I received this question from a viewer a few months ago, and didn’t want to cheat you with a short lIsT oF tOp tEN FOodS tO bOoSt yOuR iMmune blablabla.

Those have their place, and I may eat my shirt about this later, but for now, I wanted to get DEEP with you.

Is that alright?

To deliver the information I dug up, I’ve made a video you can put on while you’re vacuuming (I don’t know–you may have a really big house). Or flying your airplane (do pilots listen to podcasts?).

But if you want to speed-run this thing–or you’re just here for the references–here are the quick notes on the studies I looked at that you might benefit from reading, too. We’ll first address some of the weaker strategies that take a longer time to implement, and then addressing one huge physiological insight you must understand if you want to–well, maybe not acquire Wolverine or Deadpool’s healing factors, but at least boost your human superpowers beyond your current limit.

THE FAD ONE: VITAMIN C

I’ve known physicians who HATE the Vit C fad, and others who don’t care because you pee out the excess anyway. Most of the studies I saw right off the bat weren’t worth including (poor statistical value), but I did find this neat one:

VITAMIN C decreases GOUT (inflammation) by 12 percent in obese people (14,641 n): “The incidence rate of new gout diagnoses during follow-up was 8.0 per 1000 person-years among those assigned vitamin C compared with 9.1 per 1000 person-years among those assigned placebo. The vitamin C assignment reduced new gout diagnoses by 12% (HR: 0.88; 95% CI: 0.77, 0.99; P = 0.04). These effects were greatest among those with a BMI <25 kg/m 2 (P-interaction = 0.01).” That’s from the American Journal of Clinical Nutrition: https://academic.oup.com/ajcn/article-abstract/116/3/812/6586333?redirectedFrom=fulltext&login=false

THE OTHER FAD ONE: ECHINACEA

I did some digging on this one because it offers a great opportunity to talk about the risks of herbals in general, and the importance of understanding the “let your food be your medicine” concept: Echinacea’s gotta be eaten for a LONG time before it really seems to do good.

Kind of like Spinach. We don’t expect Popeye-like results from chugging a can of greens because at some point we learn real life real hero-strength comes from consistency over a long time, not eighties montages or cartoon instants. I love me some Popeye, by the way. Great lesson both in marketing and in healthy child engagement (for its time). But here’s what’s up with this interesting purple plant people are touting for boosting your resistance to viral disease:

THIS REVIEW ARTICLE: “Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and Echinacea in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds—Practical Advice on Dosages and on the Time to Take These Nutrients/Botanicals in order to Prevent or Treat Common Colds,” available online at https://www.hindawi.com/journals/ecam/2018/5813095/#references This is what a good peer-reviewed review of the literature should look like, by the way, if you’re browsing Pubmed and want to know what you can trust out of the not-clinical-trials section. Some GREAT references here that generally suggests, based on 82 trials, that Zinc and Echinacea preparations help protect against the common cold but you need to be taking Echinacea for a long time in large doses (2400 mg/ day for 4 months). That explains why the Cochrane database meta-analysis (https://pubmed.ncbi.nlm.nih.gov/24554461/) found that the positive trends in Echinacea aren’t statistically significant (it takes a much longer time to achieve results).

Is Echinacea even safe? https://pubmed.ncbi.nlm.nih.gov/24535321/ Insufficient to know if safety in pregnancy (but just like garlic and cranberry; we do know that “severe adverse events have been reported using blue cohosh and evening primrose oil”).

This article has a useful list of references for systematic reviews of the most commonly used herbals: https://www.rcpjournals.org/content/clinmedicine/13/1/7

Echinacia may cause GI upset and rash, allergies in very sensitive people (if allergies or asthma) but again we’re talking about most people being fine: https://pubmed.ncbi.nlm.nih.gov/15853441/

Always check the drug interactions database at Medscape or Lexicomp before adding a new herb or supplement to your regimen–OR HAVE YOUR PHYSICIAN OR HEALTH RESEARCHER CHECK FOR YOU! THIS IS SOMETHING I DO FOR MY PATIENTS AND HEALTH COACHEES, if you want to hit me up above.

