Pneumonia: The Forgotten Killer of the 21st Century

by Dr. Edward R. Rosick

image via wikipedia.org.

Those of us living in the 21st century are truly blessed. It’s easy to forgot that just 100 years ago, people the world over were had to suffer with a multitude of infectious diseases such as polio, gonorrhea and syphilis. These diseases killed millions of people around the world, not just in third-world nations but also developed countries such as the United States.

Yet today, there are physicians who will never see cases of these formerly deadly diseases. Through vaccines, illnesses like polio have almost been completely eradicated from the face of the earth; through antibiotics, diseases like gonorrhea and syphilis can be fully cured cured. However, there is still one disease feared in the time of our grandparents and great-grand parents that is still stubbornly surviving in our high-tech antibiotic world: pneumonia.

Pneumonia is a disease of the respiratory tract where the lungs become inflamed because of an infection (ether bacterial or viral), leading to fluid filling the alveoli (the part of the lungs where oxygen is taken in). If left untreated, pneumonia can literally cause a person to drown in their own fluids. Recent data shows that despite the medical communities best efforts, pneumonia is still an all-too-common disease, especially among the young and aged: it’s estimated that community-acquired pneumonia in the U.S. alone is the cause of over 4 million yearly visits to the doctor’s office, 1 million hospitalizations, and 50,000 thousand annual deaths.(1)

Fortunately, there are multiple ways you can stop from becoming part of these grim statistics. One of the first things I talk to my patients about in regards to maintaining their health and being able to fight off off infections such as pneumonia is their diet. Numerous studies have shown that people who eat a diet high in fruits and vegetables are more healthy then people who eat the standard american diet (or, as I like to say, the SAD diet) of refined sugars and processed foods. A recent web article on the site Livestrong.com detailed the ways in which a healthy diet can help keep your immune system strong and keep you from contracting upper respiratory diseases, including pneumonia.(2)

One of the ways a diet high in fruits and vegetables may help keep you healthy is in their high content of vitamins and minerals. Selenium, a mineral known to mediate immune function, has been shown to help ward off pneumonia, even in severely ill patients(3,4). A 2011 study by Intensive Care Medicine on patients in the intensive care unit of a hospital showed that daily selenium supplementation lowered the incidence of hospital-acquired pneumonia (3). Low levels of vitamin D, a vitamin crucial for overall good health, has been shown to be associated with increased risk of pneumonia as exemplified by two recent studies(5,6). In one study on 132 men and women, it was shown that those with low levels of vitamin D had a statically higher chance of contracting pneumonia and ending up in the hospital when compared to those who had high levels of vitamin D (5). Finally, studies also show us that maintaining optimal levels of vitamin E, especially among the elderly, is important for warding off respiratory infections. A double-blinded, placebo controlled trial of using 200 International Units of daily vitamin E among 617 male and female nursing home residents was shown to be, in the authors own words, “…associated with reduced risk of acquiring infections, particularly upper respiratory infections.”(7)

“Thats great, Dr. Rosick, but I already take my vitamin and mineral supplements. Isn’t there anything else I can do to decrease my chances of getting pneumonia?” The answer to that is a resounding Yes!, and that’s by the use of probiotics, or the ‘good bacteria’ found in certain foods like yogurt and kefir or available as supplements. Multiple studies show that taking probiotics is crucial in maintaining optimal health and having a robust immune system to help fight off upper respiratory infections, including pneumonia. A recent review article on aging and immunity highlighted a number of studies showing how probiotics can enhance immune functioning–especially as we age–and help protect us against respiratory diseases(8). Other studies show that even certain parts of the probiotics can help enhance the immune system. A recent article in the journal Probiotics and Health showed that mice given a supplement containing active parts of the probiotic Lactobacillus rhamnosus V had a statistically significant increase in blood levels of chemicals known as cytokines, which are known to be part of the immune system when compared to mice that were not given the probiotic formulation.(9)

With regards to pneumonia specifically, the data is just as exciting. A recent review article from French medicine journal, Médecine et Maladies Infectieuses, examined data pertaining to the use of probiotics and respiratory diseases including pneumonia, and concluded “probiotics can act directly against pathogenic bacteria…they can also be effective against these pathogens…by modifying the immune system response.”(10) Another review study published in 2014 examined the use of probiotics to prevent ventilator-associated pneumonia (VAP) in hospitalized patients and concluded “evidence suggests that the use of probiotics is associated with a reduction in the incidence of VAP.” (11) Finally, the U.S. Government itself, through the auspices of the National Institutes of HEalth, is sponsoring a study examining the use of probiotics in the prevention of pneumonia in severely ill, hospitalized patients. (12) When the government is willing to put our tax dollars to work on probiotics, you can believe that the science behind it is certainly something to bet on!

1. Quraishi SA, Bittner ED, Christopher KB, Camargo CA. Vitamin D status and community-acquired pneumonia: Results from the third national health and nutrition examination survery. Plos One 2013; 8(11): 1-11.

2. A list of foods to eat for pneumonia. Livestrong.org. https://livestrong.com/article/695233-list-foods-eat-pneumonia.

3. Manzanares W, Biestro A, Torre MH et al. High-dose selenium reduces ventilator-associated pneumonia and illness severity in critically ill patients with systemic inflammation. Inten Care Med 2011; 37(7): 1120-27.

4. Hardy G, Hardy I, Manzanares W. Selenium supplements in the critically ill. Nutri Clin Prac 2012; 27(21): 21-33.

5. Jovanovich AJ, Ginde AA, Holmen J et al. Vitamin d level and risk of community-acquired pneumonia and sepsis. Nutrients 2014; 6: 2196-2205.

6. Pletz MW, Terkamp C, Schumacher U et al. Vitamin D deficiency in community-acquired pneumonia: low levels of 1,25(OH)2 D are associated with disease severity. Resp Reserach 2014; 15(53): 1-8.

7. Meydani SN, Han SN, Hamer DH. Vitamin E and respiratory infection in the elderly. Ann NY Acad Sci 2004; 1031: 214-22.

8. Yaqoob, P. Ageing, immunity, and influenza: A role for probiotics? Proc Nutri Soc 2014; 73: 309-17.

9. Sichel L, Timoshok NA, Pidgorskyy VS, Spivak NY. Study of interferonogenous activity of the new probiotic formulation del-IMMUNE V. Probiotics and Health 2013; 1(2): 1-6.

10. Alexandre Y, Blay GL, Boisrame-Gastrin S et al. Probiotics: A new way to fight bacterial pulmonary infections? Med et maladies infec 2014; 44: 9-17.

11. Bo L, Li J, Tao T et al. Probiotics for preventing ventilator-associated pneumonia. Cochrane Database Rev 2014; 25(10): epub.

12. Probiotics: Prevention of severe pneumonia and endotracheal colonization trial (PROSPECT): A feasibility clinical trial. Clinical Trials.gov. https://clinicaltrials.gov/ct2/show/NCT01782755