9/05/2020

Boosting immunity during a pandemic : Health supplements in India during the time of COVID - 19

 


The ongoing COVID-19 pandemic has brought the world to a grinding halt and has forced us to rethink and redefine our ideas of health and nutrition, in the larger context of how we lead our daily lives. Preventive and protective measures like wearing masks, sanitising hands and surfaces we come into contact with, social distancing when in groups - all of these are vital for slowing down and reducing the impact by simply limiting its spread. Along with these preventive measures and precautions, intake of health supplements of various kinds has also been quite prevalent, with many of these supplements being endorsed and even distributed by state governments. This article seeks to discuss the growing importance of nutrition during the time of the COVID-19 pandemic, focusing specifically on health supplements.

 

During times of public health crises, especially pandemics like COVID-19, when taking efforts to keep oneself in good health, boosting one’s immunity is a huge part of it. In simple terms, immunity can be understood as the ability of the body to protect itself against certain illnesses[1]. The immune system itself is highly complex, and its strength and functioning is dependent on a lot of factors including those that are environmental and genetic. Eating a well balanced diet, getting sufficient exercise and sleep are some of the most common ways of strengthening the body and thus the immune system, to fend off illnesses. As COVID-19 is characterized by considerable derangement of the immune response,a diet enriched with immunomodulatory foods such as pro- and pre-biotics and vitamins A, C and D) are recommended (Lippi, Henry, Bovo, & Sanchis-Gomar, 2020).

 

Health supplements are a popular way of adding nutritional value to one’s diet. They’re a convenient way of incorporating additional nutrients into the diet. They come in various forms - pills and capsules, powders to be mixed in with food or water, chewable candies, packaged drinks and so on. Also called dietary supplements,  the Association of Southeast Asian Nations (ASEAN), defines them as any product that is used to supplement a diet and to maintain, enhance and improve the healthy function of a human body and may contain one or more or combinations of nutrients or substances including botanicals, in various forms such as extracts or concentrates, presented in dosage forms. These dietary supplements typically contain vitamins, minerals, proteins, amino acids, enzymes, and plant or botanical extracts[2]. It is recommended that these supplements are taken as part of a regular well balanced diet in general, and there are studies which show that it could be significantly helpful for severely malnourished people, people recovering from surgical procedures, and could provide nutritional support in both benign and malignant disease recovery (Stratton & Marinos, 2007). A study carried out on 1,530 Canadian adults aged 19 to 65 years, showed that multivitamin users to have higher total intakes of folic acid, iron, calcium, and vitamin D, compared to those who did not consume any multivitamins in addition to a regular diet (Troppmann, Gray-Donald, & Johns, 2003).

 

The landscape of health practices in India is highly diverse and fascinating. ‘Modern’ allopathic medical practices and drugs co-exist with traditional forms of medicine like Siddha, Unani and Ayurveda, as well as alternative forms of medicine which include homeopathy and acupuncture. The concept of health supplements in India typically include products which are part of these traditional systems of medicine as well. It is interesting to observe how Indians, both at the individual and State level have adopted a range of preventive measures influenced by different forms of medicine. Indians typically include nutritional supplements from traditional and alternative systems of medicine in their diets - Chyawanprash, turmeric milk mixes are examples of this. The AYUSH ministry has issued guidelines for traditional medicine systems  as precaution and treatment of COVID-19[3]. An example of this is the Kabasura Kudineer[4] endorsed by the Tamil Nadu state government, among others. It is even included in the treatment plan and given to those kept under institutional quarantine. Several other Ayurvedic herbal supplements and measures have been recommended to boost immunity[5].

 

Spirulina, a microalgae known for its high bioavailability of  various B vitamins, and minerals including calcium, iron,  potassium and zinc, in addition to amino acids and proteins (Khan, Bhadouria & Bisen , 2005). The Central Food Technologies Research Institute (CFTRI) along with Aquaseal Technologie (a Mysuru based company) has developed a chikki ( groundnut based confectionery bar) enriched with spirulina. It has been distributed to around 60,000 people across Delhi, Bengaluru and Mysuru[6].

 

It is not just traditional herbal supplements which have seen a significant rise of usage amongst Indians. With numerous reports of various vitamins, including Vitamin C and Vitamin D, having a positive impact on strengthening the immune system against COVID-19, sales of these vitamin supplements, along with health drink mixes, fish oil capsules et cetera have seen a great increase.  A news report by Livemint highlighted the surge in sales of health supplements including multivitamins and herbal concoctions during the pandemic. Sales increased in online portals as well as brick - and - mortar shops[7], with Netmeds, an online pharmaceutical company seeing a 119% growth in sales of multivitamins during April and May as compared to February and March this year.

