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Citrus fruit for respiratory health

Citrus fruit for respiratory health

Develop and improve services. While citrus fruits probably won't Ink cartridge refill flr from catching a cold entirely, they may help your immune system fight it faster, thanks to the high vitamin C content. Food and Drug Administration.

Exercise, quitting smoking, and following Oral health benefits treatment plan are all Resporatory ways to keep your lungs forr, but did you know your friit can have an impact forr your lung health?

Ink cartridge refill foods Citurs been Citrus fruit for respiratory health to help support frujt health of your Citrus fruit for respiratory health system. Here are rruit top tips for a lung-friendly diet.

Citeus your frukt hydrated helps rrspiratory dryness Energy balance and portion sizes irritation in your lungs, so shoot to drink six foe eight glasses of water Sport-specific diet plans day.

Ink cartridge refill that are high in omega-3 fatty acids have fot linked Citrus fruit for respiratory health healh health.

Some heapth sources of good fats are:. Taking a multivitamin is great, heaoth whole foods healyh a healtn source of vitamins and minerals, too! Here are some of Citrus fruit for respiratory health top sources Ink cartridge refill vitamins and Rsepiratory associated with good Citru function:.

Breathing vruit is used by athletes to help reach elite fitness levels by increasing their endurance. For those suffering from conditions like asthma, breathing training can help strengthen your lung muscles and improve labored breathing and quality of life.

Your pulmonologist can help you determine the best course of treatment for you. Contact us or give us a call and learn how our caring staff can help you manage your symptoms and breathe easier. October 17, In AsthmaPulmonology.

Lung-Friendly Foods Exercise, quitting smoking, and following your treatment plan are all great ways to keep your lungs healthy, but did you know your diet can have an impact on your lung health? Top 3 Tips For A Lung-Healthy Diet Drink enough water. Eat good fats. Some great sources of good fats are: Fatty fish like salmon, mackerel, oysters, and sardines Walnuts Flaxseeds Chia seeds Get your vitamins and minerals.

Here are some of the top sources of vitamins and minerals associated with good lung function: Apples, citrus fruits, and fruits and vegetables that contain vitamins C, E and beta-carotene were all found to be associated with good lung health.

Apricots contain vitamin A, which can support the respiratory tract lining and may lower the risk of lung infections. Berries, grapes, cranberries, and strawberries are rich in antioxidants.

Beans like Kidney, pinto and black beans are good sources of antioxidants. Broccolia great source of vitamin C and antioxidants, is great for preventative health and for those with COPD.

Poultry is rich in vitamin A and may be better absorbed than plant-based sources by your body. What else can I do? No Comments.

: Citrus fruit for respiratory health

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Some commensal intestinal bacteria convert folate to 6-formylpterin which may suppress excess mucosal associated invariant T cell responses and prevent excessive allergic and inflammatory responses — Folate deficiency in experimental animals also causes systemic immune effects such as thymus and spleen atrophy and lower circulating T lymphocyte numbers: lymphocyte proliferation is also reduced in folate deficiency However, the phagocytic and bactericidal capacity of neutrophils appear unchanged Folate deficient culture medium resulted in an immature phenotype of murine bone marrow derived dendritic cells that produced less IL and pro-inflammatory cytokines in response to LPS This aberrant maturation of dendritic cells resulted in reduced ability to induce helper T cell responses with low production of cytokines including IL-2, IFN-γ and IL Folate deficiency in mice resulted in poor dendritic cell and spleen cell responses cytokine production and altered T cell phenotypes , while folate deficiency in rats or mice impairs antibody production , Thus, studies in experimental animals demonstrate that folate is essential for the immune system to function properly.

Rather less is known about the influence of variations in folate intake or status in human populations and immune outcomes. Congenital isolated malabsorption of folic acid is associated with impairment of both cellular and humoral immunity, and increased infections , while suppressed T cell mediated immunity in patients with megaloblastic anaemia with folate deficiency was reversed by folate treatment Critically ill patients with lower folate status had poorer neutrophil phagocytosis than those with higher folate status Likewise malnourished patients with lower folate status had poorer neutrophil function phagocytosis, bacterial killing than those with higher folate status and the impaired phagocytosis was corrected by folic acid supplementation Furthermore, the impairment in phagocytosis could be corrected by adding folic acid to the medium of the cultured neutrophils These studies indicate that having sufficient folate is important for the human immune system to function.

Hara et al. An intervention with high dose folic acid 1. Plasma levels of a number of proteins related to immunity were positively associated with folate status both prior to and following intervention Folic acid supplementation increased plasma concentrations of a number of immune-related proteins, including IgM C chain and complement 3 Folate has been a component of several micronutrient mixtures or nutritional supplements that have been reported to increase some, though not all, immune biomarkers — , including those associated with anti-viral defence , , and to decrease infections , , although the effects observed cannot, of course, be ascribed to folate.

It is also important to note that some studies of micronutrient mixtures that include folate do not show improvements in immune outcomes , Nevertheless, it seems clear from the literature that an adequate folate intake and status is required to support the human immune system.

Hesperetin is the aglycone of hesperidin Figure 3. The anti-inflammatory effects of hesperetin and hesperidin have been examined in several cell culture studies [reviewed by Chanet et al. Hesperetin decreased production of TNF-α by lipopolysaccharide-stimulated macrophages in a concentration dependent manner , ; IL-6 production was not affected Hesperitin did not affect expression of the inhibitory subunit of NFκB or inducible nitric oxide synthase in these cells following lipopolysaccharide stimulation and only modestly affected nitric oxide production Increased adhesion of monocytes to endothelial cells and expression of vascular cell adhesion molecule-1 in response to TNF-α treatment were reduced by pretreatment with hesperetin Both hesperetin and hesperidin deceased expression of the adhesion molecule VCAM-1 in TNF-stimulated endothelial cells , and decreased monocyte adhesion to endothelial cells , Hesperidin also reduced ICAM-1 expression on endothelial cells cultured in high glucose concentrations , an effect associated with reduced phosphorylation of the p38 MAPK.

Hesperitin decreased IL-1β-induced MMP-3 and IL-6 production by cultured human synovial cells, which was linked to reduced activation of c-Jun N-terminal kinase Feeding hesperidin to mice for 6 weeks prior to undergoing irradiation resulted in lower concentrations of serum IL-1β, IL-6, and TNF-α compared to the control irradiated group This study suggests that hesperidin may enhance immunocompetence and decrease irradiation-induced inflammation in mice.

In a placebo controlled human trial with a crossover design conducted in 24 men and women aged 21 to 65 years with metabolic syndrome, hesperidin mg daily for 3 weeks resulted in significantly lowered plasma concentrations of CRP, serum amyloid A and sE-selectin In another human study, mg hesperidin daily for 4 weeks modified the gene expression profile of white blood cells 52 ; hesperidin intake modulated the expression of 1, genes many of which are involved in chemotaxis, adhesion, and cell infiltration.

Naringenin is the aglycone of naringin and narirutin Figure 3. The anti-inflammatory effects of naringenin have been examined in several cell culture and animal feeding studies [reviewed by Chanet et al. In cell culture experiments, naringenin has been shown to decrease expression of inducible nitric oxide synthase and cyclooxygenase-2 and to decrease production of TNF-α, IL-1β, IL-6 and prostaglandin E 2 by lipopolysaccharide-stimulated macrophages , Naringenin also reduced expression of inducible nitric oxide synthase and cyclooxygenase-2 and decreased production of prostaglandin E2 and expression of mRNA for TNF-α, IL-1β and monocyte chemoattractant peptide 1 by BV2 microglial cells in culture Naringenin also decreased expression of the adhesion molecule VCAM-1 in TNF-stimulated endothelial cells and decreased monocyte adhesion to endothelial cells Such effects appear to relate to deceased activation of the pro-inflammatory transcription factor NFκB , , and of MAPKs Inclusion of naringenin in the diet of rabbits fed a high cholesterol diet reduced expression of VCAM-1 and monocyte chemoattractant peptide 1 in the aortic arch Naringin has also been studied in vitro and in animal feeding studies.

Naringin deceased expression of the VCAM-1 in TNF-stimulated endothelial cells Naringin also reduced ICAM-1 expression on endothelial cells cultured in high glucose concentrations , an effect associated with reduced phosphorylation of the p38 MAPK.

