Issue

Vol. 1 No. 2 (2024)

Date Log

Submitted
February 8, 2026
Published
December 31, 2024

Copyright (c) 2024 Mohammad Hassan Ali Tharwan, Fahad Saud Mohammad Alsulaiman, Budur Saeed Abdulrahman Alshehri, Maryam Abdullah Ali Zayed Altimawi, Abeer Mohammed Kariri, Awad Ali Alshehri, Khulud Abdulaziz Abdulaal, Abdullah Abdulkader Abdullah Al-Ageel, Basim Tae Alharbi, Ayed Ali Mohammed Oraybi, Yousef Qaed Tali Almutairi

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Metabolic Gateways and Ecological Threats: An Integrative Review of Nutritional Status as a Master Modifier of Climate-Sensitive Infectious Disease Outcomes

https://doi.org/10.64483/202412636
Mohammad Hassan Ali Tharwan
Jazan Al-Darb Health Center, Ministry of Health, Saudi Arabia
Fahad Saud Mohammad Alsulaiman
King Salman Hospital, Ministry Of Health, Saudi Arabia
Budur Saeed Abdulrahman Alshehri
Tabuk Health Assembly Maternity And Children’s Hospital, Ministry of Health, Saudi Arabia
Maryam Abdullah Ali Zayed Altimawi
Tabuk Health Assembly Maternity And Children’s Hospital, Ministry of Health, Saudi Arabia
Abeer Mohammed Kariri
Primary Care In Bedouin And Medina Jizan, Ministry of Health, Saudi Arabia
Awad Ali Alshehri
Riyadh Prince Sultan Military Medical City, Ministry of Defence, Saudi Arabia
Khulud Abdulaziz Abdulaal
Al-Madinah Health Center, Ministry of Health, Saudi Arabia
Abdullah Abdulkader Abdullah Al-Ageel
Gizan - Phc Alrawdah (Jizan Health Cluster), Ministry of Health, Saudi Arabia
Basim Tae Alharbi
King Khalid General Hospital In Hafr Al-Batin, Ministry of Health, Saudi Arabia
Ayed Ali Mohammed Oraybi
Jazan General Season Hospital, Ministry of Health, Saudi Arabia
Yousef Qaed Tali Almutairi
Health Assistant Nursing Alghat, Ministry of Health, Saudi Arabia

Corresponding Author(s) : Mohammad Hassan Ali Tharwan

Mtharwan@Moh.Gov.Sa

Saudi Journal of Medicine and Public Health, Vol. 1 No. 2 (2024)

Abstract

Background: Anthropogenic climate change is worsening the global impact of climate-sensitive infectious diseases, especially vector-borne and waterborne illnesses, while also threatening food systems and nutritional security. This creates a harmful cycle where nutritional deficiencies weaken resistance to infections, which in turn exacerbates nutritional depletion, leading to declining health in populations. This interaction presents a significant challenge for clinical practice and public health surveillance.


Aim: This narrative review synthesizes evidence on the bidirectional pathophysiology connecting chronic systemic inflammatory diseases (CSIDs) and malnutrition, proposing an integrative framework for clinicians and environmental epidemiologists to collaboratively address this health burden.


Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar for peer-reviewed articles, systematic reviews, and grey literature from 2010-2024.


Results: The analysis reveals strong evidence for pathophysiological synergies: deficiencies in vitamin A, zinc, and iron impair immune response to key CSIDs, while infections like malaria and diarrheal diseases drive nutrient loss and anemia. Current health systems operate in silos, missing crucial interactions. Our proposed framework integrates environmental exposure data with clinical nutrition indicators in electronic medical records (EMRs), standardizes nursing-led vulnerability assessments, and establishes protocols for combined nutritional and antimicrobial interventions.


Conclusion: The climate crisis necessitates a shift from pathogen-centric to person-centric care models. Integrated approaches combining clinical medicine, nutrition, and environmental science are vital for enhancing population resilience, breaking the infection-malnutrition cycle, and bolstering health security in a warming world.

