As measles cases continue to spread in several U.S. states, the spotlight is on prevention of the highly contagious disease.
While vaccines are widely regarded as the first line of defense, some experts have suggested that nutrition plays a role in reducing severity of the disease.
HHS Secretary Robert F. Kennedy, Jr. discussed the topic during a recent exclusive interview with Dr. Marc Siegel, clinical professor of medicine at NYU Langone Health and Fox News senior medical analyst.
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"We need to understand the relationship between good health and chronic disease," RFK told Siegel.
"If you are healthy, it's almost impossible for you to be killed by an infectious disease, in modern times — because we have nutrition … and access to medicines. What we need is good science on all of these things so that people can make rational choices."
During the interview, RFK noted that in Texas — where more than 200 cases of measles have been reported in the current outbreak — malnourishment may be a factor.
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"The doctors that I'm talking to on the ground, the leaders of the community, are reporting that the people who are getting sick are people who are [malnourished]," he said.
"There's a lot of poverty in that area, [which] is kind of a food desert," RFK added.
In 1963, prior to the introduction of the vaccine, between 400 and 500 people died from measles each year in the U.S., according to the Centers for Disease Control and Prevention.
"Almost all of them were malnourished children," RFK said. "Measles still is a very, very lethal disease in foreign countries and developed countries where there is low malnutrition."
"The best thing Americans can do is to keep themselves healthy — it is very, very difficult for measles to kill a healthy, well-nourished person."
Nutrition is "critical" for overall disease prevention, the HHS secretary told Siegel.
"We need to eat good foods. We need whole foods. We need to get plenty of exercise," he said.
"We see a correlation between people who get hurt by measles and people who don't have good nutrition or don't have a good exercise regimen."
Dr. Jacob Glanville, CEO of Centivax, a San Francisco biotechnology company, agreed that measles is more likely to severely affect children in developing countries who are extremely malnourished.
"Historically, less than 1% of American children die from measles, while the Pan American Health Organization reports that as high as 10% of children die from measles in some developing countries, and it has been reported as high as 25% to 50% in a study of malnourished African infants," he told Fox News Digital.
The lack of quality medical care in many areas of the developing world also contributes to disease severity, Glanville noted.
"While better nutrition is important for American children, it’s unlikely to make a difference when it comes to measles infection or severity — 90% of well-fed but unvaccinated American children exposed to measles will become infected, around 20% of those children will be hospitalized, and 0.1-1% of those children will die."
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Dr. Trish Perl, an infectious disease expert at UT Southwestern Medical Center in Dallas, Texas, noted that malnutrition can impair some of the immune system responses for many infections — but in the case of measles, the answer is "complicated."
"For example, malnutrition may decrease the robustness of the response to the MMR vaccine," she told Fox News Digital.
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"The vaccine is still effective, but in some cases, an additional dose may be required."
Studies have shown that children who are malnourished with vitamin A deficiency and living in low- and middle-income countries have more severe illness with measles infection, face an increased risk for death and blindness, and take longer to get better, Perl said.
"There is no treatment for measles beyond supportive care," she said. "However, in low- and middle-income countries — whose mortality is greater than 1% — the World Health Organization recommends vitamin A (two doses) to reduce the severity of measles and prevent complications."
The issue isn’t as prevalent in the U.S., where vitamin A deficiency is "extremely rare," the doctor added.
There haven’t been formal studies into whether giving vitamin A to children with measles in the U.S. or other high-income countries prevents complications, according to Perl.
The American Academy of Pediatrics, however, recommends that hospitalized children with severe measles receive two doses of vitamin A as supervised by a healthcare provider.
Dr. Jonathan Jennings, board-certified internist with the Medical Offices of Manhattan, also noted that multiple studies have found nutrition can "heavily impact" the clinical course of children who contract the measles virus.
"The risk of fatal outcomes is increased in children who are already malnourished prior to being infected," he told Fox News Digital.
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"The infection has been known to worsen the nutritional status, which impacts the child's immune system and ability to recover."
Jennings recommends a balanced diet with a variety of colorful fruits, vegetables, protein and healthy fats as a means of preventing complications once infected with the virus.
"Vitamin A-containing foods are particularly helpful, such as carrots, spinach and dairy products," he said.
"Many studies have identified vitamin A supplementation as a means to prevent eye damage, which is a complication of the measles infection."
While proper nutrition is important for preventing many chronic health conditions, Perl emphasized that vaccination is the "only documented method" of preventing measles infection and "is the most important action anyone can take."
"The vaccine has been in use since 1963 and is considered extremely safe," she said.
"Vaccination should be given whether an individual is malnourished or not, as it is the only way to prevent measles."
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RFK also recognized the importance of vaccines, noting that the HHS is "making sure that anybody who wants the vaccine can get that vaccine."
"The measles vaccine protects the community," he told Dr. Siegel. "We are recommending that people in this country get vaccines … [and] we are also respectful of their personal choices."
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Jennings also reiterated the importance of vaccines.
"The most effective way to protect and prevent you and your family from getting measles is to get everyone vaccinated against the virus," he said.
The CDC recommends that adults and teens are up-to-date on MMR (measles, mumps and rubella) vaccinations with either one or two doses, depending on individual risk factors.
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