Inclusion of naringin in the diet of rabbits fed a high cholesterol diet reduced expression of VCAM-1 and MCP-1 in the aortic arch and reduced expression of ICAM-1 on endothelial cells Inclusion of naringin in the diet of mice fed a high cholesterol diet reduced blood levels of sICAM-1 and sE-selectin Dietary naringin lowered serum TNF-α concentration and increased serum adiponectin in mice ref a high fat diet Dietary naringin dose-dependently decreased serum concentrations of TNF-α, IL-6 and CRP and increased adiponectin concentration in diabetic rats fed a high fat diet compared with diabetic control rats In this same study, naringen increased liver and kidney expression of the anti-inflammatory transcription factor peroxisome proliferator activated receptor-γ and of heat shock protein and and decreased liver, kidney, and pancreas expression of NFκB Narirutin and naringin both decreased nitric oxide production by lipopolysaccharide-stimulated macrophages and decreased CRP release from incubated rat aortic vascular ring These data suggest that naringenin and its glycosides naringin and narirutin may have similar anti-inflammatory effects.

Beyond effects supporting immune function and controlling inflammation, bioactives present in citrus fruit juices may have direct anti-viral effects; these have been highlighted in the context of infection with systemic acute respiratory syndrome coronavirus SARS-CoV -2 and the disease that this virus causes, coronavirus disease discovered in COVID Using in silico modelling it was identified that hesperidin can bind with ACE2 and in doing so may make the ACE2-SARS-CoV-2 spike protein structure unstable — Through this action it is proposed that hesperidin could block SARS-CoV-2 from entering host cells and so could prevent the infection.

Hesperidin has also been shown to prevent replication of several viruses including the influenza virus acting through activation of immune-supporting MAPK pathways and in mice it prevented the spread of influenza virus Both hesperidin and hesperetin are able to inhibit key proteases involved in coronavirus replication , As reviewed by Tutunchi naringenin exerts similar actions suggesting it too could inhibit viral entry into host cells and subsequent viral replication.

It includes barrier functions and capabilities for recognition and elimination of pathogens and for immunologic memory. One component of the immune response is inflammation which is designed to create a hostile environment to pathogens.

Generation of oxidative stress is part of the inflammatory response and, in turn, oxidative stress can induce inflammation. Hence, an immune response which is appropriate to the challenge and involves controlled inflammation that is self-resolving is optimal.

Limitation of oxidative stress is one means of controlling inflammation, hence, antioxidants are often also anti-inflammatory.

Nutrition is one of many determinants of the immune response 1 , 12 — 16 including the inflammatory component 4 — 6. Micronutrients vitamins and minerals are especially important for supporting normal immune response 1 , 12 — 16 and plant polyphenols have also emerged as having important roles, not only in helping to control oxidative and inflammatory stress, but also in supporting the activities of the cellular aspects of innate and acquired immunity.

Vitamin C and folate both have roles in sustaining the integrity of immunological barriers including the skin and internal mucosal linings Figure 4 , while vitamin C is an antioxidant and helps to control inflammation Figure 4.

As described earlier, both vitamin C and folate support the function of many types of immune cell including phagocytes, natural killer cells, T-cells, and B-cells Figure 4. The Nutrient Reference Values for vitamin C and folate are 80 mg and μg respectively. Hesperidin is a glycoside of hesperetin and narirutin and naringin are glycosides of naringenin Figure 3.

Hesperidin, hesperetin, naringenin, naringin and narirutin have all been demonstrated to have anti-inflammatory effects, mainly demonstrated in cell culture and some animal studies; all seem to act, at least in part, through inhibiting activation of the pro-inflammatory transcription factor NFκB.

Human trials of hesperidin in people with metabolic syndrome or type-2 diabetes reported reductions in inflammatory markers, including CRP.

Hesperidin modified gene expression in white blood cells with significant overlap of the genes modified with those modified by orange juice Thus, citrus fruit juices contain a mix of components that control oxidative stress and inflammation, and support the immune system.

In the context of human trials, orange juice has been most widely explored, although specific trials on immunity are scarce. Orange juice was shown to limit the post-prandial inflammation induced by a high fat-high carbohydrate meal Consuming orange juice daily for a period of weeks reduced markers of inflammation, including CRP, as confirmed through a recent meta-analysis One human intervention trial with orange juice failed to find effects on markers of innate or acquired immunity 60 ; however this trial studied healthy middle aged men and it may be that groups vulnerable to declines in immune function, such as the elderly, may be a better option for this type of trial.

Despite the findings of the latter study, in general the effects of orange juice, especially with regard to inflammation, are consistent with those of its component bioactives. A newly emerging topic, driven largely by the SARS-CoV-2 pandemic, is whether polyphenols from orange juice have direct anti-viral effects.

Furthermore in vitro studies identify that hesperidin, hesperetin and naringenin can restrict viral replication acting through inhibition of key enzymes involved in this process — Whether these effects occur in infected humans at intakes and circulating concentrations of these bioactives consistent with normal fruit juice consumption is uncertain.

In this context a clinical trial of hesperidin in people newly infected with SARS-CoV-2 has been registered In summary, micronutrients and other bioactives present in citrus fruit juices have established plausible pathways for controlling oxidative stress and inflammation and for supporting innate and acquired immune responses.

Trials in humans demonstrate that orange juice reduces inflammation, while its effects on innate and acquired immunity require further exploration in well-designed trials in appropriate population sub-groups, such as older people. Figure 4 Summary of the effects of orange juice bioactives on different aspects of inflammation and immunity.

Vitamin C and folate support barrier function, T cell mediated immunity and B cell mediated immunity. Vitamin C, folate, hesperidin and its aglycone hesperetin, and narirutin and naringin and their aglycone naringenin all reduce inflammation.

The first draft of the article was prepared by PC. EM provided comment. All authors contributed to the article and approved the submitted version. The University of Southampton received funds from a consortium of orange producers, juice manufacturers and packaging companies based in Europe and Brazil under the umbrella of the European Fruit Juice Association AIJN.

The funders had no influence on the content of the article nor on the decision of where to publish. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. ACE, angiotensin converting enzyme; COVID, coronavirus disease discovered in ; CRP, C-reactive protein; FR4, folate receptor 4; ICAM, intercellular adhesion molecule; IFN, interferon; Ig, immunoglobulin; IL, interleukin; MAMP, microbe-associated molecular pattern; MAPK, mitogen-activated protein kinase; MMP, matrix metalloproteinase; NFκB, nuclear factor kappa-light-chain-enhancer of activated B cells; SARS-CoV-2, systemic acute respiratory distress syndrome coronavirus 2; TLR, toll-like receptor; TNF, tumour necrosis factor; VCAM, vascular cell adhesion molecule.

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Lauer AC, Groth N, Haag SF, Darvin ME, Lademann J, Meinke MC. Fried foods, which contain unhealthy fats, can cause bloating and discomfort in the body.

And soda, which is both sweet and carbonated, increases inflammation in the body. Broccoli contains Sulforaphane, a compound that boosts gene activity in the lung cells and protects them against damage from pollution and smoking. Broccoli is a good source of vitamin A, which has anti-inflammatory properties and protects the lungs.

Also, broccoli contains significant amounts of vitamin C. It is possible that animal-based vitamin A is more beneficial for the lungs than plant-based vitamin A.

Adding a little bit of cayenne pepper to your favorite foods or drinks is a great way to add heat to your diet and get better breath. Added to food or drinks, cayenne pepper can reduce cholesterol and regulate your metabolism.

It also helps balance blood sugar levels and reduces inflammation. You can even use cayenne pepper to make a detox drink to boost your energy level and reverse disease. A few health benefits of cayenne pepper can be directly attributed to its active compound, capsaicin.

Capsaicin is known to cause a mild inflammatory response in the body, but this reaction is intended to repair damaged cells. Cayenne also contains a variety of vitamins, minerals, and flavonoids, which have potent antioxidant properties.

It also increases saliva production by stimulating the salivary glands. This is beneficial for the digestive process. Other benefits of cayenne pepper include fighting allergy symptoms. Capsaicin found in cayenne pepper reduces the inflammatory response to certain foods.

It also helps prevent a host of other health problems. The FDA approved capsaicin in over-the-counter products. However, the pepper can be irritating to the skin and eyes.

Some users have experienced flushing and a runny nose. A healthy diet can prolong the life of your organs, including the lungs. Unfortunately, modern eating habits are focused on junk food, which often contains unhealthy fats. Fatty foods push the diaphragm, causing bloating and discomfort.

Soda, on the other hand, is a sweet and carbonated food that may actually increase inflammation. Therefore, it is important to limit your intake of these products. Honey: A healthy diet can also reduce the risk of lung disease by providing antibacterial and immune-boosting properties.

Honey also has strong antioxidant properties and may help limit inflammation in the lungs. Protein: Dietary proteins are necessary for lung health. Protein helps regenerate cells and reduce inflammation in the body, improving overall health.

Leafy green vegetables: Consume a variety of green leafy vegetables, as they are rich in chlorophyll. These foods also have lutein and zeaxanthin, which help produce immune cells and strengthen respiratory tissue.