Keywords

Climate-Sensitive Infectious Diseases, Nutritional Immunology, Syndromic Surveillance, Planetary Health, Clinical-Environmental Integration
Tharwan, M. H. A., Alsulaiman, F. S. M., Alshehri, B. S. A., Altimawi, M. A. A. Z., Kariri, A. M., Alshehri, A. A., … Almutairi, Y. Q. T. (2024). Metabolic Gateways and Ecological Threats: An Integrative Review of Nutritional Status as a Master Modifier of Climate-Sensitive Infectious Disease Outcomes. Saudi Journal of Medicine and Public Health, 1(2), 2283–2291. https://doi.org/10.64483/202412636
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX
References
  1. 1. Agostoni, C., Baglioni, M., La Vecchia, A., Molari, G., & Berti, C. (2023). Interlinkages between climate change and food systems: the impact on child malnutrition—narrative review. Nutrients, 15(2), 416. https://doi.org/10.3390/nu15020416
  2. 2. Aranow, C. (2011). Vitamin D and the immune system. Journal of investigative medicine, 59(6), 881-886. https://doi.org/10.2310/JIM.0b013e31821b8755
  3. 3. Birkhead, G. S., Klompas, M., & Shah, N. R. (2015). Uses of electronic health records for public health surveillance to advance public health. Annual review of public health, 36(1), 345-359. https://doi.org/10.1146/annurev-publhealth-031914-122747
  4. 4. Caulfield, L. E., de Onis, M., Blössner, M., & Black, R. E. (2004). Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles. The American journal of clinical nutrition, 80(1), 193-198. https://doi.org/10.1093/ajcn/80.1.193
  5. 5. Chen, S. J., Walker, P. J., Mulholland, K., Graham, H. R., & ARI Review group. (2022). Childhood pneumonia in humanitarian emergencies in low-and middle-income countries: A systematic scoping review. Journal of Global Health, 12, 10001. https://doi.org/10.7189/jogh.12.10001
  6. 6. Cohen, A. L., Platts-Mills, J. A., Nakamura, T., Operario, D. J., Antoni, S., Mwenda, J. M., ... & Serhan, F. (2022). Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network. BMJ global health, 7(9), e009548. https://doi.org/10.1136/bmjgh-2022-009548
  7. 7. Farhadi, S., & Ovchinnikov, R. S. (2018). The relationship between nutrition and infectious diseases: A review. Biomedical and Biotechnology Research Journal (BBRJ), 2(3), 168-172. DOI: 10.4103/bbrj.bbrj_69_18
  8. 8. Gentili, A., Failla, G., Melnyk, A., Puleo, V., Tanna, G. L. D., Ricciardi, W., & Cascini, F. (2022). The cost-effectiveness of digital health interventions: a systematic review of the literature. Frontiers in public health, 10, 787135. https://doi.org/10.3389/fpubh.2022.787135
  9. 9. Guerrant, R. L., Oriá, R. B., Moore, S. R., Oriá, M. O., & Lima, A. A. (2008). Malnutrition as an enteric infectious disease with long-term effects on child development. Nutrition reviews, 66(9), 487-505. https://doi.org/10.1111/j.1753-4887.2008.00082.x
  10. 10. Gunasekeran, D. V., Tseng, R. M. W. W., Tham, Y. C., & Wong, T. Y. (2021). Applications of digital health for public health responses to COVID-19: a systematic scoping review of artificial intelligence, telehealth and related technologies. NPJ digital medicine, 4(1), 40. https://doi.org/10.1038/s41746-021-00412-9
  11. 11. Hadley, K., Talbott, J., Reddy, S., & Wheat, S. (2023, December). Impacts of climate change on food security and resulting perinatal health impacts. In Seminars in perinatology (Vol. 47, No. 8, p. 151842). WB Saunders. https://doi.org/10.1016/j.semperi.2023.151842
