Micronutrients and neurodevelopment: An update

Different intrauterine environments and children motor development in the first 6 months of life: a prospective longitudinal cohort

This prospective cohort longitudinal study examines the risk factors associated with different intrauterine environments and the influence of different intrauterine environments on children's motor development at 3- and 6-months of life. Participants were 346 mother/newborn dyads enrolled in the first 24 to 48 h after delivery in public hospitals. Four groups with no concurrent condition composed the sample: mothers with a clinical diagnosis of diabetes, mothers with newborns small for gestational age due to idiopathic intrauterine growth restriction (IUGR), mothers who smoked tobacco during gestation, and a control group composed of mothers without clinical condition. Children were assessed at three- and six-months regarding motor development, weight, length, head circumference, and parents completed a socioeconomic questionnaire. The IUGR children had lower supine, sitting, and overall gross motor scores at 6 months than the other children's groups. Anthropometric and sociodemographic characteristics negatively influenced gross motor development. IUGR and anthropometric and sociodemographic characteristics negatively impact motor development. Intrauterine environment impact child neurodevelopment.

Human Milk and Brain Development in Infants

Human milk is considered the most advantageous source of nourishment for infants. Even though there is no ideal composition of human milk, it still contains a unique combination of components that contribute to brain development. The aim of this review is to provide an overview on the possible correlation of human milk with the neurodevelopment of infants, with a special emphasis on myelination and epigenetic modifications. Research in human milk is a rapidly expanding field and cutting-edge technologies might contribute to identify specific mechanisms underlying the beneficial effects on human milk on neurodevelopment.

Human Breast Milk: Bioactive Components, from Stem Cells to Health Outcomes

PURPOSE OF REVIEW

Breast milk (BM) is a peculiar fluid owing unique properties and resulting the ideal food during early neonatal period. As widely known, it can improve the outcome of both neonate and lactating mother, influencing their whole life. BM is characterized by several beneficial components; among these, a great role is played by BM own and specific microbiome, deeply investigated in many studies. Moreover, the use of metabolomics in BM analysis allowed a better characterization of its metabolic pathways that vary according to lactation stage and neonatal gestational age. The aim of this review is to describe growth factors, cytokines, immunity mediators, and stem cells (SCs) contained in BM and investigate their functions and effects on neonatal outcome, especially focusing on immuno- and neurodevelopment.

RECENT FINDINGS

We evaluated recent and updated literature on this field. The article that we analyzed to write this review have been found in MEDLINE using breast milk-derived stem cells, biofactors, growth factors, breastfeeding-related outcomes, neurodevelopment, and neonatal immunological system as keywords. Discovering and characterizing BM components could result very useful to clarify the pathophysiology of their influence on neonatal growth and even to improve artificial formulations' composition. Moreover, since SCs abilities and their involvement in the development of several diseases, they could help to discover specific targets for new therapies. It could be useful to characterize BM-derived SC markers, properties, and variations during lactation stages, to understand their potential role in therapeutic applications, since they could be noninvasively isolated from BM. More studies will help to describe more in detail the characteristics of mother-to-child communication through breastfeeding and its potential role in the next future.

Prevalence of Vitamin B12 Deficiency and Its Associated Risk Factors among Pregnant Women of Rural South India: A Community-based Cross-sectional Study

Introduction:

Vitamin B12 is essential for the normal functioning of the nervous system and for the formation of red blood cells. Vegetarian diet, low socioeconomic status, and social and religious reasons are known risk factors of its deficiency. Pregnant women, children, and the elderly are vulnerable groups. Indians have the highest prevalence, but the data among pregnant women in the rural setting is lacking.

Objectives:

The objective of this study is to assess the prevalence of Vitamin B12 deficiency and its associated factors among pregnant women of rural South India.

Materials and Methods:

A cross-sectional study was conducted to recruit consecutive 120 multigravida women with ≤20 weeks of gestation, attending the mobile doctor run clinic of Kaniyambadi block, Vellore. A structured questionnaire was administered, and blood samples were collected.

Results:

The prevalence of Vitamin B12 deficiency (<200 pgm/ml) and anemia (Hb ≤10.5 g/dL) was 55% and 17.5%, respectively. Only 11.7% were B12 deficient and anemic. Past history of abortion (odds ratio [OR] = 0.5), fatigue (OR = 0.4), and low B12 intake (OR = 2) was associated only in the bivariate analysis. First trimester (OR = 3.9) and obesity (OR = 9.6) were found to be independent risk factors of Vitamin B12 deficiency.