However, taking into account the increasing demand for multivitamins, it is imperative to understand that multivitamins and other health supplements are not in any way a panacea for any health crisis, including COVID-19. A study conducted by researchers from South Taiwan University revealed that insufficient knowledge of multivitamins and disproportionate faith in its abilities may lead to ‘illusory invulnerability[8]’, which leads people to adopt unhealthier practices especially with regards to diet, under the belief that the multivitamins will compensate for the lack of nutrition in their food choices (Chiou, Yang & Wan , 2011). In critical times like these, it is absolutely necessary to do adequate research and to fact-check any and all claims of ‘cures’. Incase the claims are dubious, the best case scenario would be if the products have no effects at all, the worst case scenario could be the products being inherently dangerous to the point of being fatal. Claims of Aresenicum Album ( a homeopathic drug ) and Coronil ( manufactured by Patanjali) being possible cures for COVID-19 have been debunked.

While health supplements, especially multivitamins, health drinks et cetera certainly help achieve the Recommended Dietary Allowance for for many vital micro and macro nutrients, they could prove to be harmful if not used judiciously along with proper medical advice[9].


- Pooja S.

[1] How does the immune system work? - Components and tasks of the immune system

[9] Dietary supplements: Do they help or hurt?

 

 

References

 

  1. Boindala S, Lewis JI. The grand challenge of regulating health foods in India. Indian J Med Res. 2019;150(3):248-253. doi:10.4103/ijmr.IJMR_1719_18
  2. Chiou, W., Yang, C., & Wan, C. (2011). Ironic Effects of Dietary Supplementation: Illusory Invulnerability Created by Taking Dietary Supplements Licenses Health-Risk Behaviors. Psychological Science, 22(8), 1081-1086. Retrieved August 15, 2020, from www.jstor.org/stable/25835503
  3. Harvard Health Publishing. (2013, January). Dietary supplements: Do they help or hurt? Retrieved August 15, 2020, from https://www.health.harvard.edu/staying-healthy/dietary-supplements-do-they-help-or-hurt
  4. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the immune system work? [Updated 2020 Apr 23]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279364/
  5. Khan, Z., Bhadouria, P., & Bisen, P. S. (2005). Nutritional and therapeutic potential of Spirulina. Current pharmaceutical biotechnology, 6(5), 373-379.
  6. Lippi, G., Henry, B., Bovo, C., & Sanchis-Gomar, F. (2020, May 26). Health risks and potential remedies during prolonged lockdowns for coronavirus disease 2019 (COVID-19). Retrieved August 15, 2020, from https://www.degruyter.com/view/journals/dx/7/2/article-p85.xml?currency=USD
  7. MacDonald, J. (2019, August 5). How Dietary Supplements Can Cause More Harm Than Good. Retrieved August 15, 2020, from https://daily.jstor.org/how-dietary-supplements-can-cause-more-harm-than-good/
  8. Ministry of AYUSH. (n.d.). Ayurveda’s immunity boosting measures for self care during COVID 19 crisis. Retrieved August 15, 2020, from https://health.ncog.gov.in/ayush-covid-dashbaord/
  9. Sathish Kumar, T. (2020, May 05). Firm prepares nutrition food to check Covid-19. Retrieved August 15, 2020, from https://www.deccanherald.com/state/karnataka-districts/firm-prepares-nutrition-food-to-check-covid-19-833982.html
  10. Stratton, Rebecca J.; Elia, Marinos Who benefits from nutritional support: what is the evidence?, European Journal of Gastroenterology & Hepatology: May 2007 - Volume 19 - Issue 5 - p 353-358 doi: 10.1097/MEG.0b013e32801055c0
  11. Troppmann, L., Gray-Donald, K., & Johns, T. (2003, April 23). Supplement use: Is there any nutritional benefit? Retrieved August 15, 2020, from https://www.sciencedirect.com/science/article/abs/pii/S0002822302901835
  12. U Tejonmayam. (2020, April 24). Ingredients in kabasura kudineer can fight Covid-19, say researchers in Chennai: Chennai News - Times of India. Retrieved August 15, 2020, from https://timesofindia.indiatimes.com/city/chennai/ingredients-in-kabasura-kudineer-can-fight-covid-say-researchers/articleshow/75335027.cms

 

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