| Enter any health food store, and lining the shelves you’ll see hundreds of nutritional supplements designed to kick-start the immune system. Many consumers buy these products with hopes of warding off the flu during flu season or speeding their recovery from a cold. But what if enhancing the immune system meant the difference between health and life-threatening disease after a serious operation—would these products pass muster?
Researchers at the University of Amsterdam set out to find the answer. They randomly assigned 45 patients at high risk of infection after cardiac surgery to either a group taking an immune-enhancing oral supplement containing L-arginine,  -3 polyunsaturated fatty acids, and yeast RNA, or a group taking a placebo (Lancet 2001, 358, 696–701). Both groups were required to participate for a minimum of five days preceding their surgery to be logged in the study.
Patients were identified as having a high risk of infection if they were aged 70 years or older; had an ejection fraction (a measure of the function of the left ventricle) of less than 0.4, an extremely low level of function; or were scheduled to undergo mitral valve replacement.
After cardiac surgery, the patient groups differed in several categories monitored by the scientists. For example, only 4 of 23 patients taking the supplement had an infection versus 12 of 22 patients in the placebo group. Compared with the placebo group, the supplement patients averaged 1 hour less on a ventilator, 2 hours less in intensive care, and 2 days less in the hospital.
The study report indicated that the positive results from the treatment group might be due to increased circulation and improved renal function. Whatever the mechanism, taking an immune-enhancing supplement before surgery might just become a useful way to improve postoperative outcomes.
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