For human, the consumption of colostrum for newborn is very much encouraged, apart from the exclusive breastfeeding up to 6 months and 2 years promotion by the Ministry of Health Malaysia (MOH), mothers are as well encouraged to give skin to skin support while breastfeeding newborn for the colostrum few hours after delivery.

The colostrum is said to have various benefits on the newborn life as they get older (2).

But what about for adult? Is the consumption of bovine colostrum in adult have the same effect as colostrum from mother to newborn?

Bovine colostrum is nutritious than the regular milk. It has higher protein, fat, carbohydrate, magnesium, A, C, B, and E vitamins than the regular milk. Due to this, studies found out that the consumption of bovine colostrum in adult is useful in boosting the immune system and as well as in improving gut health (1,3).

The linked between colostrum and immunity is due to the content of lactoferrin in the colostrum. Lactoferin is a naturally present protein in the body. It is a very versatile protein, where it is a bi-lobed protein that has the ability to bind an atom of iron (4). This iron binding glycoprotein from the transferrin family is the major component of the mammalian immune system. Due to this, it provides lactoferrin with protective effects which range from direct antimicrobial activities to anti-inflammatory and anti-cancer activities (4).

Apart from this, colostrum also contains antibodies. Antibodies are proteins, also known as immunoglobulins, used by the immune system to fight bacteria and viruses. Bovine colostrum is rich in the antibodies IgA, IgG, and IgM (1, 2). This is as well essential in fighting pathogen and improve immune system.

Since bovine colostrum is loaded with nutrients that fight disease and promote growth, it is able to boost immunity, treat infections, and offer more related benefits in humans throughout life. Thus, the consumption of bovine colostrum may have the same effect as human colostrum, it is just that the absorption of colostrum from bovine to human body is different, but with all the spectacular ingredients that colostrum possess it may possess the same effect as to boost immunity!

References

1. Healthline. What is the colostrum? Nutrition, Benefits and Downsides. https://www.healthline.com/nutrition/bovine-colostrum (Accessed on July 9, 2020).

2. Bloomlife. Breastfeeding Tips To Know Before the Baby Arrives.https://bit.ly/3Qz10sR (Accessed on July 9, 2020).

3. WebMD. Bovine Colostrum.  https://wb.md/3RctYPx (Accessed on July 9, 2020).

4. Bioquad Lifesciences.https://bit.ly/3QEsrle (Accessed on July 9, 2020).

Cordyceps is a genus of parasitic fungi that grows on the larvae of insects. When these fungi attack their host, they replace its tissue of long sprout and slender stems that grow outside the host’s body. The remains of the insect and fungi have been hand-collected, dried, and used in Traditional Chinese Medicine for centuries to treat fatigue, sickness, kidney disease and low sex drive (3).

Since there is now increase shifting of attention from synthetic drugs to natural herbal product, not only to treat common cold and flu but as well as to prevent chronic diseases, thus people start to consume various kind of  traditional medicine in the effort to prevent diseases or to control diseases (2).

Since, cordyceps lives only on certain caterpillar in the high mountain regions of China, thus natural cordyceps is hard to get and is expansive. Most supplements are made with cordyceps grown in the laboratory, which is also known as cordyceps, CS-4. People start to market the products containing cordyceps in the supplement form or as functional food since many studies start to dig on its benefits. Of more than 400 species of cordyceps discovered only two types of cordyceps are commonly used, which is cordyceps sinensis and cordyceps militaris (3).

Traditionally people use cordyceps for various purposes, until now certain people whom able to get wild cordyceps still used this in their daily life. Some people mix it with milk, it is said to improve sex drive, it is also sometimes mix with alcohol, which refers to as ‘chang’ where people drink it in the morning as tonic (5).

