Marginal vitamin A deficiency facilitates Alzheimer's pathogenesis

Deposition of amyloid β protein (Aβ) to form neuritic plaques in the brain is the unique pathological hallmark of Alzheimer's disease (AD). Aβ is derived from amyloid β precursor protein (APP) by β- and γ-secretase cleavages and turned over by glia in the central nervous system (CNS). Vitamin A deficiency (VAD) has been shown to affect cognitive functions. Marginal vitamin A deficiency (MVAD) is a serious and widespread public health problem among pregnant women and children in developing countries. However, the role of MVAD in the pathogenesis of AD remains elusive. Our study showed that MVAD is approximately twofold more prevalent than VAD in the elderly, and increased cognitive decline is positively correlated with lower VA levels. We found that MVAD, mostly prenatal MVAD, promotes beta-site APP cleaving enzyme 1 (BACE1)-mediated Aβ production and neuritic plaque formation, and significantly exacerbates memory deficits in AD model mice. Supplementing a therapeutic dose of VA rescued the MVAD-induced memory deficits. Taken together, our study demonstrates that MVAD facilitates AD pathogenesis and VA supplementation improves cognitive deficits. These results suggest that VA supplementation might be a potential approach for AD prevention and treatment.

Do Nutrient Supplements and Dietary Changes Affect Learning and Emotional Reactions of Children with Learning Difficulties?: A Controlled Series of 16 Cases

Detailed dietary and biochemical analyses were done on 16 consecutive cases of children aged 5–15 years referred for a combined remedial reading/behaviour modification program. Each child was given an individually designed vitamin and mineral supplement. Diets were also changed to reduce sugars and refined foods and toxic metals contamination. Cases were matched in pairs with 16 other cases on the program who were given no dietary changes but who received a one-a-day vitamin/mineral capsule as part of standard procedure at the clinic. Over 22 weeks on the program, the experimental group showed significantly greater improvements than the control group in behaviour assessed at school, at home and in the clinic. The experimental group also made significantly greater gains in reading skills. Routine Stanford-Binet intelligence tests given at week 2 and week 20 or 21 showed increased IQ scores of 5 to 35 points (X = 17.9) for the experimental group. Increases for the control group were 0–21 points (X = 8.4). Results suggest that subtle nutritional variables exert a substantial influence on learning and behaviour.

[Neuroradiologic findings of glutaric aciduria type I]

Glutaric aciduria type I is a rare disorder of organic acid metabolism caused by deficiency of glutaryl-CoA dehydrogenase, a mitochondrial enzyme. Improper degeneration of amino acids: tryptophan, lysine, and hydroxylysine, results in increased levels of glutaric acid, which typically becomes clinically manifest as an acute dystonic crisis in young children. Accumulation of glutaric acid causes neurotoxicity in the basal ganglia and fronto-temporal cortex which can lead to progressive dystonia, hypotonia, permanently impaired speech and seizures. Because dietary and drug therapy may alter the natural history of the disease, early diagnosis of such patients is critical. We report the magnetic resonance (MR) imaging findings in a 16 year-old girl with this disorder who presented with a chronic dystonic syndrome and previously diagnosed of brain paralysis. MR imaging demonstrated bilateral involvement of the putamina and periventricular white matter, and bilateral temporal atrophy and widened Silvian fissures.

Micronutrient supplements for children after deworming

The availability of a few inexpensive, single-dose drugs to treat soil-transmitted helminths and schistosomiasis offers the potential to reduce a considerable burden of acute disease, especially among children in sub-Saharan Africa. These treatments are being promoted as "rapid impact interventions". However, if helminth infections cause underweight, stunting, anaemia, and impaired mental development in children, how will removing worms alone lead to recovery without treating the underlying deficits that have been caused or made worse by helminth disease? Energy, protein, and micronutrients are required by children who are underweight or who have stunted growth; children who are anaemic will require iron and other micronutrients for haemopoiesis; and children who have lost education will need remedial teaching. Treating neglected worm diseases is an essential first step to good health, but anthelmintic drugs need to be integrated with simple and inexpensive nutritional interventions such as micronutrient supplements to promote recovery and have a rapid effect.

Choice in the diet of people with learning difficulties

Many adults with learning disabilities experience difficulties communicating food preferences because they may have little opportunity to do so. This article discusses how health care professionals can enable people with learning difficulties to exercise choice about food and how those choices can be recognised.

A randomized double-blind, placebo-controlled study of the effects of supplementation with highly unsaturated fatty acids on ADHD-related symptoms in children with specific learning difficulties

(1) The authors tested the prediction that relative deficiencies in highly unsaturated fatty acids (HUFAs) may underlie some of the behavioral and learning problems associated with attention-deficit/hyperactivity disorder (ADHD) by studying the effects of HUFA supplementation on ADHD-related symptoms in children with specific learning difficulties (mainly dyslexia) who also showed ADHD features. (2) Forty-one children aged 8-12 years with both specific learning difficulties and above-average ADHD ratings were randomly allocated to HUFA supplementation or placebo for 12 weeks. (3) At both baseline and follow-up, a range of behavioral and learning problems associated with ADHD was assessed using standardized parent rating scales. (4) At baseline, the groups did not differ, but after 12 weeks mean scores for cognitive problems and general behavior problems were significantly lower for the group treated with HUFA than for the placebo group; there were significant improvements from baseline on 7 out of 14 scales for active treatment, compared with none for placebo. Group differences in change scores all favored HUFA, reaching conventional significance levels for 3 out of 14 scales. (5) HUFA supplementation appears to reduce ADHD-related symptoms in children with specific learning difficulties. Given the safety and tolerability of this simple treatment, results from this pilot study strongly support the case for further investigations.

