency
				Calcium Metabolism
				Potential Pathways to Infections: Calcium
			Zinc
				Zinc Needs, Sources, and Risk of Deficiency
				Zinc Metabolism
				Potential Pathways to Infections: Zinc
			Iodine
				Iodine Needs, Sources, and Risk of Deficiency
				Iodine Metabolism
				Potential Pathways to Infections: Iodine
			Selenium
				Selenium Needs, Sources, and Risk of Deficiency
				Selenium Metabolism
				Potential Pathways to Infections: Selenium
			Copper
				Copper Needs, Sources, and Risk of Deficiency
				Copper Metabolism
				Potential Pathways to Infections: Copper
			Magnesium
				Magnesium Needs, Sources, and Risk of Deficiency
				Magnesium Metabolism
				Potential Pathways to Infections: Magnesium
		Fat Soluble Vitamins
			Vitamin A and Carotenoids
				Vitamin A and Carotenoids Needs, Sources, and Risk of Deficiency
				Vitamin A and Carotenoid Metabolism
				Potential Pathways to Infections: Vitamin A and Carotenoids
			Vitamin D
				Vitamin D Needs, Sources, and Risk of Deficiency
				Vitamin D Metabolism
				Potential Pathways to Infections: Vitamin D
			Vitamin E
				Vitamin E Needs, Sources, and Risk of Deficiency
				Vitamin E Metabolism
				Potential Pathways to Infections: Vitamin E
			Vitamin K
				Vitamin K Needs, Sources, and Risk of Deficiency
				Vitamin K Metabolism
				Potential Pathways to Infections: Vitamin K
		Water-Soluble Vitamins
			Vitamin C
				Vitamin C Needs, Sources, and Risk of Deficiency
				Vitamin C Metabolism
				Potential Pathways to Infections: Vitamin C
			The B-Complex Vitamins
				B-Complex Needs, Sources, and Risk of Deficiency
				B-Complex Absorption and Transport
				B-Complex Metabolism
				Potential Pathways to Infection: B-Complex
		Other Nutrients
			Fluorine Overview
			Phosphorus Overview
			Choline Overview
			Carnitine Overview
		Emerging Nutrients
		Conclusions
		References
	Chapter 3: Primer on Immune Response and Interface with Malnutrition
		Overview: Hosts, Pathogens, and Commensals
		Organization of Host Defenses
			Barrier Defenses
			Lymphoid Tissues
			Innate and Adaptive Immunity
		Cell Types in the Immune System
			Innate Immune Cells
			Lymphocytes and Antigen Specificity in the Adaptive Immune System
			Adaptive Immune Cells: B Cells
			Adaptive Immune Cells: T Cells
		Functions of the Immune System: Innate Immunity and Inflammation
			Local Inflammation
			Systemic Inflammation and the Acute-Phase Response
		Functions of the Immune System: Integration of Innate with Adaptive Immunity
			Antigen-Presenting Cells (APC) Link Innate to Adaptive Immunity
			Types of Immunity
			Type 1 Immunity
			Type 2 Immunity
			Type 3 Immunity
			Regulatory Immunity
		Nutrition-Infection Interactions: Infections Cause Malnutrition
			Frequency and Severity of Infections
			Decreased Food Intake
			Decreased Nutrient Absorption
			Increased Nutrient Loss
			Increased Nutrient Utilization
			Altered Nutrient Transport or Storage
		Nutrition-Infection Interactions: Malnutrition Impairs Immunity
			Protein-Energy Malnutrition (PEM)
			Fat-Soluble Vitamins
				Vitamin A
				Vitamin D
				Vitamin E
			Water-Soluble Vitamins
				Vitamins B6, B12, Folate
				Vitamin C
			Minerals
				Selenium
				Zinc
				Copper and Iron
			Omega-3 Polyunsaturated Fatty Acids (PUFA)
		Conclusion
		References
Part II: Types of Infectious Diseases and Influences of Nutrition
	Chapter 4: Bacterial Infections and Nutrition: A Primer
		Overview
		Bacteria of Importance to Humans