As for the modern studies apart from the usage of cordyceps in the cough syrup, cordyceps also  have various other health benefits, such as anti hyperglycemic. Study on diabetic rats found out that,  4g/kg/day that is administered to diabetic rats does not effect  its fasting insulin level. When oral administration of cordyceps at 150 mg/kg/day and 500mg/kg/day are ingested by mice for 4 weeks it significantly prolonged the swimming time of mice by about 20 to 24 minutes, respectively, thus showing that consumption of cordyceps also improved fatigue condition. It is due to the involvement of cordyceps in adenosine triphosphate (ATP) (energy)  production that accounts for a decrease in physical fatigue when it is administered. Apart from that, the administration of cordyceps decreased the airway inflammation in ovalbumin-induced mice, thus ease breathing for individuals with cough and flu (6).

However, most of studies with regards to cordyceps is conducted the mice subject not human subject thus the findings is considered as to have insufficient evidence (1,3,4).

However, it is safe to consume cordyceps supplement with other medication if you have any other medical condition, since the government of China use cordyceps as the natural drugs in their hospital to treat patients (1,3,4).

References

Vitamin C or its actual name is ascorbic acid, is the antioxidants used for various reasons. It becomes famous after the ‘Linus Pauling effect’ all around the world. The Nobel Laurette scientist claims that the consumption of vitamin C can treat various kind of diseases. Starting from that many manufacturers claim various benefits of Vitamin C consumption. Many researchers have then started to publish articles and studies on the benefits of vitamin C, but so far, in Malaysia the studies are still somewhat lacking for it to be used partly in treatment of a particular diseases.

Pandemic COVID-19

The outbreak of Coronavirus disease began at Wuhan, China in December 2019, thus far it has infected more that 46 million of individual all around the world and has caused more than 1.2 million of deaths. The symptoms of COVID-19 include fever, cough, dyspnoea, and myalgia. Some proportion of confirmed cases also developed severe diseases which involves acute lung injury and acute respiratory distress syndrome (ARDS) which can precipitated into multiple organ failure and death. This is also one of the reasons why infection occur to the high-risk individuals are more likely be getting serious or lead to complications as compared to healthy individuals.

It has been reported that the condition is called ‘cytokine storm’, a condition where the host immune response becomes dysfunction due to the attack from the virus to body’s immune system. In the absence of approved vaccine to prevent this from happening, management of critically ill COVID19 patients include administration of azithromycin (antibiotic) and hydroxychloroquine (malaria medicine), this is due to that there is no specific medication yet for COVID-19.

However, growing study interest is seen on the administration of COVID-19 recently, where even in Malaysia, Ministry of Health has conducted few studies to see whether the usage of vitamin C among critically ill COVID-19 patients is beneficial. The first study was conducted among 17 patients, the critically ill patients were given 1g of vitamin C in every 8 hour for three days. Although the findings are promising, but according to Deputy Health Minister, Datuk Dr, Noor Azmi Ghazali, it cannot still be used as management of critically ill COVID-19 patients as the sample size of the studies is too small for the result to be used.

Another study involving critically ill COVID-19 patients, divide between two groups of critically ill patients, the one administered with Vitamin C and the one without administration of vitamin C. The result found out that group with vitamin C administration has 57% lower on mortality rate, 9 days shorter of hospital stay, 5.6 days faster in successful extubating, and 7.5 days faster in weaning off oxygen support.

There is another unpublished study that was conducted among critically ill COVID-19 patients in two different tertiary hospital in Malaysia comparing individual treated with vitamin C against those who are not treated with vitamin C. Both groups show similar clinical background, comorbidity, illness severity, and severity score on admission. The finding shows that the vitamin C group has lower mortality rate (14.3%) as compared to the group without vitamin C (71.4%). Duration of days on the ventilator were also shorter in vitamin C groups compared to non-vitamin C group (14 vs 19.6 days). Similarly, the duration to complete weaning of oxygen therapy was also shorter in vitamin C group (16 vs 23.5 days). Since the result is very promising currently, a multicenter randomized controlled trial is underway in evaluating the effectiveness of high dosage of intravenous vitamin C for the treatment for severe COVID-19 patients.