Conclusion:

Our study showed a high prevalence of Vitamin B12 deficiency in pregnancy in rural India. Some risk factors were identified. However, studies with a higher sample size will be beneficial to study the associated risk factors better.

Nutritional Support of Neurodevelopment and Cognitive Function in Infants and Young Children-An Update and Novel Insights

Proper nutrition is crucial for normal brain and neurocognitive development. Failure to optimize neurodevelopment early in life can have profound long-term implications for both mental health and quality of life. Although the first 1000 days of life represent the most critical period of neurodevelopment, the central and peripheral nervous systems continue to develop and change throughout life. All this time, development and functioning depend on many factors, including adequate nutrition. In this review, we outline the role of nutrients in cognitive, emotional, and neural development in infants and young children with special attention to the emerging roles of polar lipids and high quality (available) protein. Furthermore, we discuss the dynamic nature of the gut-brain axis and the importance of microbial diversity in relation to a variety of outcomes, including brain maturation/function and behavior are discussed. Finally, the promising therapeutic potential of psychobiotics to modify gut microbial ecology in order to improve mental well-being is presented. Here, we show that the individual contribution of nutrients, their interaction with other micro- and macronutrients and the way in which they are organized in the food matrix are of crucial importance for normal neurocognitive development.

Nicotinamide restricts neural precursor proliferation to enhance catecholaminergic neuronal subtype differentiation from mouse embryonic stem cells

Emerging evidence indicates that a strong relationship exists between brain regenerative therapies and nutrition. Early life nutrition plays an important role during embryonic brain development, and there are clear consequences to an imbalance in nutritional factors on both the production and survival of mature neuronal populations and the infant’s risk of diseases in later life. Our research and that of others suggest that vitamins play a fundamental role in the formation of neurons and their survival. There is a growing body of evidence that nicotinamide, the water-soluble amide form of vitamin B₃, is implicated in the conversion of pluripotent stem cells to clinically relevant cells for regenerative therapies. This study investigated the ability of nicotinamide to promote the development of mature catecholaminergic neuronal populations (associated with Parkinson’s disease) from mouse embryonic stem cells, as well as investigating the underlying mechanisms of nicotinamide’s action. Nicotinamide selectively enhanced the production of tyrosine hydroxylase-expressing neurons and serotonergic neurons from mouse embryonic stem cell cultures (Sox1GFP knock-in 46C cell line). A 5-Ethynyl-2´-deoxyuridine (EdU) assay ascertained that nicotinamide, when added in the initial phase, reduced cell proliferation. Nicotinamide drove tyrosine hydroxylase-expressing neuron differentiation as effectively as an established cocktail of signalling factors, reducing the proliferation of neural progenitors and accelerating neuronal maturation, neurite outgrowth and neurotransmitter expression. These novel findings show that nicotinamide enhanced and enriched catecholaminergic differentiation and inhibited cell proliferation by directing cell cycle arrest in mouse embryonic stem cell cultures, thus driving a critical neural proliferation-to-differentiation switch from neural progenitors to neurons. Further research into the role of vitamin metabolites in embryogenesis will significantly advance cell-based regenerative medicine, and help realize their role as crucial developmental signalling molecules in brain development.

Contrasting prenatal nutrition and environmental exposures in association with birth weight and cognitive function in children at 7 years

Background

Good nutrition is essential for individual health, a notion that is particularly true during pregnancy. We have used a nutrition index that measures the adequacy of one’s diet relative to the unique nutritional needs of individuals due to, for example, their activity level, dietary restrictions, lifestyle and body size. The use of this personalised metric of dietary nutritiousness in the analysis of prenatal environmental exposures and developmental outcomes permits testing for potential mitigating effects of good nutrition. We also provide an analysis strategy for investigating the balance in beneficial food sources which are also the source of environmental toxicants.

Methods

A holistic measure of nutrition, My Nutrition Index (MNI), measures the nutrient quality (ie, ‘nutritiousness’) of a specified daily diet. MNI is calculated based on quantification of dozens of macronutrients and micronutrients that are specific to an individual’s nutritional needs by incorporating dietary restrictions, subject characteristics, activity level and health behaviours. The Swedish Environmental, Longitudinal, Mother and child, Asthma and allergy Study is a Swedish pregnancy cohort, with prenatal endocrine disrupting chemicals (EDCs) exposure and dietary data available. This makes it possible to test for the potential mitigating effects of good nutrition on health and development effects in offspring from EDCs.