  12. 12. Hantoul, M. Y., Alrasheedi, N. F., Majrashi, Y. A. S., Awaf, F. I. A., Alshahrani, A. A., Alghanim, L. H. G., ... & Al Awal, A. A. A. A. T. A. (2024). Addressing malnutrition in elderly patients using biochemical markers: the role of nurses in nutrition screening and intervention. Egyptian Journal of Chemistry, 67(13), 1631-1643. https://doi.org/10.21608/ejchem.2024.335955.10790
  13. 13. Kamel Boulos, M. N., & Zhang, P. (2021). Digital twins: from personalised medicine to precision public health. Journal of personalized medicine, 11(8), 745. https://doi.org/10.3390/jpm11080745
  14. 14. Kraus, E. M., Brand, B., Hohman, K. H., & Baker, E. L. (2022). New directions in public health surveillance: using electronic health records to monitor chronic disease. Journal of Public Health Management and Practice, 28(2), 203-206. DOI: 10.1097/PHH.0000000000001501
  15. 15. Levy, K., Woster, A. P., Goldstein, R. S., & Carlton, E. J. (2016). Untangling the impacts of climate change on waterborne diseases: a systematic review of relationships between diarrheal diseases and temperature, rainfall, flooding, and drought. Environmental science & technology, 50(10), 4905-4922. doi:10.1021/acs.est.5b06186.
  16. 16. Long, K. Z., Santos, J. I., Rosado, J. L., Estrada-Garcia, T., Haas, M., Al Mamun, A., ... & Nanthakumar, N. N. (2011). Vitamin A supplementation modifies the association between mucosal innate and adaptive immune responses and resolution of enteric pathogen infections. The American journal of clinical nutrition, 93(3), 578-585. https://doi.org/10.3945/ajcn.110.003913
  17. 17. Mordecai, E. A., Caldwell, J. M., Grossman, M. K., Lippi, C. A., Johnson, L. R., Neira, M., ... & Villena, O. (2019). Thermal biology of mosquito‐borne disease. Ecology letters, 22(10), 1690-1708. https://doi.org/10.1111/ele.13335
  18. 18. Myers, S. S., Smith, M. R., Guth, S., Golden, C. D., Vaitla, B., Mueller, N. D., ... & Huybers, P. (2017). Climate change and global food systems: potential impacts on food security and undernutrition. Annual review of public health, 38(1), 259-277. https://doi.org/10.1146/annurev-publhealth-031816-044356
  19. 19. Naheed, S. (2023). An overview of the influence of climate change on food security and human health. Archives of Food and Nutritional Science, 7(1), 001-011. https://doi.org/10.29328/journal.afns.1001044
  20. 20. Niroomandi, E., Maleki, S., Abdollahpour, G., Zakian, A., & Ahmadvand, H. (2022). The effect of natural infection with different Leptospira interrogans serovars on oxidative stress biomarkers and acute‐phase responses in horses and cattle. Veterinary Clinical Pathology, 51(1), 84-92. https://doi.org/10.1111/vcp.13042
  21. 21. Prentice, A. M., Mendoza, Y. A., Pereira, D., Cerami, C., Wegmuller, R., Constable, A., & Spieldenner, J. (2017). Dietary strategies for improving iron status: balancing safety and efficacy. Nutrition reviews, 75(1), 49-60. https://doi.org/10.1093/nutrit/nuw055
  22. 22. Rocklöv, J., & Dubrow, R. (2020). Climate change: an enduring challenge for vector-borne disease prevention and control. Nature Immunology, 21(5), 479-483.
  23. 23. Roth, D. E., et al. (2018). Vitamin D supplementation in pregnancy and lactation and infant growth. New England Journal of Medicine, 379(6), 535-546.
  24. 24. Sauer, A. C., Alish, C. J., Strausbaugh, K., West, K., & Quatrara, B. (2016). Nurses needed: Identifying malnutrition in hospitalized older adults. NursingPlus Open, 2, 21-25. https://doi.org/10.1016/j.npls.2016.05.001
  25. 25. Schaible, U. E., & Kaufmann, S. H. (2007). Malnutrition and infection: complex mechanisms and global impacts. PLoS Medicine, 4(5), e115.