Usage of Vitamin C as prophylaxis to COVID-19 for general population

Apart from vitamin C is a water-soluble vitamin it is also a potent antioxidant. It acts as free radical scavenger and has its anti-inflammatory properties, which influence cellular immunity and vascular integrity. Which explain why it is being studied as one of the treatments for COVID-19. As for general population, National Health Service (NHS) U.K. treatment guideline stated that for non critically ill COVID-19 individuals and for non-COVID19 individuals there is insufficient data to recommend usage of high dosage of vitamin C in combating COVID-19. This being stated because, in critically ill COVID-19 individuals they experience high oxidative stress and severe inflammation, which may be helpful with the administration of vitamin C but unlike non COVID19 and non critical COVID19 individuals.

In general, sufficient consumption of vitamin C and healthy eating habit may helps with combating COVID-19 pandemic. A proper diet can help to ensure that the body is in the strongest possible state to battle the virus. Certain precaution with regards to food safety as well may helps in combating the virus although researchers have found that there is no source of virus contamination via food packaging or food. However, good food practices are always recommended to minimize the risk of contamination and to ensure that there is no window for the virus to weaken immune system.

• Eat plenty of fruits daily ( such as guava, apple, banana, strawberry, cantaloupe melon, grapefruit, pineapple, papaya, orange, Longman fruit, blackcurrant, pumelo) these are fruits have high vitamin C.
• Eat plenty of fresh vegetables daily (such as green bell peppers, garlic, ginger, kale, lime, coriander, broccoli, green chili pepper). Do not overcook vegetables as it leads to the loss of important nutrients such as vitamins and minerals.
• Eat whole grains and nuts, which have high amount of good fats! Limit intake of red meat, processed and fast foods.
• For snacks, choose fresh fruits and raw vegetables rather than foods that are high in sugar, salt or fat.
• Limit the salt intake to less than 6g/day.
• Drink 8–10 glasses of water every day. It helps to transport nutrients in the blood, gets rid of waste, and regulates the body temperature.
• Maintain a healthy lifestyle of exercise, meditation, and regular sleep. Adequate sleep will help to support immune function.
• Eat at home to avoid contact with other people and try to reduce the chance of being exposed to COVID-19.
• Wash vegetables and fruits before eating.
• Wash, rinse, and disinfect objects and surfaces every time before and after use.
• Keep cooked and raw foods separate, as it would prevent the harmful microbes from raw foods spreading to cooked foods. Use different chopping boards and utensils for cooked and raw foods to prevent cross-contamination.

References

1. Ministry of Health Malaysia (MOH). Kajian dan Penyelidikan MahTAS COVID-19 rapid evidence update. Intravenous Vitamin C for COVID-19. Based on the availa le evidence up to 16 November 2020. http://covid-19.moh.gov.my/kajian-dan-penyelidikan/mahtas-covid-19-rapid-evidence-updates/12_INTRAVENOUS_VITAMIN_C_FOR_COVID-19_editted.pdf (Access on Feb 2, 2021).
2. New Straits Times (NST). Vitamin C injections not used in COVID-19 treatment in Malaysia. https://www.nst.com.my/news/nation/2020/11/637714/vitamin-c-injection-not-used-covid-19-treatment-malaysia (Accessed on Feb 2, 2021).
3. National Institute of Health (NIH). Vitamin C usage and COVID-19. https://www.covid19treatmentguidelines.nih.gov/adjunctive-therapy/vitamin-c/ (Accessed on Feb 2, 2021).
4. Feyaerts, A. F., & Luyten, W. (2020). Vitamin C as prophylaxis and adjunctive medical treatment for COVID-19? Nutrition (Burbank, Los Angeles County, Calif.), 79-80, 110948. https://doi.org/10.1016/j.nut.2020.110948
5. Aman, F., & Masood, S. (2020). How Nutrition can help to fight against COVID-19 Pandemic. Pakistan journal of medical sciences, 36(COVID19-S4), S121–S123. https://doi.org/10.12669/pjms.36.COVID19-S4.2776

Benefits of EPA and DHA

There are various benefits of EPA and DHA, among well studied one is its relation to cardiovascular disease. Many studies show that consuming food high with EPA and DHA or consume it from dietary supplement is able to reduce level of triglycerides. Which is why American Heart Association (AHA) recommend people who have high risk of getting heart disease consuming about 1g of EPA plus DHA daily. According to Joseph C. Maroon, MD, professor of the department of neurological surgery at University of Pittsburgh School of Medicine and author of Fish Oil: The Natural Anti-Inflammatory book; large enough amount of omega 3 will reduce the inflammatory process that leads to many chronic conditions. Which is why many other diseases which have the genesis of inflammation such as arthritis problem, dry eyes, age related macular degeneration (AMD), dementia, Alzheimer and cognitive problem may also help with the consumption of omega 3 for it has the anti-inflammatory effect. But what about COVID-19?

