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MAY 2020  
Special Report
Malnutrition and Susceptibility to Viral Infections: Role of Traditional Indian Medicine to Boost Im

The whole world is currently reeling under the impact of a pandemic, a viral infection caused by the COVID-19 or more commonly known as the coronavirus infection. Infected persons usually show respiratory or flu-like symptoms such as cough, fever, shortness of breath, and so on, within 2-14 days after exposure to the virus. The good news is that most patients usually experience mild to moderate severity of the illness and recover without requiring special treatment. However, older patients and patients with pre-existing medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to manifest serious symptoms and the disease may even prove fatal. The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. As there are no specific vaccines or treatments available currently, the only ways to reduce the spread of the disease are practising respiratory etiquette, observing social distancing, maintaining hygiene, washing hands thoroughly, and so on.

As researchers around the world desperately try to develop the vaccine for the infection and develop the prophylaxis for it, governments have been working on a war footing to control the spread of the virus and minimize the number of fatalities resulting from it. Although too early to confirm, the virus shares certain similarities with other virus strains such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome coronavirus (MERS-CoV). As scientists are still working on the exact nature of the similarities, certain common precautionary measures have been advised to the general public.

However, it would be noteworthy to assess the status of malnutrition and susceptibility to viral infections through the lens of other similar viral diseases/epidemic/endemic case studies. As the COVID-19 is a newly discovered virus, confirmed information available about the virus is limited; a study of similar experiences with previous episodes of infections would help develop possible measures to ensure preparedness for
the future.

Malnutrition and Immunodeficiency

Malnutrition is a major factor responsible for increased morbidity and mortality burden in a population. Malnutrition usually results from disordered nutrient assimilation or recurrent infections and chronic inflammation, which could be the result of an underlying immune defect.Studies have shown that immune dysfunction can be both a cause and a consequence of malnutrition. Immune dysfunction can directly drive pathological processes in malnutrition, including mal-absorption, increased metabolic demand, dysregulation of the growth hormone, and greater susceptibility to infection.

Malnutrition is not just a result of inadequate food intake but also improper nutrient intake and poor diets leading to consequences such as obesity and diabetes. Characterizing pathogenesis across the spectrum of malnutrition is essential to underpin novel therapeutic approaches to support international goals to improve nutrition, health, and well-being. Even common infections could be fatal to undernourished children implying that mortality is related to underlying immunodeficiency even in mild forms of undernutrition. Infections are also more common and more severe in people with obesity. Immune dysfunction can also arise before birth via developmental pathways, compounded by environmental and behavioural factors, particularly those experienced during early life.

Co-relation Between Micronutrient Deficiencies and Susceptibility to Infections

Malnutrition can be a consequence of energy deficit (protein-energy malnutrition or PEM) or a micronutrient deficiency and in both cases is still a major burden in developing countries and is considered the most relevant risk factor for illness and death, affecting particularly hundreds of millions of pregnant women and young children.

A seemingly healthy child might also be more susceptible to viruses if suffering from micro-nutrient deficiencies which often go unnoticed. Together, infections and micronutrient deficiencies can induce immunodeficiency in otherwise healthy children, increasing their susceptibility to viral infections as well as other ailments. A sick person’s nutritional status is further aggravated by diarrhoea, mal-absorption, loss of appetite, diversion of nutrients for immune response, and so on, all of which lead to nutrient losses and further hinder the body’s defence mechanisms, with fever also increasing both energy and micronutrient requirements. Malnutrition thus magnifies the effect of disease and vice versa.

Malnutrition is the leading cause of immunodeficiency in human beings. Multiple studies have proven that the immune system cannot function optimally if malnutrition is present.1 There is a direct relationship between malnutrition and immunodeficiency as reflected through the susceptibility to infections caused by influenza and Zika viruses.

1  https://www.longdom.org/open-access/protein-energy-malnutrition-and-susceptibility-to-viral-infections-as-zika-and-influenza-viruses-2155-9600-1000489.pdf

Nutritional Security as the First Line of Defence

A malnourished person has more severe disease episodes, more complications, and spends more time ill for each episode.Thus, malnutrition and the susceptibility of a person to infectious diseases is not only closely linked but is also a vicious cycle of infection, reduced immunity, and deteriorating nutritional status leading to consequences such as impaired child development, compromised immunity leading to infections and diseases, reduced productivity, poverty, impaired development of education and health system and socio-economic and political instability.

Recommendations

  1. Use of government mechanisms such as the Public Distribution System (PDS), Mid-day meal, and the Integrated Child Development System (ICDS) for the distribution of vitamin supplements, especially to the most vulnerable populations.
  2. An extensive public awareness campaign implemented to generate awareness regarding the significance of sanitary hygienic practices to prevent the spread of the coronavirus was successfully carried out by the Indian Government, media, public figures, and so on. A similar outreach programme enlightening the public regarding the significance of good nutrition to improve immunity against the virus could also greatly help strengthen the fight against the spread of the infection.
  3. The learnings from the current outbreak of the coronavirus should be used to tackle similar situations in the future by increasing our preparedness for the same, especially with respect to measures by the government (rapid testing, early detention and isolation, sufficient medical equipment, and so on) and the citizens (increasing personal immunity, improving the nutritional quality of available food, personal hygiene, and so on).