			Gram-Positive Bacteria
			Gram-Negative Bacteria
			Other Bacteria
			Mycobacteria
			Pathogenic and Nonpathogenic Bacteria
			Antimicrobial Resistance
		The Human-Bacterial Interface
			Symbiotic Relationships
			The Intestinal Microbiome
			Malnutrition and Dysbiosis
			Environmental Enteric Dysfunction
		Colonization as a Precursor to Infection in the Respiratory Tract
		Effect of Nutritional Status and Diet on Risks of Bacterial Infection
			Barriers to Infection
			Systemic Immunity, Malnutrition, and Bacterial Infections
			Specific Micronutrients and Bacterial Infections
			Antibacterial Vaccine Responses
		Nutrients in Treatment of Serious Bacterial Infection
		Effects of Bacterial Infection on Host Nutritional Status
		Conclusions
		References
	Chapter 5: Viral Infections and Nutrition: Influenza Virus as a Case Study
		Brief Overview of Viruses
			Viral Structure and Replication
			Rotavirus (Reoviridae)
			Measles (Paramyxoviridae)
			Herpes Simplex Virus (Herpesviridae)
			Ebola Virus (Filoviridae)
			HIV (Retroviridae)
			Hepatitis B (Hepadnaviridae)
			Hepatitis C (Flaviviridae)
			Rhinovirus (Picornaviridae)
		Coronaviruses (Coronaviridae)
		Influenza Virus: A Case Study
		Influenza and the Host-Nutrient Environment
			Malnutrition, Obesity, and the Triple Burden
		Vitamins and Influenza Virus
			Respiratory Infections and Vitamin A
			Influenza and Vitamin D
			Influenza and Vitamin E
			Influenza Vaccination and Vitamin K
			Vitamin B Complex and Influenza Vaccine Response
			Influenza Infection and Vitamin C (Ascorbic Acid)
		Minerals and Influenza Virus
			Calcium (Ca) and Influenza Viral Replication
			Magnesium (Mg) and Influenza Inflammation
			Phosphorous (P)
			Influenza and Potassium (K)
			Influenza and Copper (Cu)
			Iron (Fe) and Influenza Infection
			Selenium (Se) and Influenza
			Zinc (Zn) and Respiratory Infection
			Arsenic (As) and Influenza
		Life Stages Influence Micronutrient Needs and Influenza
			Pregnancy/Breastfeeding
			Aging
		The Future of Nutrition at the Host-Influenza Interface
		References
	Chapter 6: Nutrition and Protozoan Pathogens of Humans: A Primer
		Introduction
		Nutrition and Infection
		Trichomoniasis
			Trichomonad Metabolism
		Intestinal Protozoan Infections
			Amebiasis
			Giardiasis
			Cryptosporidiosis
		Malaria
			Life Cycle
			The Food Vacuole and Digestion of Hemoglobin
			Sequestration and Severe Falciparum Malaria
		Kinetoplastids
			Human African Trypanosomiasis
			Chagas Disease
			Leishmaniasis
		Toxoplasmosis
			Transmission
			Pathogenesis
		Conclusion
		References
	Chapter 7: Human Helminth Infections: A Primer
		Introduction
		Nematode Infections
			Gastrointestinal Infections
			Systemic Infections
			Pathogenesis
			Effects on Human Nutritional Status
		Trematode Infections
		Cestode Infections
		Helminth Feeding Strategies
			Systemic Nematodes
			Soil-Transmitted Helminths
			Schistosomes
			Cestodes
		Influence of Human Nutritional Status on Helminth Infections
		Impact of Control Programs
			Filarial Infections
			Soil-Transmitted Helminths
			Trematodes
			Cestodes
		Challenges, Gaps, and Unmet Needs
			Climate Change
			Impacts of Elimination Programs
			Understanding Microbiome-Helminth Interactions
			The Hygiene Hypothesis
		Conclusions
		References
Part III: Nutrition Issues During Major Infections: Case Studies of Nutrition and Infectious Diseases
	Chapter 8: Nutrition and Diarrheal Disease and Enteric Pathogens