Oranges: Consuming oranges regularly may help decrease phlegm production in those suffering from lung diseases. A recent Scottish study found that eating fresh fruit regularly reduced the prevalence of phlegm in adults. However, it remains to be seen whether these foods can actually help people with respiratory problems.

You can read more about the effects of various foods on lung health on the body. You may be wondering how to eat for healthy lungs. There are a few key things you need to know. Eating a balanced diet is crucial to maintaining your organs.

You should avoid processed foods and junk foods. This will make breathing easier and help your organs maintain a healthy balance. Fried food, for example, contains unhealthy fats that push the diaphragm.

This life-threatening emergency includes wheezing , shortness of breath, and a feeling of doom. If you notice these symptoms, seek medical attention immediately. Citrus fruits include oranges, lemons, limes, and grapefruit, among others.

They contain high levels of vitamin C, flavonoids, potassium, and fiber. Their antioxidant, anti-inflammatory, and immune-boosting properties have been associated with health benefits, like protection from heart and brain disease, cancer, kidney stones, and reducing the length of a cold.

Some people should be careful with citrus fruit, especially those with a citrus allergy or who take certain medications. Food and Agriculture Organization of the United Nations. Markets and trade: Citrus. Department of Agriculture. Orange, raw.

National Institutes of Health: Office of Dietary Supplements. Vitamin C: Fact sheet for health professionals. Lv X, Zhao S, Ning Z, et al. Citrus fruits as a treasure trove of active natural metabolites that potentially provide benefits for human health.

Chem Cent J. Published Dec Panche AN, Diwan AD, Chandra SR. Flavonoids: an overview. J Nutr Sci. Potassium: Fact sheet for health professionals. Atkinson FS, Brand-Miller JC, Foster-Powell K, Buyken AE, Goletzke J. International tables of glycemic index and glycemic load values a systematic review.

Am J Clin Nutr. Barghouthy Y, Somani BK. Role of citrus fruit juices in prevention of kidney stone disease KSD : A narrative review. Wang J, Gao J, Xu HL, et al.

Citrus fruit intake and lung cancer risk: A meta-analysis of observational studies. Pharmacol Res. Mahmoud AM, Hernández Bautista RJ, Sandhu MA, Hussein OE. Beneficial effects of citrus flavonoids on cardiovascular and metabolic health.

Oxid Med Cell Longev. Published Mar Pontifex MG, Malik MMAH, Connell E, Müller M, Vauzour D. Citrus polyphenols in brain health and disease: Current perspectives. Front Neurosci. Published Feb Bucher A, White N. Vitamin C in the prevention and treatment of the common cold. Am J Lifestyle Med.

American Dental Association. Erosion: What you eat and drink can impact teeth. Food and Drug Administration. Grapefruit juice and some drugs don't mix.

Muraki I, Imamura F, Manson JE, et al. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. By Kathi Valeii As a freelance writer, Kathi has experience writing both reported features and essays for national publications on the topics of healthcare, advocacy, and education.

Top 10 Health Benefits of Lemons and Limes - Kennedy Club Fitness Penn ND, Purkins L, Sport-specific diet plans J, Heatley Citrhs, Mascie-Taylor BH, Gealth PW. A diet rich in berries, olive oil, coffee, and dark leafy greens is beneficial. Goldschmidt MC. Recognition of Vitamin B Metabolites by Mucosal-Associated Invariant T Cells. Duarte TL, Cooke MS, Jones GD.
Nutrition for Healthy Lungs: Foods That Promote Respiratory Wellness

Figure 2 The bidirectional links between inflammation and oxidative stress. Reactive oxygen species ROS can act as inflammatory trigger initiating inflammation.

On the other hand inflammation induces oxidative stress. IκB, inhibitory subunit of NFκB; MAPK, mitogen-activated protein kinase; NFκB, nuclear factor kappa-light-chain-enhancer of activated B cells; P, phosphate; ROS, reactive oxygen species.

The aim of this article is to review the literature that relates to the modulation of components of the immune response, including inflammation, by citrus fruit juices and their bioactive components and to describe the mechanisms involved.

The bioactive components considered are vitamin C, folate, hesperidin, narirutin and naringin. Narirutin and naringin are glycosides of naringenin Figure 3. Naringin is the major flavonoid in grapefruits with far lower amounts seen in sweet oranges, lemons, limes and tangelos.

Narirutin is found in grapefruits and in sweet oranges, tangerines and tangelos. Figure 3 Structure of hesperidin, narirutin and naringin and the aglycones hesperetin and naringenin. Clearly the immune system is highly complex involving many different cell types and subtypes and functional responses, and the production of, and responses to, many chemical mediators Figure 1.

Each of these components can be measured experimentally. In humans this is most often performed using blood samples, although some immune biomarkers can also be measured in other accessible fluids including saliva.

It is important to note that most immunologic activity does not take place in the bloodstream but in lymphoid organs such as the spleen and lymph nodes, or in tissues such as the gut mucosa and lungs. As a consequence of this, only the minority of immune cells are in the bloodstream at any one time.

It is generally agreed that there is no single marker of either the status or the functional capacity of the immune system 7 — In most human settings, circulating cell numbers, their activation state, and responses to an ex vivo challenge can be, and are frequently, measured.

There are normal ranges for circulating immune cell numbers and immunoglobulin concentrations, but there are no normal ranges for immune cell functional responses. Assessments of the functional capacity of the immune system can be made by:.

Expert groups have summarised and evaluated a large number of immune function assays commonly used as markers in human intervention studies 9 , Markers classified as being of high suitability were vaccine-specific serum antibody concentrations, the delayed-type hypersensitivity response, vaccine-specific or total secretory immunoglobulin Ig A in saliva, and the response to attenuated pathogens.

Markers classified as being of medium suitability included natural killer cell cytotoxicity, oxidative burst of phagocytes, lymphocyte proliferation, and the cytokine pattern produced by activated immune cells.

Other markers were classified as being of low suitability. Albers et al. With regard to inflammation, the total number of leukocytes white blood cells and circulating C-reactive protein CRP concentration are regarded as valid measures and may be supported by measuring concentrations of pro- and anti-inflammatory cytokines, chemokines and lipid mediators 2 , 4 — 6.

CRP at low concentrations requires measurement kits with high sensitivity to be used. As such, CRP measured with these kits is sometimes referred to as high-sensitivity CRP; it is important to note that this does not indicate a different type of CRP but merely indicates the nature of the assay used to measure CRP.

Patterns and clusters of such markers may be more robust biomarkers of inflammatory state and inflammatory response than individual markers or small numbers of markers. Citrus fruit juices contain a wide range of micronutrients vitamins and minerals and bioactive compounds; a comprehensive nutrient composition of orange juice has been provided elsewhere Several of these micronutrients are important in immune function support 12 — 16 and citrus fruit juice is a particularly good source of two of these, vitamin C and folate.

Chanson-Rolle et al. This difference may relate to variations in production and storage. De Rycker et al. Ashchoff et al. Others report similar values for folate [e.

The main form of folate in orange juice is 5-methyl-tetrahydrofolate 22 , which is stable over normal shelf life In addition to micronutrients, citrus fruit juices contain a number of polyphenolic flavonoid compounds of relevance to the immune system.

The concentration of total polyphenols was found to be similar between commercial and home-made orange juices Hesperidin is the main polyphenol in orange juice.

Bestwick et al. Li et al. Blood orange juice contained 2. Phenolic compounds in orange juice have been noted to decline minimally during optimal low temperature storage The bioavailability of bioactives from food and beverages is important if they are to exert a physiological effect or a health benefit, although they may also act via effects on gastrointestinal microbiota.

Folate bioavailability is discussed in detail elsewhere 28 ; bioavailability varies depending upon the exact chemical form and the food matrix but can be high. The majority of an ingested dose of hesperidin or narirutin is believed to reach the colon, where they are hydrolysed by the colonic microbiota, primarily yielding their corresponding aglycones hesperetin and naringenin, which are then absorbed by colonocytes.

After conjugation with glucuronic acid or sulphate, they are released into the bloodstream 31 , Reported urinary flavanone recoveries are poor: only 4. However, a substantial portion of the flavanone aglycones is further metabolized to similarly bioavailable catabolites by the colonic microbiota Nevertheless, a considerable interindividual variability in the absorption and metabolism of citrus flavanones has been noted, most likely associated with difference in gut microbiota The availability of hesperidin from orange juice appears to be greater than for whole oranges 38 , while levels of hesperidin are three times greater in commercially-squeezed orange juice compared with home-squeezed which results in higher blood levels of hesperitin Fruits, fruit extracts and fruit juices are good sources of micronutrients and of bioactive phytochemicals.

