Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE)

Abstract

An increasing recognition has emerged of the complexities of the global health agenda—specifically, the collision of infections and noncommunicable diseases and the dual burden of over- and undernutrition. Of particular practical concern are both 1) the need for a better understanding of the bidirectional relations between nutritional status and the development and function of the immune and inflammatory response and 2) the specific impact of the inflammatory response on the selection, use, and interpretation of nutrient biomarkers. The goal of the Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE) is to provide guidance for those users represented by the global food and nutrition enterprise. These include researchers (bench and clinical), clinicians providing care/treatment, those developing and evaluating programs/interventions at scale, and those responsible for generating evidence-based policy. The INSPIRE process included convening 5 thematic working groups (WGs) charged with developing summary reports around the following issues: 1) basic overview of the interactions between nutrition, immune function, and the inflammatory response; 2) examination of the evidence regarding the impact of nutrition on immune function and inflammation; 3) evaluation of the impact of inflammation and clinical conditions (acute and chronic) on nutrition; 4) examination of existing and potential new approaches to account for the impact of inflammation on biomarker interpretation and use; and 5) the presentation of new approaches to the study of these relations. Each WG was tasked with synthesizing a summary of the evidence for each of these topics and delineating the remaining gaps in our knowledge. This review consists of a summary of the INSPIRE workshop and the WG deliberations.

Keywords: BOND and inflammation/infection; assessment of micronutrient biomarkers; immune function and nutrients; inflammation and nutrition; nutrition biomarkers.

FIGURE 1

Bidirectional relation between inflammation and nutrition in obstructive lung diseases. Various nutritional contributors and outcomes are associated with systemic inflammation resulting from lung inflammation in obstructive lung disease. Original to manuscript produced with permission from William Checkley. CRP, C-reactive protein.

FIGURE 2

Maternal and fetal effects with infectious and noninfectious inflammation. Factors such as infections, hormonal factors, or maternal obesity affect the systemic immune system during pregnancy. Maternal and fetal immune responses are modulated by placental pro- and anti-inflammatory cytokine networks. Adapted from reference with permission.