EPA & DHA with COVID19?

As COVID-19 is a new disease, there are many things that is not yet discovered about the disease by the scientist but among potential management and treatment that scientist is looking at is regarding the relation between EPA and DHA with COVID19. Since many well documented studies suggest that EPA and DHA have potential benefits for COVID19 due to its anti-inflammatory properties.

COVID19 is a disease where it attacks body’s immune system. The attack causes the body to activate its immune system and fight the disease. During the war, body defense system work by releasing cytokine. This is what scientist refers to as ‘cytokine storm’. The higher the cytokine in the body, the less possibility for the body to win the war. This is based on study that was conducted previously among sepsis (a condition when body’s response to an infection damages its own tissue) patients. When EPA and DHA is administered, resolvin is release which involve in promoting restoration to the cellular function following inflammation that occurs after tissue injury. Which explains why administration and consumption of diet high with EPA and DHA is being studied as a potential mechanism for COVID19. Other than this study, a meta-analysis study also reported that significant reduction in ventilator-free days, organ failures, length of stay in the ICU and low mortality rate among individuals with acute respiratory distress syndrome (ARDS) is also seen with the administration of high EPA and DHA through parenteral and enteral nutrition. Since ARDS is one of the complications occur to COVID19 critically ill patients thus the same outcome is postulated to be seen.

Other parameter that is use in measuring severity of COVID19 especially among critically ill COVID19 patients are their body’s coagulation ability. It is said that, among non-survivor of COVID19 patients are those who has higher ability of platelet aggregation and activation. Easily translate, the patients’ blood are easily clump which makes it have higher risk of thrombosis (clotting) which will result in death threatening condition. An investigation using moderate amount of three species of high omega 3 (EPA & DHA) fish in 18 days by 23 healthy men revealed that it can improved bleeding time and decreased platelet aggregation which will reduce risk of thrombosis among COVID19 patients. Another study also noted that healthy subject that is supplemented with EPA for 4 weeks also showed reduction of platelet activation (an early step of platelet aggregation).

In conclusion  

 Administration or consumption of EPA and DHA may help with critically ill COVID19 patients’ conditions. However, the usage of EPA and DHA among healthy individuals as prophylaxis to COVID19 must be investigated since little known about the virus pathology and how the characteristics of the patients are involved in the recovery. Thus, studies suggest that randomized and controlled trials need to be carried out, taking into account the type of supplementation, dosage, individuals’ characteristics, adverse effects and the combination of medication and antioxidants using.

References

1. National Institute of Health (NIH). Office of Dietary Supplements. Fact sheet for consumer. Omega 3 Fatty Acids. https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/ (Accessed on Feb 4, 2021).
2. National Institute of Health (NIH). Office of Dietary Supplements. Fact sheet for Health Professionals. Omega 3 Fatty Acids. https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/ (Accessed on Feb 4, 2021).
3. Nourish by WebMD. What to know about Omega 3 and fish? Annie Stuart. https://www.webmd.com/diet/features/what-to-know-about-omega-3s-and-fish#1 (Accessed on Feb 4, 2021).
4. Rogero, M. M., Leão, M. D. C., Santana, T. M., de MB Pimentel, M. V., Carlini, G. C., da Silveira, T. F., … & Castro, I. A. (2020). Potential benefits and risks of omega-3 fatty acids supplementation to patients with COVID-19. Free Radical Biology and Medicine.
5. Bistrian B. R. (2020). Parenteral Fish-Oil Emulsions in Critically Ill COVID-19 Emulsions.  Journal of parenteral and enteral nutrition, 44(7), 1168. https://doi.org/10.1002/jpen.1871.