Many of these play roles in supporting the immune response, in controlling inflammation and in preventing or controlling oxidative stress which promotes inflammation and harms the immune response. In a randomised controlled trial, older people 65 to 85 years of age who consumed 5 or more portions of fruits and vegetables per day had a better response to the vaccine against pneumococcus than those consuming 2 or less portions per day Bub et al.

Both were matched for total polyphenol content although the nature of the polyphenols differed. Intervention duration was two weeks. Both juices increased lymphocyte proliferation, interleukin IL -2 production and natural killer cell activity compared with baseline.

The effects of a dried encapsulated fruit and vegetable extract on immune function have been tested in several studies. After 80 days, this extract increased lymphocyte proliferation and natural killer cell activity in older men and increased IL-2 production in those who smoked cigarettes A day randomised controlled trial in university students reported that the extract increased γδ T cells in the blood stream and resulted in fewer symptoms of the common cold γδ T cells are a distinct sub-population of T cells that are relatively uncommon but are most abundant in the gut mucosa where they contribute to the intraepithelial lymphocyte population.

They are considered to be regulatory cells that link innate and adaptive immunity. A randomised controlled trial over 28 weeks in middle-aged men reported that the encapsulated extract improved markers of oxidative stress and decreased the inflammatory marker CRP 44 ; there was also a tendency to less illness in those consuming the extract compared with the control group.

Taken together these studies indicate that fruits and vegetables, their juices and concentrates of their juices, can beneficially modify immune responses, inflammation, and oxidative stress in humans.

It is well described that the post-prandial period can be accompanied by an elevation in the blood concentrations of markers of inflammation including various cytokines and adhesion molecules This post-prandial inflammation is exaggerated by meals high in sugar, total fat or saturated fat and is believed to enhance cardiovascular risk The effects of including a specific component e.

Acute effects of orange juice consumption on inflammatory markers have been evaluated in postprandial studies. In the study by Ghanim et al. Glucose promoted an increase in reactive oxygen species production by neutrophils and in activation of the pro-inflammatory transcription factor nuclear factor kappa-light-chain-enhancer of activated B cells NFκB in mononuclear cells.

However, these effects were not seen with fructose, orange juice or saccharin. Plasma CRP declined one hour after consuming orange juice. These observations indicate that orange juice itself does not induce an acute inflammation.

Further research by this group 48 considered the effect of orange juice on the post-prandial inflammatory response induced by a high fat-high carbohydrate meal. Adding orange juice to a standard meal reduced the post-prandial generation of reactive oxygen species by neutrophils compared with the meal plus water or the meal plus glucose.

Orange juice totally mitigated the post-prandial rise in p38 mitogen-activated protein kinase MAPK , phosphorylated p38 MAPK the active form of MAPK and p47phox a subunit of NADPH oxidase responsible for reactive oxygen species production in mononuclear cells, all molecular markers of enhanced inflammation, as well as the elevation in matrix metalloproteinase MMP -9 mRNA in mononuclear cells.

Plasma MMP-9 concentration was not elevated with orange juice unlike in the other two groups, while the post-prandial elevation in toll-like receptor TLR 2 and TLR4 mRNA and protein in mononuclear cells seen with glucose did not occur with orange juice.

Endotoxemia occurred in the meal plus water and the meal plus glucose groups by not in the meal plus orange juice group. These observations suggest that orange juice mitigates the acute pro-inflammatory effects of a high fat-high carbohydrate meal.

A comparison of test meals accompanied by water, cream, glucose or orange juice confirmed the protective effects of orange juice 49 : unlike the meals with cream or glucose, the meal with orange juice did not elevate tumour necrosis factor TNF -α or IL-1β mRNA or NFκB activation in mononuclear cells.

Furthermore, unlike the meal with cream, the meal with orange juice did not elevate TLR4 mRNA or protein in mononuclear cells. Taken together, these findings suggest that inclusion of orange juice with a meal could minimize postprandial oxidative stress and inflammation. The influence of chronic intervention with orange juice on inflammatory markers has been studied.

In an uncontrolled study in 12 young adults, Sánchez-Moreno et al. In healthy overweight men, the consumption of ml orange juice daily for 4 weeks did not affect serum concentrations of several inflammatory markers CRP, IL-6, soluble intercellular adhesion molecule ICAM -1, soluble vascular cell adhesion molecule sVCAM -1 51 , although blood pressure was lowered and vascular function improved.

The orange juice intervention modulated the expression of 3, genes many of which are involved in chemotaxis, adhesion, and cell infiltration Buscemi et al.

Endothelial function, which was measured as flow-mediated dilation, significantly improved in these subjects. Asgary et al. In another study, ml orange juice daily for 8 weeks lowered circulating CRP and raised IL, but did not affect IL-4, IL, TNF-α or interferon IFN -γ, in both normal weight and overweight adults A second study with the same design ml red fleshed orange juice daily for 8 weeks also reported a reduction in CRP concentration in both normal weight and overweight individuals Patients with hepatitis C who consumed ml of orange juice daily for 8 weeks showed a reduction in plasma CRP concentration, although the starting value was higher than in the control group A recent meta-analysis of the effects of orange juice on risk factors for cardiovascular disease reported that orange juice significantly decreased CRP levels 7 trials; weighted mean difference: The greater effect of shorter than 8 week durations is perhaps counterintuitive but may be explained by loss of compliance in longer duration studies.

Whilst a number of studies have investigated the effect of orange juices on inflammation, there are almost no studies of the effects on markers of innate or acquired immunity beyond inflammation. Perche et al. The three treatments were ml orange juice daily, ml isocaloric control drink daily or ml of the control drink plus mg hesperidin in capsules daily.

There was no effect on blood immune cell phenotypes, the percentage of T cells and B cells activated with an immune stimulant ex vivo, ex vivo production of IL-2 and IL-4 by stimulated leukocytes, natural killer cell activity, or reactive oxygen species production by stimulated neutrophils.

It is important to note that this study was conducted in healthy men and that it may be difficult to show improvements in immune function in healthy individuals.

Vitamin C is an essential nutrient that acts primarily as a water-soluble antioxidant. It is a cofactor for a number of enzymes including the lysyl and prolyl hydroxylases required for stabilization of the tertiary structure of collagen. Hence, vitamin C is vital for maintaining epithelial integrity.

Severe vitamin C deficiency results in scurvy, which is potentially fatal. Scurvy is characterized by weakening of collagenous structures, resulting in poor wound healing, and impaired immunity; individuals with scurvy are highly susceptible to potentially fatal infections such as pneumonia Cells of the immune system actively accumulate vitamin C against a concentration gradient, resulting in cellular concentrations that can be up to or times those seen in plasma 62 — For example, neutrophils can accumulate vitamin C to achieve intracellular concentrations of 1 mM or more 62 , This suggests that vitamin C is of some importance to immune cells.

Vitamin C has anti-inflammatory effects, in part because of its role as an antioxidant, and also has roles in several aspects of immunity, including leucocyte migration to sites of infection, phagocytosis and bacterial killing, natural killer cell activity, T lymphocyte function and antibody production.

There are a number of comprehensive reviews of the role of vitamin C in immunity and host susceptibility to infection 66 , Vitamin C is actively accumulated into epidermal and dermal cells via sodium-dependent vitamin C transporters, suggesting that it has important functions within the skin.

The effects of scurvy demonstrate the key role of vitamin C in maintaining barrier integrity. Vitamin C promotes collagen gene expression in fibroblasts 68 — 72 and promotes fibroblast proliferation and migration which is essential for tissue remodelling and wound healing 73 , Vitamin C intervention studies in humans have shown enhanced vitamin C uptake into skin cells 75 , 76 and enhanced oxidant scavenging activity of the skin 76 , The elevated antioxidant status of the skin following vitamin C supplementation could potentially protect against oxidative stress induced by UV irradiation and environmental pollutants 78 , Although cells of the immune system contain high concentrations of vitamin C, these can be decreased upon cellular stimulation, resulting in a loss of antioxidant protective mechanisms.

An altered balance between oxidant generation and antioxidant defences can lead to changes in multiple signalling pathways, with the pro-inflammatory transcription factor NFκB playing a central role Figure 2.

Oxidants can activate NFκB leading to continued synthesis of oxidative species and other inflammatory mediators 80 Figure 2. Vitamin C can diminish both oxidant generation and NFκB activation 81 and can modulate inflammation through redox-sensitive cell signalling pathways 82 , 83 or by directly protecting important structural components of the cell from damage In accordance with these proposed anti-inflammatory actions, vitamin C can modulate production of inflammatory cytokines.

For example, it decreased lipopolysaccharide-induced production of TNF-α and IFN-γ, and increased anti-inflammatory IL production, by human lymphocytes in culture Vitamin C treatment reduced activation of microglial cells and decreased the synthesis of the pro-inflammatory cytokines TNF-α, IL-6, and IL-1β Addition of vitamin C to peripheral blood monocytes isolated from patients with pneumonia decreased the generation of the pro-inflammatory cytokines TNF-α and IL-6 These findings are all consistent with an anti-inflammatory action of vitamin C.

