Write an article 150 words on "How to boost immunity"
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Background: The concept that one can “boost” immunity is a popular one. Although the only evidence-based approach to this is vaccination, the lay public is exposed to a wide range of information on how to boost immunity. The aim of this study was to analyze such information available on the Internet.
Methods and findings: We visited 185 webpages returned from a Google search on “boost immunity” and classified them by typology (blogs, commercial, government, no-profit, news, professional, scientific journals) and by using standard indicators of health information quality (JAMA score, HONCode). We then analyzed their content in terms of disease and “boosters” mentioned. Commercial and news websites represented one third of the results each. Of the 37 approaches to boost immunity recorded, the top ones were diet (77% of webpages), fruit (69%), vitamins (67%), antioxidants (52%), probiotics (51%), minerals (50%), and vitamin C (49%). Interestingly, vaccines ranked 27th, with only 12% of webpages mentioning them.
Conclusions: Commercial websites are an important component of the information available to the public on the topic, and thus contribute providing biased information.
Immunity is the main mechanism of host defense against infectious agents, demonstrated by the enormous success of vaccination in eradicating disease (1). The concept that vaccines are the most effective means of preventing infection is well-recognized, both by public health authorities and by the public. Daniel Davis wrote, “the public are fascinated by the connections between lifestyle choices and immunity because there may be practical implications for what it takes to be healthy” (2). There is, in particular, a public interest on increasing immune defense easily. Probably, the most popular belief is about the use of vitamin C to prevent infection, an idea that became popular after a series of scientific articles by Linus Pauling, who advocated the intake of larger amounts than those recommended at the time (3, 4).
The popularity, among lay persons, of this concept is such that “Improving the body's immune system” is the top reason for consuming nutritional supplements (5, 6). The “immune boosters” market includes vitamins, minerals, antioxidants, probiotics, and “functional foods” as well as other complementary and alternative medicine (CAM) approaches. A study based on the US National Health and Nutrition Examination Survey showed that over 50% of the US population reported the use of supplements (7). This has a huge commercial impact, with the global market of dietary supplements estimated around 133 billion USD (8).
An additional issue is whether the use of non-evidence based approaches to boost immunity can be considered an effective alternative to vaccination. This is a particularly important aspect at a time when vaccine hesitancy is becoming a major threat to global health, as indicated by the World Health Organization (9). A study on 9,000 US children has shown that exposure to some complementary therapies, including chiropractice and other types of alternative medicine (excluding multivitamins/multi-minerals) is associated with a lower uptake if influenza vaccine (10), although this was not observed in adults (11). Similar results were obtained in a survey of over 9,000 Australian women, with those using naturopathy or herbal medicine less likely to vaccinate against influenza (12). It is important to note that, in two of the cited studies, use of multivitamins/multiminerals was associated with a higher vaccination rate (10, 12). However, when vaccine confidence was studied in a survey on attitudes to vaccination among 1,250 Australian adults, use of most CAM, including vitamins, was associated with lower levels of vaccination endorsement (13). It is therefore important to establish what type of information the lay public is exposed to as this is likely to be the basis of their knowledge of the topic and have important consequences on public health.