		Introduction
			Definitions
			Epidemiology
			Etiology
		Risk Factors and Determinants of Diarrhea
		Ways in Which Malnutrition Contributes to Enteric Infection
			Increased Risk of Exposure
			Reduced Immune Response Increases Susceptibility to Pathogens
				Alterations of the Gastrointestinal Mucosal Barrier
				Environmental Enteric Dysfunction
				Defects in Immune Function
				Impaired Inflammatory Response
				Changes in the Microbiota
		Impact of Malnutrition on Disease Progression, Resolution, and Recovery
		Malnutrition Increases Severity of Infection and Treatment Failure
		Cycling Back to Malnutrition
		Closing Thoughts
		References
	Chapter 9: Nutrition in HIV and Tuberculosis
		Introduction
		Nutrition in HIV
			HIV-Associated Wasting
			Gastrointestinal Disorders and HIV Enteropathy
			Lipodystrophy Syndrome
			HIV, ART, and Obesity
			Substance Use and Abuse Among PLWH
				Nutritional Status and Substance Use
				Nutritional Status and Substance Use Among PLWH
			HIV and Micronutrients
			Micronutrient Intervention Trials Among PLWH
				Trials Comparing a Single Micronutrient Versus Placebo
				Supplementation with Multiple Micronutrients
		Nutrition in Tuberculosis
			Epidemiology of Tuberculosis
			Tuberculosis and Malnutrition
				Malnutrition as a Consequence of Tuberculosis
				Active Tuberculosis as a Consequence of Malnutrition
			Micronutrients and Tuberculosis
		Nutrition Assessment in HIV and TB
			Anthropometric Measurements
				Anthropometric Measurements in PLWH/TB
			Biochemical Assessments
				Biochemical Assessment in PLWH/TB
			Clinical Assessment
				Clinical Assessment with PLWH/TB
			Food-/Nutrition-Related History
				Dietary Assessment Among PLWH/TB
		Conclusions
		References
	Chapter 10: Nutrition and Arboviral Infections
		Introduction
		A Framework for the Study of Nutrition and Arboviral Infections
		Nutrition and Dengue
			Epidemiology, Pathophysiology, and Clinical Aspects
			Relations Between Nutritional Status and the Outcome of Dengue Infection
		Nutrition and Other Arboviral Infections
			Chikungunya
			Zika
		Conclusions
		References
	Chapter 11: Nutritional Frameworks in Malaria
		An Introduction to Malaria and Nutrition
		Critical Factors to Consider in Outlining Pathways Between Nutritional Status and Malaria
		Susceptibility: Ways in Which Diet and Nutrition Influence Infection
		Severity: The Role of Nutritional Status in Pathogenesis of Malaria Disease
			Malaria Metabolism
			Complex Relationships Between Nutrition and Malaria Morbidity and Mortality
		Relationship Between Malaria and Anemia
			General Anemia
			Anemia and Malaria
			Contribution of Anemia to Malaria Severity
			The Iron-Infection Axis, Hepcidin, and Iron Deficiency Anemia
			Combating Anemia with Iron Supplementation: A Double-Edged Sword?
		Impact of Nutritional Status on Immune Responses to Malaria
		Adding Hookworm to the Mix
		Drug-Nutrient Interactions in Malaria
			Impact of Preventative Antimalarials on Nutrition
			Impact of Nutritional Status on Efficacy on Antimalarial Treatment
		Spread: The Role of Human and Mosquito Nutritional Status on Malaria Transmission
		Challenges and Opportunities for Integrated Public Health Interventions
			Challenges
			Opportunities
		The Way Forward: Addressing Key Knowledge Gaps and Integrating Interventions
		References
	Chapter 12: Soil-Transmitted Helminths: Does Nutrition Make a Difference?