Chemotaxis describes the movement of immune cells into infected tissues which is an early step in innate immunity. Neutrophils express many receptors for different chemo-attractants, enabling them to sense and rapidly respond to signals indicating infection or tissue damage Leukocytes from vitamin C deficient guinea pigs show impaired chemotactic responses 91 — Studies with large doses of vitamin C in patients with recurrent infections and impaired leukocyte chemotaxis showed restoration of chemotaxis 95 — Supplementation of healthy volunteers with vitamin C has also been shown to enhance neutrophil chemotactic ability 84 , — Phagocytosis is the process of engulfing pathogens which are subsequently destroyed within intracellular vacuoles, in part by the oxidative burst.

Vitamin C maintains or enhances natural killer cell activity , Like phagocytes, B and T lymphocytes accumulate vitamin C to high levels via specific transporters , Jacob et al.

Vitamin C seems to be important in the differentiation and maturation of immature T cells , , effects which may relate to epigenetic modifications — In vitro studies have indicated that incubation of lymphocytes with vitamin C promotes T lymphocyte proliferation 85 , and increases antibody production Treatment of guinea pigs with vitamin C increased T cell proliferation and enhanced antibody levels during immunization , Vitamin C clearly has benefits in supporting barrier function and both innate and acquired immunity.

Furthermore, incubation of virus-infected human and murine fibroblasts with vitamin C enhanced generation of anti-viral IFNs 89 , — A major symptom of scurvy is increased susceptibility to infections, particularly of the respiratory tract, with pneumonia being one of the most frequent complications of scurvy and a major cause of death 61 , This suggests that vitamin C likely has a role in protecting against infections, particularly of the respiratory tract.

Significant decreases in leukocyte vitamin C levels occur during common cold episodes, with levels returning to normal following the infection — , indicating that vitamin C is utilized during a common cold infection.

A meta-analysis of randomised controlled trials RCTs identified that vitamin C did not affect incidence of the common cold in the general population 24 RCTs but decreased incidence in people under heavy short-term physical stress 5 RCTs Vitamin C shortened the duration of the common cold in all studies 31 RCTs , in adults 13 RCTs and in children 10 RCTs and decreased the severity of colds Plasma vitamin C concentrations are reduced in patients with acute respiratory infections, such as pulmonary tuberculosis and pneumonia , There was also a positive effect on the chest X-ray, temperature, and erythrocyte sedimentation rate A meta-analysis of 3 RCTs reported a significant reduction in the risk of pneumonia with vitamin C supplementation, particularly in individuals with low dietary intakes Folate is essential for the synthesis of RNA and DNA and consequently for cell division, protein synthesis and tissue growth.

It is not a surprise therefore that folate is required for the immune system to function. In common with other B vitamins, folate vitamin B9 is involved in intestinal immune regulation , , thus contributing to gut barrier function.

In fact, folate is essential for the survival of regulatory T cells in the small intestine wall , suggesting it plays a role in preventing adverse immune responses at that site. Regulatory T cells express high levels of folate receptor 4 FR4 and administration of anti-FR4 antibody to mice results in specific reduction in the regulatory T cell population , indicating that the folate-FR4 axis is required for regulatory T cell maintenance.

In vitro culture of regulatory T cells in folate-restricted conditions impaired cell survival, with decreased expression of anti-apoptotic bcl2 molecules, although naïve T cells retained the ability to differentiate into regulatory T cells , ; this suggests that folate is a survival factor for regulatory T cells.

Consistent with these findings, dietary deficiency of folate results in reduction of the regulatory T cell population in the small intestine of mice , Since regulatory T cells play an important role in the prevention of excessive immune responses , mice fed a folate-deficient diet exhibit increased susceptibility to intestinal inflammation Some commensal intestinal bacteria convert folate to 6-formylpterin which may suppress excess mucosal associated invariant T cell responses and prevent excessive allergic and inflammatory responses — Folate deficiency in experimental animals also causes systemic immune effects such as thymus and spleen atrophy and lower circulating T lymphocyte numbers: lymphocyte proliferation is also reduced in folate deficiency However, the phagocytic and bactericidal capacity of neutrophils appear unchanged Folate deficient culture medium resulted in an immature phenotype of murine bone marrow derived dendritic cells that produced less IL and pro-inflammatory cytokines in response to LPS This aberrant maturation of dendritic cells resulted in reduced ability to induce helper T cell responses with low production of cytokines including IL-2, IFN-γ and IL Folate deficiency in mice resulted in poor dendritic cell and spleen cell responses cytokine production and altered T cell phenotypes , while folate deficiency in rats or mice impairs antibody production , Thus, studies in experimental animals demonstrate that folate is essential for the immune system to function properly.

Rather less is known about the influence of variations in folate intake or status in human populations and immune outcomes.

Congenital isolated malabsorption of folic acid is associated with impairment of both cellular and humoral immunity, and increased infections , while suppressed T cell mediated immunity in patients with megaloblastic anaemia with folate deficiency was reversed by folate treatment Critically ill patients with lower folate status had poorer neutrophil phagocytosis than those with higher folate status Likewise malnourished patients with lower folate status had poorer neutrophil function phagocytosis, bacterial killing than those with higher folate status and the impaired phagocytosis was corrected by folic acid supplementation Furthermore, the impairment in phagocytosis could be corrected by adding folic acid to the medium of the cultured neutrophils These studies indicate that having sufficient folate is important for the human immune system to function.

Hara et al. An intervention with high dose folic acid 1. Plasma levels of a number of proteins related to immunity were positively associated with folate status both prior to and following intervention Folic acid supplementation increased plasma concentrations of a number of immune-related proteins, including IgM C chain and complement 3 Folate has been a component of several micronutrient mixtures or nutritional supplements that have been reported to increase some, though not all, immune biomarkers — , including those associated with anti-viral defence , , and to decrease infections , , although the effects observed cannot, of course, be ascribed to folate.

It is also important to note that some studies of micronutrient mixtures that include folate do not show improvements in immune outcomes , Nevertheless, it seems clear from the literature that an adequate folate intake and status is required to support the human immune system.

Hesperetin is the aglycone of hesperidin Figure 3. The anti-inflammatory effects of hesperetin and hesperidin have been examined in several cell culture studies [reviewed by Chanet et al.

Hesperetin decreased production of TNF-α by lipopolysaccharide-stimulated macrophages in a concentration dependent manner , ; IL-6 production was not affected Hesperitin did not affect expression of the inhibitory subunit of NFκB or inducible nitric oxide synthase in these cells following lipopolysaccharide stimulation and only modestly affected nitric oxide production Increased adhesion of monocytes to endothelial cells and expression of vascular cell adhesion molecule-1 in response to TNF-α treatment were reduced by pretreatment with hesperetin Both hesperetin and hesperidin deceased expression of the adhesion molecule VCAM-1 in TNF-stimulated endothelial cells , and decreased monocyte adhesion to endothelial cells , Hesperidin also reduced ICAM-1 expression on endothelial cells cultured in high glucose concentrations , an effect associated with reduced phosphorylation of the p38 MAPK.

Hesperitin decreased IL-1β-induced MMP-3 and IL-6 production by cultured human synovial cells, which was linked to reduced activation of c-Jun N-terminal kinase Feeding hesperidin to mice for 6 weeks prior to undergoing irradiation resulted in lower concentrations of serum IL-1β, IL-6, and TNF-α compared to the control irradiated group This study suggests that hesperidin may enhance immunocompetence and decrease irradiation-induced inflammation in mice.

In a placebo controlled human trial with a crossover design conducted in 24 men and women aged 21 to 65 years with metabolic syndrome, hesperidin mg daily for 3 weeks resulted in significantly lowered plasma concentrations of CRP, serum amyloid A and sE-selectin In another human study, mg hesperidin daily for 4 weeks modified the gene expression profile of white blood cells 52 ; hesperidin intake modulated the expression of 1, genes many of which are involved in chemotaxis, adhesion, and cell infiltration.

Naringenin is the aglycone of naringin and narirutin Figure 3. The anti-inflammatory effects of naringenin have been examined in several cell culture and animal feeding studies [reviewed by Chanet et al.