Role of Traditional Indian Medicine to Boost Immunity and Curing Viral Infections

Developing novel antiviral drugs is always an important on-going process. Traditional medicines using natural ingredients offer unique opportunities to explore medicines and its active principles. For example, the recent outbreak and spread of COVID-19 has led to research and development for vaccines and medicines to tackle the fast-spreading pandemic. Further, the on-going treatment is a hit and miss trial of numerous drugs being administered. These drugs are mainly effective only to reduce or cure certain symptoms rather than the viral infection. While the antiviral drugs and vaccines are being developed, the traditional systems focus more on building the immunity of the body and providing a holistic solution for the well-being of an individual as a coordinated strategy. The antiviral drugs are often very specific and can not only prevent infection but also treat illnesses.

In India too, the Ministry of AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy), Government of India, has issued an advisory to the states suggesting ‘add-on traditional medicine interventions to conventional care’. It has also listed 40 national and international research papers that highlight the importance of traditional medicines. The traditional Indian medicine system-Ayurveda was developed around 2000 years ago and relies heavily on herbal medicinal products (HMPs). Approximately 80 per cent of India’s population use Ayurveda in some form or another, through more than one-half million Ayurvedic practitioners.

Ayurveda also focuses on lifestyle practices and immunity for cure and prevention of diseases. For instance, consuming tea fortified with five Ayurvedic herbs, namely Ocimum sanctum (tulsi), Glycyrrhzia glabra (liquorice), Withania somnifera (Ashwagandha), Zingiber officinale (ginger), and Elettaria cardamomum (cardamom) is found to enhance innate immunity of the body. Similarly, herbs like Ocimum basilicum, Allium sativum (Garlic), Embelica officinalis (Indian Gooseberry), Aloe vera and Camphor and Eucalyptus oil have shown success in building immunity against the H1N1 virus and relieving swine flu symptoms.

Broad spectrum antiviral properties have been reported for plants such as Taraxacum officinale (Common Dandelion), Allium fistulosum (Welsh Onion), Ocimum basilicum, and Embelica officinalis. Thus, in view of the current scenario of the COVID-19 pandemic, the Ministry of AYUSH, Government of India, has also issued a list of self-care immunity boosting measures (Box 1).

It may be argued that these systems do take longer time to cure as compared to modern medicines, but usually have the advantage of lesser side effects and cost effectiveness. Along with modern medicine, these systems could also be explored as a potential treatment/ prevention for COVID-19.

The review of literature suggests that the traditional medicine system has the potential to cure and prevent infectious diseases. However, there is a need to strengthen and standardize the treatments while using traditional medicines. Further, the use of these traditional medicines not only helps cure symptoms but also helps improve immunity and reduce the risk of infections to a great extent. The potential of these plant-based remedies for curing and preventing the COVID-19 infection must be extensively explored to develop globally acceptable therapeutic remedies along with the modern medicines and vaccines. 

Vaishnavi Barthwal, Project Associate; Roshni George, Research Associate & Area Convenor;  and Dr Anjali Parasnis, Senior Fellow & Associate Director, NSEC, TERI, Mumbai.

   
© TERI 2020
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Nominations open for CSP Today India awards 2013


The inaugural CSP Today India awards ceremony takes place on March 12, and CSP developers, EPCs, suppliers and technology providers can now be nominated.

CSP has made tremendous progress since the announcement of the Jawaharlal Nehru National Solar Mission in 2010. With Phase I projects now drawing closer to completion, the first milestone in India’s CSP learning curve is drawing closer. CSP Today has chosen the next CSP Today India conference (12-13 March, New Delhi) as the time for the industry to reflect upon its progress and celebrate its first achievements.

At the awards ceremony, industry leaders will be recognized for their achievements in one of 4 categories: CSP India Developer Award, CSP India Engineering Performance Award, CSP India Technology and Supplier Award, and the prestigious CSP India Personality of the Year.

Matt Carr, Global Events Director at CSP Today, said at the opening of nominations that “CSP Today are excited to launch these esteemed awards, which will enhance the reputation of their recipients. I am particularly excited to launch the CSP India Personality of the Year award, a distinguished honor for the industry figure deemed worthy by their peers.”

All eyes will be on the CSP Today India 2013 Awards when nomination entry closes on February 4 and the finalists are announced on February 11. The awards are open to all industry stakeholders to nominate until February 4 at
http://www.csptoday.com/india/awards-index.php or by e-mail to [email protected]

Contact:
Matt Carr
+44 (0) 20 7375 7248
[email protected]