Results

Using prenatal Food Frequency Questionnaire data to construct an individual’s MNI, the index was significantly and positively associated with important metabolic outcome (as measured by birth weight) and cognitive function at age 7 years (as measured by WISC IQ) in children when adjusted for covariates and prenatal concentrations of an EDC. In a stratified analysis of ‘low’ and ‘high’ fish consumption, a potential source of perfluoro-octanesulfonic acid (PFOS), the association between PFOS and birth weight was diminished in the high consumption group compared with the low consumption group.

Conclusions

Thus, MNI is evidently a metric of the general nutritiousness of daily diets and is useful in environmental health studies in representing the impact of good nutrition, even during pregnancy.

Choline, Neurological Development and Brain Function: A Systematic Review Focusing on the First 1000 Days

The foundations of neurodevelopment across an individual's lifespan are established in the first 1000 days of life (2 years). During this period an adequate supply of nutrients are essential for proper neurodevelopment and lifelong brain function. Of these, evidence for choline has been building but has not been widely collated using systematic approaches. Therefore, a systematic review was performed to identify the animal and human studies looking at inter-relationships between choline, neurological development, and brain function during the first 1000 days of life. The database PubMed was used, and reference lists were searched. In total, 813 publications were subject to the title/abstract review, and 38 animal and 16 human studies were included after evaluation. Findings suggest that supplementing the maternal or child's diet with choline over the first 1000 days of life could subsequently: (1) support normal brain development (animal and human evidence), (2) protect against neural and metabolic insults, particularly when the fetus is exposed to alcohol (animal and human evidence), and (3) improve neural and cognitive functioning (animal evidence). Overall, most offspring would benefit from increased choline supply during the first 1000 days of life, particularly in relation to helping facilitate normal brain development. Health policies and guidelines should consider re-evaluation to help communicate and impart potential choline benefits through diet and/or supplementation approaches across this critical life stage.

Starting strong: Dietary, behavioral, and environmental factors that promote "strength" from conception to age 2 years

Beginning with conception and continuing through childhood and adolescence, the word "strength" connotes the totality of optimal early bone and tissue growth; neural wiring of the brain; and acquisition of fine motor, gross motor, language, and socioemotional skills. The robustness of each of these attributes depend on 3 critical epigenetic (external) factors: the quality of nutrition; positive adult nurturing; and experiences acquired within a stimulating, safe environment that affords free exploration. This review highlights the relationship between the epigenetic factors in the period of conception to age 2 years and a child's future health, cognitive capacity, and social aptitude, which collectively comprise their "strength". This paper was presented as part of the 2018 Strength Summit conference entitled, The Role of Strength in Optimal Health and Well-being. Novelty Strength in infants signifies the totality of optimal early growth and neural wiring of the brain. Strength at this life stage also includes the acquisition of motor, language, and socioemotional skills. Three epigenetic factors are critical during birth to 24 months: nutrition, nurturing, and free exploration.

Associations Between Broader Autism Phenotype and Dietary Intake: A Cross-Sectional Study (Japan Environment & Children's Study)

The purpose of the present study was to investigate associations of dietary intake including vitamin D, folate, and n-3 and n-6 polyunsaturated fatty acids (PUFA) in pregnant women with broad autism phenotype (BAP). The Japan Environment and Children's Study is a government-funded birth cohort study. All complete data of 92,011 were analyzed. The Japanese version of the Autism Spectrum Quotient was used to assess mothers' BAP level, and a food frequency questionnaire was used to estimate their dietary intake. Mothers with BAP consumed less vegetables, fruits, and fish and shellfish, and they consumed lower folate, vitamin C, vitamin D, and n-3 PUFA than their counterparts. Dietary intervention should be considered for pregnant women with high BAP scores.

Magnesium Status in Children with Attention-Deficit/Hyperactivity Disorder and/or Autism Spectrum Disorder

Objective:

The objective of this study was to assess serum, hair, and urinary magnesium (Mg) levels in children with attention-deficit/ hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and both ASD and ADHD to reveal potential interactive effects.

Methods:

A total of 148 boys aged 4–9 years old were enrolled in this study, including 44 children with ADHD, 40 pediatric patients with ASD, 32 patients with both ADHD and ASD, as well as 32 healthy neurotypical children. Hair, serum, and urinary Mg levels were assessed using inductively-coupled plasma mass spectrometry (ICP-MS). Laboratory quality control was performed using certified reference materials of human hair, plasma, and urine.