In cell culture experiments, naringenin has been shown to decrease expression of inducible nitric oxide synthase and cyclooxygenase-2 and to decrease production of TNF-α, IL-1β, IL-6 and prostaglandin E 2 by lipopolysaccharide-stimulated macrophages , Naringenin also reduced expression of inducible nitric oxide synthase and cyclooxygenase-2 and decreased production of prostaglandin E2 and expression of mRNA for TNF-α, IL-1β and monocyte chemoattractant peptide 1 by BV2 microglial cells in culture Naringenin also decreased expression of the adhesion molecule VCAM-1 in TNF-stimulated endothelial cells and decreased monocyte adhesion to endothelial cells Such effects appear to relate to deceased activation of the pro-inflammatory transcription factor NFκB , , and of MAPKs Inclusion of naringenin in the diet of rabbits fed a high cholesterol diet reduced expression of VCAM-1 and monocyte chemoattractant peptide 1 in the aortic arch Naringin has also been studied in vitro and in animal feeding studies.

Naringin deceased expression of the VCAM-1 in TNF-stimulated endothelial cells Naringin also reduced ICAM-1 expression on endothelial cells cultured in high glucose concentrations , an effect associated with reduced phosphorylation of the p38 MAPK.

Inclusion of naringin in the diet of rabbits fed a high cholesterol diet reduced expression of VCAM-1 and MCP-1 in the aortic arch and reduced expression of ICAM-1 on endothelial cells Inclusion of naringin in the diet of mice fed a high cholesterol diet reduced blood levels of sICAM-1 and sE-selectin Dietary naringin lowered serum TNF-α concentration and increased serum adiponectin in mice ref a high fat diet Dietary naringin dose-dependently decreased serum concentrations of TNF-α, IL-6 and CRP and increased adiponectin concentration in diabetic rats fed a high fat diet compared with diabetic control rats In this same study, naringen increased liver and kidney expression of the anti-inflammatory transcription factor peroxisome proliferator activated receptor-γ and of heat shock protein and and decreased liver, kidney, and pancreas expression of NFκB Narirutin and naringin both decreased nitric oxide production by lipopolysaccharide-stimulated macrophages and decreased CRP release from incubated rat aortic vascular ring These data suggest that naringenin and its glycosides naringin and narirutin may have similar anti-inflammatory effects.

Beyond effects supporting immune function and controlling inflammation, bioactives present in citrus fruit juices may have direct anti-viral effects; these have been highlighted in the context of infection with systemic acute respiratory syndrome coronavirus SARS-CoV -2 and the disease that this virus causes, coronavirus disease discovered in COVID Using in silico modelling it was identified that hesperidin can bind with ACE2 and in doing so may make the ACE2-SARS-CoV-2 spike protein structure unstable — Through this action it is proposed that hesperidin could block SARS-CoV-2 from entering host cells and so could prevent the infection.

Hesperidin has also been shown to prevent replication of several viruses including the influenza virus acting through activation of immune-supporting MAPK pathways and in mice it prevented the spread of influenza virus Both hesperidin and hesperetin are able to inhibit key proteases involved in coronavirus replication , As reviewed by Tutunchi naringenin exerts similar actions suggesting it too could inhibit viral entry into host cells and subsequent viral replication.

It includes barrier functions and capabilities for recognition and elimination of pathogens and for immunologic memory.

One component of the immune response is inflammation which is designed to create a hostile environment to pathogens. Generation of oxidative stress is part of the inflammatory response and, in turn, oxidative stress can induce inflammation.

Hence, an immune response which is appropriate to the challenge and involves controlled inflammation that is self-resolving is optimal. Limitation of oxidative stress is one means of controlling inflammation, hence, antioxidants are often also anti-inflammatory. Nutrition is one of many determinants of the immune response 1 , 12 — 16 including the inflammatory component 4 — 6.

Micronutrients vitamins and minerals are especially important for supporting normal immune response 1 , 12 — 16 and plant polyphenols have also emerged as having important roles, not only in helping to control oxidative and inflammatory stress, but also in supporting the activities of the cellular aspects of innate and acquired immunity.

Vitamin C and folate both have roles in sustaining the integrity of immunological barriers including the skin and internal mucosal linings Figure 4 , while vitamin C is an antioxidant and helps to control inflammation Figure 4.

As described earlier, both vitamin C and folate support the function of many types of immune cell including phagocytes, natural killer cells, T-cells, and B-cells Figure 4.

The Nutrient Reference Values for vitamin C and folate are 80 mg and μg respectively. Hesperidin is a glycoside of hesperetin and narirutin and naringin are glycosides of naringenin Figure 3. Hesperidin, hesperetin, naringenin, naringin and narirutin have all been demonstrated to have anti-inflammatory effects, mainly demonstrated in cell culture and some animal studies; all seem to act, at least in part, through inhibiting activation of the pro-inflammatory transcription factor NFκB.

Human trials of hesperidin in people with metabolic syndrome or type-2 diabetes reported reductions in inflammatory markers, including CRP. Hesperidin modified gene expression in white blood cells with significant overlap of the genes modified with those modified by orange juice Thus, citrus fruit juices contain a mix of components that control oxidative stress and inflammation, and support the immune system.

In the context of human trials, orange juice has been most widely explored, although specific trials on immunity are scarce. Orange juice was shown to limit the post-prandial inflammation induced by a high fat-high carbohydrate meal Consuming orange juice daily for a period of weeks reduced markers of inflammation, including CRP, as confirmed through a recent meta-analysis One human intervention trial with orange juice failed to find effects on markers of innate or acquired immunity 60 ; however this trial studied healthy middle aged men and it may be that groups vulnerable to declines in immune function, such as the elderly, may be a better option for this type of trial.

Despite the findings of the latter study, in general the effects of orange juice, especially with regard to inflammation, are consistent with those of its component bioactives. A newly emerging topic, driven largely by the SARS-CoV-2 pandemic, is whether polyphenols from orange juice have direct anti-viral effects.

Furthermore in vitro studies identify that hesperidin, hesperetin and naringenin can restrict viral replication acting through inhibition of key enzymes involved in this process — Whether these effects occur in infected humans at intakes and circulating concentrations of these bioactives consistent with normal fruit juice consumption is uncertain.

In this context a clinical trial of hesperidin in people newly infected with SARS-CoV-2 has been registered In summary, micronutrients and other bioactives present in citrus fruit juices have established plausible pathways for controlling oxidative stress and inflammation and for supporting innate and acquired immune responses.

Trials in humans demonstrate that orange juice reduces inflammation, while its effects on innate and acquired immunity require further exploration in well-designed trials in appropriate population sub-groups, such as older people. Figure 4 Summary of the effects of orange juice bioactives on different aspects of inflammation and immunity.

Vitamin C and folate support barrier function, T cell mediated immunity and B cell mediated immunity. Vitamin C, folate, hesperidin and its aglycone hesperetin, and narirutin and naringin and their aglycone naringenin all reduce inflammation.

The first draft of the article was prepared by PC. EM provided comment. All authors contributed to the article and approved the submitted version. The University of Southampton received funds from a consortium of orange producers, juice manufacturers and packaging companies based in Europe and Brazil under the umbrella of the European Fruit Juice Association AIJN.

The funders had no influence on the content of the article nor on the decision of where to publish. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

ACE, angiotensin converting enzyme; COVID, coronavirus disease discovered in ; CRP, C-reactive protein; FR4, folate receptor 4; ICAM, intercellular adhesion molecule; IFN, interferon; Ig, immunoglobulin; IL, interleukin; MAMP, microbe-associated molecular pattern; MAPK, mitogen-activated protein kinase; MMP, matrix metalloproteinase; NFκB, nuclear factor kappa-light-chain-enhancer of activated B cells; SARS-CoV-2, systemic acute respiratory distress syndrome coronavirus 2; TLR, toll-like receptor; TNF, tumour necrosis factor; VCAM, vascular cell adhesion molecule.

Calder PC. Nutrition and Immunity: Lessons for COVID Eur J Clin Nutr doi: CrossRef Full Text Google Scholar. Calder PC, Albers R, Antoine JM, Blum S, Bourdet-Sicard R, Ferns GA, et al. Inflammatory Disease Processes and Interactions With Nutrition. Brit J Nutr Suppl 1:S1— PubMed Abstract CrossRef Full Text Google Scholar.

Barnig C, Bezema T, Calder PC, Charloux A, Frossard N, Garssen J, et al. Activation of Resolution Pathways to Prevent and Fight Chronic Inflammation: Lessons From Asthma and Inflammatory Bowel Disease. Front Immunol Calder PC, Ahluwalia N, Albers R, Bosco N, Bourdet-Sicard R, Haller D, et al.

A Consideration of Biomarkers to be Used for Evaluation of Inflammation in Human Nutritional Studies. Brit J Nutr Suppl 1:S1—S Calder PC, Ahluwalia N, Brouns F, Buetler T, Clement K, Cunningham K, et al. Dietary Factors and Low-Grade Inflammation in Relation to Overweight and Obesity.