Effects of age and dietary restriction on animal model SAMP8 mice with learning and memory impairments

This study was to investigate a hypothesis that dietary restriction (DR) suppresses learning and memory impairments in dementia animal model SAMP8 mice. Four-week-old female SAMP8 mice were fed either ad libitum (AL) or fed restricted (40% of the food consumed by AL). Results showed that acetylcholine (ACh) levels in hippocampus at aged 12 months of age were 12% higher in DR than that of AL group. Dopamine (DA) and norepinephrine (NE) levels in cerebellum at 8 and 12 months of age were significantly higher (26~94% and 34~43%, respectively) in DR group than those in AL group. Serotonin (5-HT) levels in cerebellum at aged 12 months of age were markedly increased (~53%) in DR group. Homovanillic acid (HVA) and 5-hydroxyindole acetic acid (5-HIAA) levels in cerebellum at 8 and 12 months of age were significantly increased (28~41% and 24~64%, respectively) in DR group compared with AL group. In addition, neurotransmitter-related enzymes, choline acetyltransferase (ChAT) and acetylchoinesterase (AChE) activities at 8 and 12 months of age were elevated (6~8% and 5~7%, respectively) in DR group. Monoamine oxidase-B (MAO-B) that catalyzes oxidative deamination in brain were suppressed by 7~10% in DR group. At aged 12 months of age, the generation of basal and induced reactive oxygen species (ROS) in brain significantly decreased by 20% in DR group compared with AL group. These results suggest that inhibitory effect of oxidative stress by DR may play a pivotal role in attenuating the age-related changes observed in dementia animal model SAMP8.

Rational dosages of nutrients have a prolonged effect on learning disabilities

CONTEXT

Reports that administration of nutrients has increased the academic performance of learning-disabled children exist in the literature.

OBJECTIVE

To document the effects of nutrients on learning-disabled children in a controlled study.

DESIGN

A randomized, double-blind, placebo-controlled crossover trial, which followed 1 year of open-label nutrients. Children who improved in the open-label trial were eligible to enter the controlled phase of the study.

SETTING

Subjects were enrolled from the general community through advertisements.

PATIENTS OR OTHER PARTICIPANTS

Twenty children met the criteria for being learning disabled.

INTERVENTION

Each child was tried out on some (but not necessarily all) of the B vitamins and minerals used in this study. These were administered semi-blinded for the first year; double-blinded in crossover rotations during the second year; and open-label in the ensuing years.

MAIN OUTCOME MEASURES

At various time points, school-certified psychologists administered psychoeducational tests. School report cards were evaluated at baseline and for all subsequent periods.

RESULTS

Twenty learning-disabled children entered the study, but 1 dropped out because of nausea. The remaining 19 children showed significant academic and behavioral improvements within a few weeks or months of open-label treatment with nutrient supplements. Some children gained 3 to 5 years in reading comprehension within the first year of treatment; and all children in special education classes became mainstreamed, and their grades rose significantly. Twelve of the children completed the 1-year double-blind phase, after which approximately half of the children chose to remain on the nutrients for at least 2 additional years. For those who discontinued, it took at least 1 year to begin to see the first indications of decline in academic performance, and another year for their grades to drop significantly. In contrast, for children who remained on nutrients, the gains continued the upward trend; at the end of year 4, the difference in scores between the 2 groups had reached statistical significance (P < .01).

CONCLUSION

The overall results of this study tentatively support the concept that learning disabilities may in some cases be a nutrient-responsive disorder.

The food additive-free diet in the treatment of behavior disorders: a review

A food additive-free diet has been recommended as a component of the treatment of developmental/behavioral disorders in children. This diet was initially developed by Dr. Benjamin Feingold for the treatment of aspirin sensitivity in adults, and then extended by him to the management, particularly, of hyperactivity and learning disability in children. The rationale for this diet and the methods employed in investigating its use are described. The claimed therapeutic effects of this diet have been investigated in a number of well-designed studies reviewed here. These studies generally refute a causal association between food additives and behavioral disturbance in children. Suggestions are made regarding the approach towards food additive-free diet therapy in the management of developmental/behavioral disorders.

Nonstandard therapies in the developmental disabilities

The complexity of management issues with regard to developmentally disabled children has led to a broad acceptance of a number of therapeutic approaches that purport to be effective for a wide range of problems. These are generally empiric in origin, and the efficacy of most of them cannot be supported by controlled research studies. In addition, there has been little or no investigation of potential or actual side effects. Acceptance of new therapies and validation of older approaches need to be based on appropriately designed, controlled studies.