		Introduction
		Agriculture, Diet, and Nutrient Deficiencies Influence Exposure to STH Eggs and Larvae
			Crop Production and Livestock Practices That Increase Risk of Transmission
			Fruit and Vegetables as a Source of STH Infection
			Geophagia Increases Risk of STH Transmission
			Low Dietary Intake and Poor Appetite Reduce Risk of STH Infection
			Take-Home Messages (Box 12.1)
		Nutritional Status Alters STH Establishment and Passage Across Host Tissue Barriers
			The Skin Barrier
			The Lung
			The Stomach
			The Intestinal Mucosa
			The Intestinal Microbiome
			Site Selection in the Intestine
			Other Barriers
			Take-Home Messages (Box 12.2)
		Host Nutrition Affects STH Feeding and Reproduction
			Nutrient Absorption and Feeding
			Macronutrients Alter Egg Reproduction
			Micronutrients Alter Egg Production
			Host Hormones Influence STH Development and Reproduction
			Take-Home Messages (Box 12.3)
		Host Nutrition Influences Immunity Against STHs
			Nutritional Deficiencies Alter the Th2 Response
			Supplementation and Refeeding Restore Components of the Th2 Response
			Take-Home Messages (Box 12.5)
		Host Nutrition Associated with STH-Induced Pathology
			Malnutrition, Immunosuppression, and Strongyloides
			Iron and Zinc Deficiencies Increase STH-Induced Pathology
			Protein Deficiency May Increase or Reduce STH-Induced Pathology
			Vitamin A and E Deficiencies Protect Against STH-Induced Pathology in Mice
			Lung Pathology Is Increased by Vitamin A Deficiency
			Take-Home Messages (Box 12.8)
		STHs Cause Host Malnutrition
			STH Infections Reduce Appetite
			STH Infections Reduce Nutrient Absorption
			Loss of Iron and Protein due to Intestinal Tissue Damage
			Increased Nutrient Demand
			Consequences of STH Infections on Child Growth and Perinatal Growth and Development
			STHs Alter Gut Microbiome with Implications for Nutritional Status
			Take-Home Messages (Box 12.9)
		Evidence That STHs Are Protective Against Nutrition-Related Chronic Conditions
			Why STH Infections May Be Relevant
			Obesity
			Insulin Sensitivity and Diabetes
			Inflammatory Bowel Disease
			Take-Home Messages (Box 12.10)
		Nutrition, Drug Efficacy, and Medicinal Plants
			Diet and Nutritional Status and Efficacy of Commercially Available Anthelmintic Drugs
			Medicinal Plants
			Toxic Effects of Copper and Boron
			Take-Home Messages (Box 12.11)
		Interventions to Address STH Infections and Malnutrition
			Reducing STH Infection as a Means of Improving Nutritional Status
			Improving Nutritional Status as a Means of Reducing STH Infection
			Combined Nutrition and Infection Interventions
			Co-existing Infections and Co-existing Nutrient Deficiencies
			Take-Home Messages (Box 12.12)
		Challenges for Future Research and Conclusions
		References
Part IV: Integration of Cross-Cutting Issues in Nutrition/Infection Interactions
	Chapter 13: Drug-Nutrition Interactions in Infectious Diseases
		Introduction
			Nutrition and Infection
			Nutrition and the Microbiota
			Antimicrobials and Nutrition
		Definitions and Clinical Relevance
		Mechanisms of Interaction
			General
			Pharmaceutical
			Pharmacokinetic
			Pharmacodynamic
			Limitations
		Food-Antimicrobial Interactions
			Mechanism
			Meal Conditions
			Fat Content
			Other Meal Components
			Enteral Feeding
		Specific Food Component or Nutrient-Antimicrobial Interactions
			Grapefruit
			Nutrition Supplements
			Dietary Supplements
				Vitamin Supplements
				Mineral Supplements
		Nutritional Status-Antimicrobial Interactions
			Infection Risk with Nutritional Status
			Antimicrobial Prophylaxis in Malnutrition