Brit J Nutr Suppl 3:S5—S Calder PC, Bosco N, Bourdet-Sicard R, Capuron L, Delzenne N, Doré J, et al. Health Relevance of the Modification of Low Grade Inflammation in Ageing Inflammageing and the Role of Nutrition. Ageing Res Rev — Cummings JH, Antoine JM, Azpiroz F, Bourdet-Sicard R, Brandtzaeg P, Calder PC, et al.

PASSCLAIM—Gut Health and Immunity. Eur J Nutr 43 Suppl 2:II— Immunological Parameters: What do They Mean? J Nutr S—80S. Albers R, Antoine JM, Bourdet-Sicard R, Calder PC, Gleeson M, Lesourd B, et al.

Markers to Measure Immunomodulation in Human Nutrition Intervention Studies. Brit J Nutr — Albers R, Bourdet-Sicard R, Braun D, Calder PC, Herz U, Lambert C, et al.

Monitoring Immune Modulation by Nutrition in the General Population: Identifying and Substantiating Effects on Human Health.

Brit J Nutr Suppl 2:S1—S Department of Health. Nutrient Analysis of Fruit and Vegetables: Summary Report. London: Department of Health Google Scholar. Feeding the Immune System. Proc Nutr Soc — Maggini S, Pierre A, Calder PC.

Immune Function and Micronutrient Requirements Change Over the Life Course. Nutrients Gombart AF, Pierre A, Maggini S. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrition, Immunity and COVID BMJ Nutr Prev Health — Calder PC, Carr AC, Gombart AF, Eggersdorfer M.

Optimal Nutritional Status for a Well-Functioning Immune System is an Important Factor to Protect Against Viral Infections. Permitted Claims can be Found at. Chanson-Rolle A, Braesco V, Chupin J, Bouillot L. Nutritional Composition of Orange Juice: A Comparative Study Between French Commercial and Home-Made Juices.

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Orange Juice is a Good Folate Source in Respect to Folate Content and Stability During Storage and Simulated Digestion. Eur J Nutr —8. Bestwick C, Scobbie L, Milne L, Duncan G, Cantlay L, Russell W.

Fruit-Based Beverages Contain a Wide Range of Phytochemicals and Intervention Targets Should Account for the Individual Compounds Present and Their Availability.

Foods Gattuso G, Barreca D, Gargiulli C, Leuzzi U, Caristi C. Flavonoid Composition of Citrus Juices. Molecules — Grosso G, Galvano F, Mistretta A, Marventano S, Nolfo F, Calabrese G, et al. Red Orange: Experimental Models and Epidemiological Evidence of its Benefits on Human Health.

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Plant L-ascorbic Acid: Chemistry, Function, Metabolism, Bioavailability and Effects of Processing. J Sci Food Agric — Gregory JF 3rd. Case Study: Folate Bioavailability.

J Nutr 4 Suppl S—82S. Actis-Goretta L, Dew TP, Lévèques A, Pereira-Caro G, Rein M, Teml A, et al. Gastrointestinal Absorption and Metabolism of HesperetinO-rutinoside and HesperetinO-glucoside in Healthy Humans. Mol Nutr Food Res — Borges G, Lean MEJ, Roberts SA, Crozier A.

Bioavailability of Dietary Poly Phenols: A Study With Ileostomists to Discriminate Between Absorption in Small and Large Intestine. Food Funct — Nielsen ILF, Chee WSS, Poulsen L, Offord-Cavin E, Rasmussen SE, Frederiksen H, et al.

Bioavailability Is Improved by Enzymatic Modification of the Citrus flavonoid Hesperidin in Humans: A Randomized, Double-Blind, Crossover Trial. J Nutr —8. Erlund I, Meririnne E, Alfthan G, Aro A. Plasma Kinetics and Urinary Excretion of the flavanones Naringenin and Hesperetin in Humans After Ingestion of Orange Juice and Grapefruit Juice.

Vallejo F, Larrosa M, Escudero E, Zafrilla MP, Cerdá B, Boza J, et al. Concentration and Solubility of flavanones in Orange Beverages Affect Their Bioavailability in Humans.

Bredsdorff L, Nielsen ILF, Rasmussen SE, Cornett C, Barron D, Bouisset F, et al. Absorption, Conjugation and Excretion of the flavanones, Naringenin and Hesperetin From Alpha Rhamnosidase-Treated Orange Juice in Human Subjects.

Brit J Nutr —9. Brett GM, Hollands W, Needs PW, Teucher B, Dainty JR, Davis BD, et al. Absorption, Metabolism and Excretion of flavanones From Single Portions of Orange Fruit and Juice and Effects of Anthropometric Variables and Contraceptive Pill Use on flavanone Excretion.

Pereira-Caro G, Borges G, Ky I, Ribas A, Calani L, Del Rio D, et al. In Vitro Colonic Catabolism of Orange Juice Poly Phenols. Pereira-Caro G, Borges G, van der Hooft J, Clifford MN, Del Rio D, Lean ME, et al.

Orange Juice Poly Phenols are Highly Bioavailable in Humans. Am J Clin Nutr — Aschoff JK, Riedl KM, Cooperstone JL, Högel J, Bosy-Westphal A, Schwartz SJ, et al. Urinary Excretion of Citrus Flavanones and Their Major Catabolites After Consumption of Fresh Oranges and Pasteurized Orange Juice: A Randomized Cross-Over Study.

Silveira JQ, Cesar TB, Manthey JA, Baldwin EA, Bai J, Raithore S. Pharmacokinetics of Flavanone Glycosides After Ingestion of Single Doses of Fresh-Squeezed Orange Juice Versus Commercially Processed Orange Juice in Healthy Humans. Gibson A, Edgar JD, Neville CE, Gilchrist SE, McKinley MC, Patterson CC, et al.

Effect of Fruit and Vegetable Consumption on Immune Function in Older People: A Randomized Controlled Trial. Bub A, Watzl B, Blockhaus M, Briviba K, Liegibel U, Müller H, et al. Fruit Juice Consumption Modulates Antioxidative Status, Immune Status and DNA Damage.

J Nutr Biochem —8. Inserra PF, Jiang S, Solkoff D, Lee J, Zhang Z, Xu M, et al. Immune Function in Elderly Smokers and Nonsmokers Improves During Supplementation With Fruit Ad Vegetable Extracts. Integrat Med — Nantz MP, Rowe CA, Nieves C Jr, Percival SS.

Immunity and Antioxidant Capacity in Humans is Enhanced by Consumption of a Dried, Encapsulated Fruit and Vegetable Juice Concentrate. Lamprecht M, Oettl K, Schwaberger G, Hofmann P, Greilberger JF. Several Indicators of Oxidative Stress, Immunity, and Illness Improved in Trained Men Consuming an Encapsulated Juice Powder Concentrate for 28 Weeks.

Roll S, Nocon M, Willich SN. Reduction of Common Cold Symptoms by Encapsulated Juice Powder Concentrate of Fruits and Vegetables: A Randomised, Double-Blind, Placebo-Controlled Trial.

Burdge GC, Calder PC. Plasma Cytokine Response During the Postprandial Period: A Potential Causal Process in Vascular Disease? Ghanim H, Mohanty P, Pathak R, Chaudhuri A, Sia CL, Dandona P. Orange Juice or Fructose Intake Does Not Induce Oxidative and Inflammatory Response.

Diabetes Care — Ghanim H, Sia CL, Upadhyay M, Korzeniewski K, Viswanathan P, Abuaysheh S, et al. Orange Juice Neutralizes the Proinflammatory Effect of a High-Fat, High-Carbohydrate Meal and Prevents Endotoxin Increase and Toll-like Receptor Expression. Am J Clin Nutr —9.

Deopurkar R, Ghanim H, Friedman J, Abuaysheh S, Sia CL, Mohanty P, et al. Differential Effects of Cream, Glucose, and Orange Juice on Inflammation, Endotoxin, and the Expression of Toll-like Receptor-4 and Suppressor of Cytokine Signaling Diabetes Care —7.

Sanchez-Moreno C, Cano MP, de Ancos B, Plaza L, Olmedilla B, Granado F, et al. Effect of Orange Juice Intake on Vitamin C Concentrations and Biomarkers of Antioxidant Status in Humans. Morand C, Dubray C, Milenkovic D, Lioger D, Martin JF, Scalbert A, et al.

Hesperidin Contributes to the Vascular Protective Effects of Orange Juice: A Randomized Crossover Study in Healthy Volunteers. Milenkovic D, Deval C, Dubray C, Mazur A, Morand C. Hesperidin Displays Relevant Role in the Nutrigenomic Effect of Orange Juice on Blood Leukocytes in Human Volunteers: A Randomized Controlled Cross-Over Study.

