Nutrition and Resilience (Micronutrients and Triage Theory)

Hello everyone Floyd Meyer here I am a Physician Assistant with a Master’s in public health, a degree in molecular biology, and I am currently working in physical medicine and rehabilitation. Today we are continuing our series on Resilience which is the ability to remain well, recover, or even thrive in the face of adversity.

Last week we started our conversation about nutrition and how it relates to resilience specifically talking about how Obesity is a big risk factor for not just chronic disease, but now it is associated with severe complications from COVID.

This week we are going to move from the macro to the micro discussing the importance of micronutrient status when it comes to Resilience specifically Immune Resilience, and how to optimize our own immune function through nutrition.

We know that we need certain vitamins and minerals in order to prevent severe diseases. For example we know that vitamin C is necessary to prevent scurvy, and that vitamin D is necessary to prevent rickets.

What we do not spend time discussing is, how to ensure optimal micronutrient status providing an available pool of resources for when a stressful event occurs.

According to a review in the BMJ Nutrition, Prevention, & Health; “The immune system is always active, carrying out surveillance, but its activity is enhanced if an individual becomes infected. This heightened activity is accompanied by an increased rate of metabolism, requiring energy sources, substrates for biosynthesis and regulatory molecules. These energy sources, substrates and regulatory molecules are ultimately derived from the diet. Hence an adequate supply of a wide range of nutrients is essential to support the immune system to function optimally.” (Calder, 2020)

Another article in the Journal Nutrients states that; “A wealth of mechanistic and clinical data show that vitamins, including vitamins A, B6, B12, C, D, E, and folate; trace elements, including zinc, iron, selenium, magnesium, and copper; and the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid play important and complementary roles in supporting the immune system. Inadequate intake and status of these nutrients are widespread, leading to a decrease in resistance to infections and as a consequence an increase in disease burden.” (Calder et al., 2020)

This brings us to the idea of Triage Theory. Triage Theory was put forth by one of the world’s top scientists Dr. Bruce Ames, whose scientific contributions are immense. You can thank him for creating a test to see if specific chemicals cause DNA damage. Which is why kids bedding and clothing no longer have cancer-causing fire retardants woven in them. 

Let’s look at Vitamin K as a specific example to explain triage theory. Vitamin K is a cofactor that is necessary for us to repair DNA damage, something that is extremely important when it comes to living a long healthy life. Vitamin K is also necessary for blood clotting for when you accidently cut your finger.

Now if you have low levels of Vitamin K, where do you think the body will send your limited supply? To the blood to help with clotting of course. Our bodies are designed to survive and reproduce. Living a long healthy life is not the priority for evolution. Short term survival is.

Things get even more complicated when you start adding in a significantly stressful event that increases our need for these limited resources. For example, when someone gets an acute infection.

Say someone has enough B12 for regular everyday processes. They are not clinically deficient, they are just getting the daily recommended amount of B12. Then the person picks up a bad infection. As we discussed earlier this sends the immune system into overdrive increasing its metabolic demand and its need for certain micronutrients like B12.

Because this individual was only getting enough B12 to prevent clinical deficiency they won’t have enough B12 to compensate for the increased metabolic demand from their immune cells dividing and mobilizing to fight off this new pathogen.

This idea can be applied to any of the essential vitamins and minerals that we discussed above.

It’s not just about having enough micronutrients to prevent diseases like scurvy. It is about ensuring optimal levels of these micronutrients for the inevitable time that you need the increased pool of resources to deal with a significant stressor.

AKA you want optimal levels of micronutrients to be Resilient.

So how do we go about ensuring an adequate level of these nutrients? Unfortunately we do not have clear scientific consensus on what levels would be optimal for immune resilience, but there are steps we can take to ensure adequate levels.  

First is to make sure you are eating 7-9 servings of vegetables and fruit each day. Yes that is a lot of veggies. Probably more than you are currently eating or maybe even more than you have ever eaten unless you are a strict vegetarian or vegan. Eating this amount of a variety of different vegetables should give your body sufficient levels of a range of vitamins and minerals.

Second is to make sure that you are eating the rainbow. The chemicals that give fruits and vegetables their color are the same ones that are needed for our enzymes to work properly. When you are eating those 7-9 servings of fruits and vegetables you want them to have a variety of colors. Red and orange veggies are going to have different micronutrients than blue or purple ones. The different chemicals that make the colors are going to be needed for different processes, and the best results will be found when you have enough of all of them.

Third, is to supplement appropriately. As I stated the optimal micronutrient levels for resilience aren’t exactly known, but as stated in an article in BMJ Nutrition, Prevention & Health, “Consumption of a diet of diverse and varied plant-based and animal-based foods that is consistent with current healthy eating guidelines would be best to support the immune system. However, human trials suggest that the intakes of some micronutrients (vitamins C, D and E and zinc and selenium) needed to optimally support the immune system are in excess of intakes that can easily be achieved through diet alone and in this case supplementation might be considered.” (Calder, 2020)

It has never been more important to ensure optimal micronutrient status increasing your overall resilience. Unfortunately, Americans are known to be extremely deficient in a number of vitamins and minerals. 70% of people don’t get enough Vitamin D, and 45% of people don’t get enough magnesium.

So make sure you are eating a lot of fruits and vegetables each day, eating a range of different colored vegetables, and supplementing appropriately. If this resonated with you please share with your friends and family and subscribe and follow for more of this content. The time for action is now. Again this is Floyd Meyer. Have a great day!


Calder, P.C.; Carr, A.C.; Gombart, A.F.; Eggersdorfer, M. Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections. Nutrients 2020, 12, 1181.

Calder PC. Nutrition, immunity and COVID-19. BMJ Nutrition, Prevention & Health 2020;0. doi:10.1136/ bmjnph-2020-000085

Gombart, A., Pierre, A., & Maggini, S. (2020, January 16). A Review of Micronutrients and the Immune System–Working in Harmony to Reduce the Risk of Infection. Retrieved July 06, 2020, from

McAuliffe S, Ray S, Fallon E, et al. Dietary micronutrients in the wake of COVID-19: an appraisal of evidence with a focus on high-risk groups and preventative healthcare. BMJ Nutrition, Prevention & Health 2020;0. doi:10.1136/ bmjnph-2020-000100

McCann, J. C., & Ames, B. N. (2009). Vitamin K, an example of triage theory: is micronutrient inadequacy linked to diseases of aging? The American Journal of Clinical Nutrition, 90(4), 889–907. doi:10.3945/ajcn.2009.27930 

McCann, J. C., & Ames, B. N. (2011). Adaptive dysfunction of selenoproteins from the perspective of the triage theory: why modest selenium deficiency may increase risk of diseases of aging. The FASEB Journal, 25(6), 1793–1814. 


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