  26. 26. Scricciolo, A., Elli, L., Doneda, L., Bascunan, K. A., Branchi, F., Ferretti, F., ... & Roncoroni, L. (2020). Efficacy of a high-iron dietary intervention in women with celiac disease and iron deficiency without anemia: a clinical trial. Nutrients, 12(7), 2122. https://doi.org/10.3390/nu12072122
  27. 27. Singer, M., Bulled, N., Ostrach, B., & Lerman Ginzburg, S. (2021). Syndemics: A cross-disciplinary approach to complex epidemic events like COVID-19. Annual Review of Anthropology, 50(1), 41-58. https://doi.org/10.1146/annurev-anthro-100919-121009
  28. 28. Springmann, M., Clark, M. A., Rayner, M., Scarborough, P., & Webb, P. (2021). The global and regional costs of healthy and sustainable dietary patterns: a modelling study. The Lancet Planetary Health, 5(11), e797-e807. https://doi.org/10.1016/S2542-5196(21)00251-5
  29. 29. Sullivan, E. S., Daly, L. E., Scannell, C., Bhuachalla, É. B. N., Cushen, S., Power, D. G., & Ryan, A. M. (2022). A large, multi-centre prospective study demonstrating high prevalence of malnutrition associated with reduced survival in ambulatory systemic anti-cancer therapy patients. Clinical Nutrition ESPEN, 52, 208-217. https://doi.org/10.1016/j.clnesp.2022.10.009
  30. 30. Teymouri, P., & Dehghanzadeh, R. (2022). Climate change and water-related diseases in developing countries of Western Asia: a systematic literature review. Climate and Development, 14(3), 222-238. https://doi.org/10.1080/17565529.2021.1911773
  31. 31. Tsai, A. C., Mendenhall, E., Trostle, J. A., & Kawachi, I. (2017). Co-occurring epidemics, syndemics, and population health. The Lancet, 389(10072), 978-982. https://doi.org/10.1016/S0140-6736(17)30403-8
  32. 32. Walker, C. L. F., Rudan, I., Liu, L., Nair, H., Theodoratou, E., Bhutta, Z. A., ... & Black, R. E. (2013). Global burden of childhood pneumonia and diarrhoea. The Lancet, 381(9875), 1405-1416. https://doi.org/10.1016/S0140-6736(13)60222-6
  33. 33. Wang, Q., Su, M., Zhang, M., & Li, R. (2021). Integrating digital technologies and public health to fight Covid-19 pandemic: key technologies, applications, challenges and outlook of digital healthcare. International Journal of Environmental Research and Public Health, 18(11), 6053. https://doi.org/10.3390/ijerph18116053
  34. 34. Weiss, G., & Goodnough, L. T. (2005). Anemia of chronic disease. New England Journal of Medicine, 352(10), 1011-1023. DOI: 10.1056/NEJMra041809
  35. 35. Wintergerst, E. S., Maggini, S., & Hornig, D. H. (2007). Contribution of selected vitamins and trace elements to immune function. Annals of nutrition and metabolism, 51(4), 301-323. https://doi.org/10.1159/000107673
  36. 36. Wu, X., Lu, Y., Zhou, S., Chen, L., & Xu, B. (2016). Impact of climate change on human infectious diseases: Empirical evidence and human adaptation. Environment international, 86, 14-23. https://doi.org/10.1016/j.envint.2015.09.007
  37. 37. Yakoob, M. Y., & Qadir, M. (2018). Vitamin A supplementation for prevention and treatment of malaria during pregnancy and childhood: a systematic review and meta-analysis. Journal of epidemiology and global health, 8(1), 20-28. https://doi.org/10.2991/j.jegh.2018.04.104
  38. 38. Zavala-Alvarado, C., G. Huete, S., Vincent, A. T., Sismeiro, O., Legendre, R., Varet, H., ... & Benaroudj, N. (2021). The oxidative stress response of pathogenic Leptospira is controlled by two peroxide stress regulators which putatively cooperate in controlling virulence. PLoS Pathogens, 17(12), e1009087. https://doi.org/10.1371/journal.ppat.1009087
Read More
Author biographies is not available.
Download
PDF
Statistic
Read Counter : 31 Download : 60