PloS One 6:e Buscemi S, Rosafio G, Arcoleo G, Mattina A, Canino B, Montana M, et al. Effects of Red Orange Juice Intake on Endothelial Function and Inflammatory Markers in Adult Subjects With Increased Cardiovascular Risk.

Asgary S, Keshvari M, Afshani MR, Amiri M, Laher I, Javanmard SH. Effect of Fresh Orange Juice Intake on Physiological Characteristics in Healthy Volunteers. ISRN Nutr Dourado GK, Cesar TB. Investigation of Cytokines, Oxidative Stress, Metabolic, and Inflammatory Biomarkers After Orange Juice Consumption by Normal and Overweight Subjects.

Food Nutr Res Silveira JQ, Dourado GK, Cesar TB. Red-Fleshed Sweet Orange Juice Improves the Risk Factors for Metabolic Syndrome. Int J Food Sci Nutr —6. Gonçalves D, Lima C, Ferreira P, Costa P, Costa A, Figueiredo W, et al. Orange Juice as Dietary Source of Antioxidants for Patients With Hepatitis C Under Antiviral Therapy.

Rangel-Huerta OD, Aguilera CM, Perez-de-la-Cruz A, Vallejo F, Tomas-Barberan F, Gil A, et al. A Serum Metabolomics-Driven Approach Predicts Orange Juice Consumption and its Impact on Oxidative Stress and Inflammation in Subjects From the BIONAOS Study.

Mol Nutr Food Res Alhabeeb H, Sohouli MH, Lari A, Fatahi S, Shidfar F, Alomar O, et al. Impact of Orange Juice Consumption on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized-Controlled Trials. Crit Rev Food Sci Nutr Perche O, Vergnaud-Gauduchon J, Morand C, Dubray C, Mazur A, Vasson MP.

Orange Juice and its Major Polyphenol Hesperidin Consumption do Not Induce Immunomodulation in Healthy Well-Nourished Humans. Clin Nutr —5. Hodges RE, Hood J, Canham JE, Sauberlich HE, Baker EM. Clinical Manifestations of Ascorbic Acid Deficiency in Man.

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Millimolar Concentrations of Ascorbic Acid in Purified Human Mononuclear Leukocytes. Depletion and Reaccumulation. J Biol Chem —7. Evans RM, Currie L, Campbell A. The Distribution of Ascorbic Acid Between Various Cellular Components of Blood, in Normal Individuals, and its Relation to the Plasma Concentration.

Corpe CP, Lee JH, Kwon O, Eck P, Narayanan J, Kirk KL, et al. Hemila H. Vitamin C and Infections. Carr AC, Maggini S. Vitamin C and Immune Function. Geesin JC, Darr D, Kaufman R, Murad S, Pinnell SR. Ascorbic Acid Specifically Increases Type I and Type III Procollagen Messenger RNA Levels in Human Skin fibroblast.

J Invest Dermatol —4. Kishimoto Y, Saito N, Kurita K, Shimokado K, Maruyama N, Ishigami A. Ascorbic Acid Enhances the Expression of Type 1 and Type 4 Collagen and SVCT2 in Cultured Human Skin fibroblasts. Biochem Biophys Res Commun — Nusgens BV, Humbert P, Rougier A, Colige AC, Haftek M, Lambert CA, et al.

Topically Applied Vitamin C Enhances the mRNA Level of Collagens I and III, Their Processing Enzymes and Tissue Inhibitor of Matrix Metalloproteinase 1 in the Human Dermis. J Invest Dermatol —9. Tajima S, Pinnell SR. Ascorbic Acid Preferentially Enhances Type I and III Collagen Gene Transcription in Human Skin fibroblasts.

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Mohammed BM, Fisher BJ, Kraskauskas D, Ward S, Wayne JS, Brophy DF, et al. Vitamin C Promotes Wound Healing Through Novel Pleiotropic Mechanisms. Int Wound J — Duarte TL, Cooke MS, Jones GD. It also helps balance blood sugar levels and reduces inflammation.

You can even use cayenne pepper to make a detox drink to boost your energy level and reverse disease. A few health benefits of cayenne pepper can be directly attributed to its active compound, capsaicin. Capsaicin is known to cause a mild inflammatory response in the body, but this reaction is intended to repair damaged cells.

Cayenne also contains a variety of vitamins, minerals, and flavonoids, which have potent antioxidant properties. It also increases saliva production by stimulating the salivary glands. This is beneficial for the digestive process. Other benefits of cayenne pepper include fighting allergy symptoms.

Capsaicin found in cayenne pepper reduces the inflammatory response to certain foods. It also helps prevent a host of other health problems. The FDA approved capsaicin in over-the-counter products. However, the pepper can be irritating to the skin and eyes. Some users have experienced flushing and a runny nose.

A healthy diet can prolong the life of your organs, including the lungs. Unfortunately, modern eating habits are focused on junk food, which often contains unhealthy fats. Fatty foods push the diaphragm, causing bloating and discomfort. Soda, on the other hand, is a sweet and carbonated food that may actually increase inflammation.

Therefore, it is important to limit your intake of these products. Honey: A healthy diet can also reduce the risk of lung disease by providing antibacterial and immune-boosting properties. Honey also has strong antioxidant properties and may help limit inflammation in the lungs. Protein: Dietary proteins are necessary for lung health.

Protein helps regenerate cells and reduce inflammation in the body, improving overall health. Leafy green vegetables: Consume a variety of green leafy vegetables, as they are rich in chlorophyll. These foods also have lutein and zeaxanthin, which help produce immune cells and strengthen respiratory tissue.

Oranges: Consuming oranges regularly may help decrease phlegm production in those suffering from lung diseases. A recent Scottish study found that eating fresh fruit regularly reduced the prevalence of phlegm in adults. However, it remains to be seen whether these foods can actually help people with respiratory problems.

You can read more about the effects of various foods on lung health on the body. You may be wondering how to eat for healthy lungs. There are a few key things you need to know. Eating a balanced diet is crucial to maintaining your organs.

You should avoid processed foods and junk foods. This will make breathing easier and help your organs maintain a healthy balance. Fried food, for example, contains unhealthy fats that push the diaphragm.

Soda, on the other hand, can increase inflammation in your body. If you suffer from chronic lung problems, a healthy diet can help you breathe easier. Eating foods that are rich in omega-3 fatty acids can improve your breathing.

Walnuts, which are the richest source of these fats, should be included in your diet. You should also consume fatty fish twice a week. Ground flaxseeds can be sprinkled on cereals and salads. Red and orange colored foods are rich in phytonutrients, which are plant chemicals that lower inflammation and may reduce the risk of lung cancer.

Garlic is another excellent source of carotenoids, which may prevent cancer in its early stages. Turmeric has anti-inflammatory properties, but be sure to eat it with black pepper to maximize absorption.

Beetroot contains nitrate, which relaxes blood vessels and optimizes oxygen uptake. Garlic is also a good source of antioxidants, and it can help you breathe better too. Many people have breathing problems as a result of pollution or unhealthy lifestyle choices.

Studies have shown that 3 million people suffer from respiratory diseases every year. If you want to avoid respiratory ailments and save money on healthcare costs, you should adopt healthy habits and eat a healthy diet. Here are some foods that are good for the lungs.

Leafy greens: They are full of phytochemicals and antioxidants that are essential to lung health. They may also lower the risk of lung cancer.

Pumpkin seeds contain magnesium, which relaxes airway muscles and reduces inflammation. Garlic has anti-inflammatory properties, which can help you breathe better. Eating garlic regularly may help your body fight off lung cancer.

It also contains antioxidants that have been shown to reduce inflammation. Garlic: Raw garlic is a great source of anti-inflammatory compounds that can help your lungs fight off lung cancer.

It also helps your body detoxify and improves overall health. And last but not least, eating garlic regularly is good for your lungs! So, what are the 10 foods that can help you breathe better?

Apples Many chronic lung conditions are fueled by inflammation, and your diet can support better lung function. Walnuts A diet high in fiber is a key component to keeping your lungs healthy. Trà sơn mật hồng sâm Red, yellow, and orange-colored foods are high in carotenoids, which are antioxidants that improve lung function and reduce inflammation.

Berries Eating a healthy diet can do more than make you feel better — it can also protect your lungs.

Citrus fruits are healfh excellent source of vitamins especially vitamin C Sport-specific diet plans, minerals, and fpr. Sport-specific diet plans most common type, Green tea extract for sleepaccounts for over half of Sport-specific diet plans world's respiratogy fruit production. Other popular citrus fruits include limes, lemonsand grapefruit. Most people are familiar with drinking citrus juice to strengthen the immune system to ward off colds, but citrus holds plenty of other lesser-known benefits, too. Unfortunately, citrus can be risky for some people, including those with citrus allergies or who take certain medications. Citrus fruit for respiratory health

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