THE REAL MAJOR PHYSIOLOGICAL CHANGE IN YOUR FOOD THAT CAN IMPROVE YOUR IMMUNE SYSTEM IS…

(Drumroll, please…)

The REAL Answer lies in your GUT MICROBIOME, because that is where your immune system gets its training ground; this is the physiological use of the appendix, as you can hear in my rant in the video above, with all its Crypts of Lieberkuhn, and Paneth cells. BASIC GUT BIOLOGY allows your immune system cells to “practice” and learn by interacting with the bacteria in these Crypts. Incidentally, this is why your appendix ISN’T some useless vestigial organ–but like your heart itself, it can attack you, and fortunately by the time you need it taken out it’s already done most of its job. Yay for redundant systems–just like you have two eyes, and two ears, you have other ways for your immune system to train in your gut. Just the appendix has some of the richest and best Crypts you could ask for. I’m sure there’s an offensive joke in there somewhere…

Appendix aside, it’s just KNOWN that a complex gut microbiome is good for your immune system. In the video I go in depth explaining how C Diff works, too–that’s a terrible disease you get when your good bacteria is all wiped out by antibiotic use, which is why you shouldn’t seek abx for most viral illnesses even if you’re feeling miserable. Note you can also have the opposite, SIBO, where you have too much bacteria of the wrong kinds (not all your gut bacteria wiped out, as is pretty much the case with C. Diff).

There’s all this complex data on gut microbiome from the National Health and Nutrition Examination: https://www.cdc.gov/nchs/nhanes/index.htm

It was analyzed here (Journal of Nutrition “A Classification System for Defining and Estimating Dietary Intake of Live Microbes in US Adults and Children”, found at https://academic.oup.com/jn/article/152/7/1729/6588008?login=false)–and that analysis finds only 20-26 percent of people get high microbiome foods: “Our analysis showed that 52%, 20%, and 59% of children/adolescents, and 61%, 26%, and 67% of adults, consumed Med, Hi, or MedHi foods.”

Gut microbiome depends on your location in the world, so eating local and gardening and getting your local bacteria may be best: “People living in industrial environments are less likely to acquire beneficial viruses, bacteria, and fungi through vaginal birth and breastmilk as babies, through contact with soil, and through living in close contact with farm animals and people in large households. Our diets lack nutrients, such as soluble fiber, to feed these organisms. Pollution, antibiotics, and tobacco kill some of those that remain.” (This is from a Medscape article by Doctor Marya and her farm: https://www.medscape.com/viewarticle/980400#vp_3–not a study, just a physician with good sound-bites).

I mean, the importance of location makes sense when you think about the native peoples who died historically from European diseases–obviously location matters for your population. How do you get your local bacteria? “People who immigrate from less-developed to more-developed countries don’t increase their own risk for IBD but do increase the risk for any of their children born in their new country,” says Doctor Marya’s article.

I also talked about this article in Nature Medicine–it’s not great, doesn’t cite population numbers or explain study mechanics in the abstract, so you have to pay for the rest of the information BUT THE SCIENCE STILL MAKES SENSE: https://www.nature.com/articles/s41591-020-0963-8 “Comparative metagenomics of gut microbiomes shows that Irish Travelers retain a microbiota similar to that of non-industrialized societies. Their microbiota is associated with non-dietary factors and is proportionately linked with risk of microbiome-related metabolic disease.”

Should you get a home test for your microbiome?

Well, home tests might be not good yet. In the video, I’m citing this Medscape article with Dr. Kashyap: https://www.medscape.com/viewarticle/982679#vp_1; note the guy saying that also has conflicts of interest because he’s designing a new home test, but the point is, studies for home tests in general have conflicts of interest: “most of the measuring techniques are based on ‘proprietary methods that lack validation in large cohorts.'”

“Both technologies are commonly used in experimental efforts to characterize and understand the activity of the gut microbiome,” the article goes on, “but neither can reliably reveal the degree to which microorganisms in the gut are contributing to risk for disease in general or to specific diseases. One of the most important reasons is that the function of microbial strains appears to depend on the interrelationship with other microorganisms that are present….This overlap becomes confusing quickly, because ‘there is also functional redundancy so that multiple taxa can perform the same function.'”

What’s that mean? It means WE DON’T KNOW WHAT IS EXACTLY THE HEALTHY GUT/RIGHT BACTERIA BECAUSE IT DIFFERS PER AREA AND PERSON–you have to be able to defend against what is in YOUR area and your gut is a practice field for your immune system to understand that.