Results:

No significant group difference in serum Mg levels was observed. Mg content in hair was found to be reduced in children with ADHD and ADHD+ASD compared to that in healthy controls by 11% and 15%, respectively. Urinary Mg levels in children with ADHD+ASD exceeded the control, ADHD, and ASD values by 51, 76, and 65%, respectively. Factorial analysis revealed significant contribution of ADHD to hair and urinary Mg levels. Multiple regression analysis demonstrated that hair and urinary Mg levels were considered as significant predictors of neurodevelopmental disorder complexity.

Conclusion:

We propose that impaired Mg status may provide a link between ADHD and ASD.

Dietary Inflammatory Index and Non-Communicable Disease Risk: A Narrative Review

There are over 1,000,000 publications on diet and health and over 480,000 references on inflammation in the National Library of Medicine database. In addition, there have now been over 30,000 peer-reviewed articles published on the relationship between diet, inflammation, and health outcomes. Based on this voluminous literature, it is now recognized that low-grade, chronic systemic inflammation is associated with most non-communicable diseases (NCDs), including diabetes, obesity, cardiovascular disease, cancers, respiratory and musculoskeletal disorders, as well as impaired neurodevelopment and adverse mental health outcomes. Dietary components modulate inflammatory status. In recent years, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed to characterize the inflammatory potential of habitual diet. Subsequently, a large and rapidly growing body of research investigating associations between dietary inflammatory potential, determined by the DII, and risk of a wide range of NCDs has emerged. In this narrative review, we examine the current state of the science regarding relationships between the DII and cancer, cardiometabolic, respiratory and musculoskeletal diseases, neurodevelopment, and adverse mental health outcomes. We synthesize the findings from recent studies, discuss potential underlying mechanisms, and look to the future regarding novel applications of the adult and children's DII (C-DII) scores and new avenues of investigation in this field of nutritional research.

Iron as a model nutrient for understanding the nutritional origins of neuropsychiatric disease

Adequate nutrition during the pre- and early-postnatal periods plays a critical role in programming early neurodevelopment. Disruption of neurodevelopment by nutritional deficiencies can result not only in lasting functional deficits, but increased risk of neuropsychiatric disease in adulthood. Historical periods of famine such as the Dutch Hunger Winter and the Chinese Famine have provided foundational evidence for the long-term effects of developmental malnutrition on neuropsychiatric outcomes. Because neurodevelopment is a complex process that consists of many nutrient- and brain-region-specific critical periods, subsequent clinical and pre-clinical studies have aimed to elucidate the specific roles of individual macro- and micronutrient deficiencies in neurodevelopment and neuropsychiatric pathologies. This review will discuss developmental iron deficiency (ID), the most common micronutrient deficiency worldwide, as a paradigm for understanding the role of early-life nutrition in neurodevelopment and risk of neuropsychiatric disease. We will review the epidemiologic data linking ID to neuropsychiatric dysfunction, as well as the underlying structural, cellular, and molecular mechanisms that are thought to underlie these lasting effects. Understanding the mechanisms driving lasting dysfunction and disease risk is critical for development and implementation of nutritional policies aimed at preventing nutritional deficiencies and their long-term sequelae.

Quality of Prenatal and Childhood Diet Predicts Neurodevelopmental Outcomes among Children in Mexico City

Adequate nutrition is important for neurodevelopment. Although nutrients are ingested in combination, the impact of specific nutrients within the context of a nutrient mixture has not been studied with respect to health, such as neurodevelopment. Therefore, we examined the impact of prenatal and childhood nutrient mixtures on neurodevelopmental outcomes. Participants included mother⁻child pairs in the Programming Research in Obesity, Growth, Environment, and Social Stress (PROGRESS) prospective birth cohort in Mexico City. We assessed prenatal and child micro- and macronutrient profiles among 65 and 329 children, respectively, via food frequency questionnaires. Neurodevelopmental outcomes of 4⁻6-year-old children were measured using the McCarthy Scales of Children's Abilities (MSCA). We conducted weighted quantile sum (WQS) regression analyses to calculate indices reflecting "good" and "poor" prenatal and childhood nutrition. After adjusting for maternal education, socioeconomic status, the Home Observation for Measurement of the Environment (HOME) score, and total caloric intake, the good prenatal and childhood nutrition indices predicted more favorable neurodevelopment, while both poor nutrition indices predicted poorer neurodevelopment. These associations were stronger in prenatal than childhood models. Monounsaturated fats predicted various neurodevelopmental abilities relatively strongly in both models. Prenatal and childhood consumption of combinations of beneficial nutrients may contribute to more favorable neurodevelopment.