			Approach to Dosing
				Dose Format
				Body Composition
			Protein-Energy Malnutrition
				Volume of Distribution (Vd)
				Clearance (Cl)
				Antituberculars
				Antivirals
				Antimalarials
			Micronutrient Deficits
			Obese and Overweight
				Antibacterials
					Beta-Lactam Antibiotics
					Aminoglycosides
					Glycopeptides
					Others
				Antifungals
				Antivirals and Antiretrovirals
		Antimicrobial-Nutrition Status Interactions
			Subset of Adverse Drug Effects
			Overall Nutritional Status
			Nervous and Musculoskeletal Systems
			Gastrointestinal System
			Metabolic Effects
			Electrolyte Status
		Antimicrobial-Nutrient Interactions
		Drug-Nutrition Interactions from the CoVid-19 Experience
			Overview of the CoVid-19 Experience
				Approach to Management
				Prophylactic Measures
				Treatment Measures
				Role of Nutrition Status and Interventions
			Drug-Nutrition Interactions
		Conclusions
		References
	Chapter 14: Co-infection and Nutrition: Integrating Ecological and Epidemiological Perspectives
		Introduction
		An Ecological Framework for Integrating Co-infection and Nutrition
		Effects of Co-infection on Nutrition: Helminths and Malaria as a Case Study
		Effects of Nutrition on Co-infection: Helminths and TB as a Case Study
		Applying a Trophic Approach to Co-infection-nutrition Interactions in Practice
		Conclusion
		References
	Chapter 15: Climate Change Pathways and Potential Future Risks to Nutrition and Infection
		Climate Change Pathways to Nutrition and Infection
		Climate Change, Food Systems, and Nutrition
			Impacts of Nutrition and Agriculture on Climate Change
			Impacts of Climate on Agriculture and Nutrition
				Factors Affecting Agricultural Yield
				Oceans
				Food Prices and Food Trade
				Malnutrition
		Climate Change and Infectious Disease
			Arboviruses
			Malaria
			Waterborne Infections
			Helminth Infections
			Foodborne Infections
		The 2030 Sustainable Development Goals
		Gaps and Future Directions
		References
	Chapter 16: Public Health and Clinical Implications of Nutrition-Infection Interactions
		Introduction
		Ancient Traditions
		Foundations of Nutrition/Infection Relationships
			Conceptual Frameworks and Causality
			Principles of Nutrition and Immunology
			Types of Infectious Diseases and Influence of Nutrition
				Bacterial Infections (See Chap. 4) [75]
				Viral Infections (See Chap. 5) [77]
				Protozoan Infections (See Chap. 6) [79]
				Helminth Infections (See Chap. 7) [83]
			Examples of Nutrition/Infection Interactions
				Diarrhea (See Chap. 8) [36]
				HIV/TB (See Chap. 9) [37]
				Arboviruses (See Chap. 10) [84]
				Malaria (See Chap. 11) [38]
				Soil-Transmitted Helminths (STH) (Chap. 12) [88]
			The Bigger Picture
				Nutritional Factors Affect Pharmaceuticals Used in Treatment of Infectious Diseases (Chap. 13) [89]
				The Community Ecologist Perspective (Chap. 14) [62]
				Climate Science (Chap. 15) [93]
		Clinical and Public Health Relevance of the Bidirectional Nature of the Relationship between Nutrition and Infection
			Poor Nutritional Status May Increase Severity of Infections
			Infectious Diseases May Contribute to Malnutrition
			Malnutrition May Protect Against Infections
			Combined Malnutrition and Infection May Affect Chronic Disease
			Nutritional Status and Practices May Affect Infectious Disease Prevention
			Nutritional Factors May Affect Disease Diagnosis
			Need for Integrated Action
		A Post-Script on Modern Medicine and Clinical Care
			Opportunistic Infections
			Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and COVID-19 Disease
		Conclusion
		References
Index