SO EAT LOCAL VEGGIES. THIS IS WHY BREASTFEEDING, DOING YOGURT/KIMCHEE/OTHER LOCAL FERMENTED FOODS, matter.

I show some pictures and explanations about breastfeeding in the video. BTW if that pisses you off you can go suck a cow instead.

Another really good study to analyze (in the video I also show the picture halfway down on this article): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215979/ Int J Mol Sci. 2020 Apr; 21(8): 2890.
Published online 2020 Apr 21. doi: 10.3390/ijms21082890
PMCID: PMC7215979
PMID: 32326175
Microbial Medicine: Prebiotic and Probiotic Functional Foods to Target Obesity and Metabolic Syndrome

Note we can’t be sure exactly which probiotics are the best, because different studies have supported and negated the bacteriodetes hypothesis. BUT IT’S INTERESTING IN THIS ARTICLE THAT THE LEAKY GUT HYPOTHESIS MAKES SENSE AND HAS BEEN USED FOR EVERYTHING.

I talk for a while on a SIDE NOTE ON THE LEAKY GUT HYPOTHESIS, and how discussions of the immune system can spiral out of control. That hypothesis is basically the idea that as your tight junctions fail, inflammatory factors leak from the “immune system training ground” out into your blood stream, causing a BAD immune reaction. This theory has been used to explain everything from obesity to…uh, well, autism? Many parents anecdotally swear by the “leaky gut” when they talk about special diets they believe helped their children’s autism, and I talk that debate in the video; I also explain on a personal note that this is why even though I believe firmly in vaccination, I understand the difference between uneducated screamers and educated anti-vaxxers who are honestly concerned, based on real gut science, about early immune system issues in early vaccinated kids.

Basically, people aren’t a monolith. Not every anti-vaxxer is talking about thimerosal mercury preservatives in MMR (which was a real thing, and a far cry from modern COVID conspiracy theorists screaming about mind-control chips). Even among the group that say vaccines cause autism, some vaccine critiques are wrapped up in real historical issues with the combined diphtheria, pertussis, and tetanus formulations: it’s important to understand the historical story of the DTAP formulation vs. the older DTP, and the seizures that the early DTP vaccines triggered in 1/500 doses. We replaced DTP with modern DTAP to deal with that seizures issue: this historical fact was even taught in the very pro-vaccine med school pediatric BRS review books I had. The big tragedy with that conversation is that autistic kids are predisposed to seizures, so when a kid had a seizure after DTP, and later got diagnosed with autism, was it 1) the DTP vaccine causing brain inflammation and autism, or 2) was that just a kid who was already going to have autism, already predisposed to seizures, who got triggered by that old formulation? Whichever answer you believe, we never got to have those conversations with our patients because we as a profession treated any and all questioning the way certain religions treat it: like sin. I still remember a pediatrician who hadn’t studied modern autism criteria telling my Mom that my brother didn’t have anything wrong with him–my brother who now is 23 years old and completely nonverbal and nonfunctional in society because of his severe ASD. How strong do you think my mother’s faith is in US medical education as a result? The American medical profession is RIFE with that kind of arrogance and failure to communicate, so when the new DTaP came out, we never bothered to say, “we hear you, the old things caused too many seizures, this should be better.” So because we lack basic social skills to communicate and negotiate, we as a profession created the blanket group of people who believe all vaccines cause autism.

And not all “anti-vaxxers” are actually anti-vaccine! Some people are just concerned that we should be following vaccination schedules more similar to Denmark or Japan, where there is more space between vaccines. These particular “anti-vaxxers” worry that certain kids with sensitive immune systems may have brain issues that can result in autistic behavior if their guts leak out certain toxins in response to combined vaccine inflammation on their tight junctions. For these folks, the idea isn’t so much that a vaccine causes autism, as the fear that a powerful combined formulation in an overly-young baby with a strong family history messes with immune system development (which, they say, then causes brain inflammation). That is a concern that makes sense; the issue is testing it. These aren’t crazy people, and whether they’re wrong or right isn’t the point: the point is we need to be having conversations with openness and evidence, not rage and ire. I didn’t get a chance in the video to talk about the corporate capitalism problem in the United States where vaccine companies legally can’t be sued, but that’s an ethical issue that makes these people afraid, too! They’re asking why corporate interests get to determine government policy–which is kind of a good question. I have found that by having respectful conversations full of joint decision-making, rather than just forcing my way, many “anti-vaxxers” will actually vaccinate if given space.

If you’d like more data on vaccines and vaccine injury, you can check and compare the National Vaccine Injury Council data and CDC vaccine archives from the MMWR; Australian public health data is also really nicely compiled:
http://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/index.html
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5515a1.htm#tab5 Table 5 is great.
http://www.public.health.wa.gov.au/cproot/432/2/FS%20Vaccine%20Side%20Effects.pdf
www.nvic.org/faqs/vaccines-infectious-disease.aspx

SO ANY WAY, LEAKY GUT and OBESITY.

“One of the hallmarks of obesity and metabolic syndrome is a systemic, low-grade inflammatory state. Research has shown that a wide range of inflammatory markers, including C-reactive protein and pro-inflammatory cytokines, are strongly associated with development of adiposity [51,52] and increased risk of metabolic disorders such as cardiovascular diseases, fatty liver disease, and type 2 diabetes [53]. ” The review cited above https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215979/ cites a neat CRP metaanalysis study and interleukin measurements: https://pubmed.ncbi.nlm.nih.gov/17505154/ and https://pubmed.ncbi.nlm.nih.gov/23171381 And of course we know diabetes is an inflammatory disease. SO DECREASING OBESITY (less easy-to-digest carbs) DECREASES YOUR RISK OF INFLAMMATORY-IMMUNE DISEASES LIKE DIABETES. BUT ALSO:

“Thus, not only is diet a direct factor in modulating systemic inflammation, but a pro-inflammatory state is sufficient to promote obesity and perturbed metabolic function. More recent studies have mechanistically corroborated these findings, linking microbiota-related inflammatory changes during HFD-induced obesity to Toll-like receptor 4 (TLR4) signaling and a resultant increase in plasma levels of LPS [63].”

“or one, pathogenic strains that may dominate a dysbiotic gut are a rich source of LPS and other endotoxins, that may infiltrate circulation to initiate an immune response [56,57]. Second, there is strong evidence for the critical role of the gut microbiota in maintaining integrity of the gut epithelial lining, a function that if compromised would permit increased intestinal translocation of endotoxins into the blood [64].”

“In addition, a high-fat, obesogenic Western diet has been proven to significantly reduce bacterial diversity and richness in the GI tract of mice, an effect that is readily reversible upon reverting back to a normal chow diet [84]. This effect has also been replicated in humans transitioning between high-fiber and high-fat-and-simple-sugar diets, with the microbiome showing equally flexible functional and taxonomic profiles [14].”

All of that’s from the review article I love above.

SO EATING SOLUBLE FIBER (psyllium powder if you think you’re not getting enough)–which is a prebiotic to feed your bacteria–should help your immune system.

I SHOWED THIS BEAUTIFUL TABLE WITH REFERENCES:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215979/table/ijms-21-02890-t001/?report=objectonly

I did critiqued the table a bit: NOTE TO BE CAREFUL WITH COW’S MILK BECAUSE IT CAN AT EARLY AGES INCREASE INFLAMMATION BECAUSE IT REALLY REQUIRES GUT BACTERIA THAT THE BABY DOESN’T HAVE YET–I also went out of my way EXPLAIN WHY HONEY IS BAD FOR KIDS BUT MAYBE GOOD FOR ADULTS.

All of that critique and conversation–really this whole article–boils down to WHY YOU NEED AN INDIVIDUALIZED CONSULTATION. This article can’t be medical advice because what works for the population may not work for you. A good doctor should be able to take the general population data, your family history, and your individual symptoms and concerns to help you create an individual plan that’s safe for you.

And yes, I’m available. Healthcare.byjenfinelli.com and so forth.

SO THERE WE GO, TO REALLY IMPROVE YOUR IMMUNE SYSTEM, EAT VEGGIES, LESS CARBS, AND SPECIFICALLY THESE FOODS:

“Asparagus, sugar beet, garlic, chicory, onion, Jerusalem artichoke, wheat, honey, banana, barley, tomato and rye, blue agave, yacon root, leeks” (and by the way fructans are also present in echinacea).

The end!