MUST READ - Choline: The underappreciated nutrient that's vital for our brains

The compound has been linked to improved cognitive performance and reduced anxiety – but are you getting enough of it?

Jessica Bradley  BBC  4 days ago

(Credit: Getty Images/ Serenity Strull/ BBC)

You may not have heard of choline before, but studies show that it's crucial for our health, at various stages of life.

Choline is neither a vitamin or a mineral – it's an organic compound that's vital to the healthy functioning of the human nervous system. Now there's emerging evidence that consuming more choline can have a wide range of powerful effects, from improving cognitive performance to protecting against neurodevelopmental disorders, including attention-deficit/hyperactivity disorder (ADHD) and dyslexia.

The nutrient also seems to play a significant role in human neurodevelopment. In one study, babies who whose mothers took choline supplements during pregnancy gave birth to infants with higher information processing speeds – a measure of healthy cognitive functioning.

Scientists say that choline is a wonder-nutrient, but that it has been hugely overlooked. So, where does choline come from – and are you getting enough of it?

A crucial nutrient

Every cell in our body contains choline, says Xinyin Jiang, professor of health and nutrition sciences at Brooklyn College in New York, US.

Choline is an "essential" nutrient, which means we need it for our health, but our bodies don't produce enough on their own. Instead, we need to get some of it from our diets. In this sense, it's similar to omega 3 fatty acids, although it's actually closely associated with B vitamins, says Emma Derbyshire, science writer and founder and CEO of the consultancy Nutritional Insight.


More like this:
How much protein do you need to get strong?
Collagen supplements: The secret to perfect skin, or marketing hype?

The perfect, but slow, way to boil an egg – according to science

Choline can be found mostly in animal-based foods, including beef, eggs, fish, chicken and milk, but it's also in peanuts, kidney beans, mushrooms and cruciferous vegetables such as broccoli – although animal foods tend to contain more choline than plant-based sources.

We need choline for numerous functions in our bodies, including liver function. Not having enough can cause a number of problems.

"Choline helps fat transport out of the liver, and when a person is deficient, they can get a fatty liver," says Jiang.

Choline also helps the body to synthesise phospholipids, which are the main component of the cell membranes in our bodies. Being deficient in the nutrient can affect the expression of genes involved in the process of our cells multiplying. During the development of a foetus, choline deficiency can be particularly harmful because it inhibits cell proliferation in the brain.

Choline's role in the brain is crucial – in fact it's primarily a "brain nutrient", says Derbyshire. It's needed for our bodies to produce the neurotransmitter acetylcholine, which is a chemical that carries messages from your brain to your body through nerve cells. Acetylcholine plays a major role in brain nerve cells, which are needed for our memory, thinking and learning.

In one study involving almost 1,400 people aged 36 to 83, researchers found that people with a higher choline intake tended to have better memories, and that choline intake during midlife may help to protect our brains. Choline is commonly included as an ingredient in supplements taken as "nootropics" – a diverse group of substances which some people believe can enhance learning and memory.

On the other hand, choline deficiency has also been associated with neurodegenerative disorders such as Alzheimer's and Parkinson's disease.

Another way choline may affect the brain is our mental health. One study found that higher intake of choline was associated with lower levels of anxiety. In another study, having a higher dietary intake of choline was linked to a lower risk of depression.

Having an adequate choline intake can also come with a number of other benefits. A higher dietary intake of this nutrient .

Separately, research in mice has found that choline can help to lower the levels of homocysteine, an amino acid which can increase the risk of heart disease. High levels of homocysteine can also be linked to osteoporosis, and research has found that people with higher choline intakes from their diets tend to have a higher bone density – an indicator of strong, healthy bones with a lower risk of being fractured.

"Choline can potentially have an effect against bone loss," says Øyen Jannike, a researcher at the Institute of Marine Research in Norway, who has studied the link between choline and bone health.

This may partly be because of homocysteine, she says, but also because choline is an essential structure in our cell membranes.

The first 1000 days

It's well established that a child's first two years are critical for their development, and that the mother's diet during pregnancy and breastfeeding has an integral influence on this.

Studies show that choline is vitally important for a baby's development in the womb. In fact, babies are born with three times as much choline as their mothers, which Derbyshire says shows how important it is at this stage of life.

According to one study, people who eat eggs tend to have roughly
twice the choline intake of those who don’t (Credit: Getty Images)

Several studies have found that the supply of choline in the womb correlates to the cognitive outcome of the baby, and its benefits may continue for years as the child develops. In one study, pregnant women who had the highest dietary choline intake during the second trimester of pregnancy (from week 13 to week 28) went on to have children who scored higher on a test of short- and long-term memory at the age of seven.

Some research even suggests insufficient choline intake when a woman is pregnant could be linked ADHD behaviours in their offspring.

Are we getting enough choline?

In Europe, the European Food Safety Authority (EFSA) has set recommendations for choline intake: 400mg for adults, and 480mg and 520mg for pregnant and breastfeeding individuals, respectively.

In the US, the Institute of Medicine (IOM) first established adequate choline intake recommendations in 1998: 550mg per day for men and 425mg per day for women, or 450mg during pregnancy and 550mg while breastfeeding.

An egg has around 150mg of choline, while a chicken breast has around 72mg, and a handful of peanuts has around 24mg.

In 2017, the American Media Association (AMA) also advised that prenatal vitamin supplements should contain "evidence-based" amounts of choline.

"We're seeing a lot more ADHD and dyslexia in schools, and some is genetic, but it's also possible that, in utero, they're not getting key nutrients," Derbyshire says. "These very subtle neurodevelopment changes are occurring and impacting them later on. We're treating the aftermath now."

Jiang has studied the relationship between the supply of choline during pregnancy and breastfeeding, and brain development. "In animal findings, when the mum has more choline, the cognitive development of their offspring is better," she says. "We're starting to find similar results in human studies, although, not exactly the same."

Feeding the brain

A 2020 review of 38 animal and 16 human studies concluded that choline supplementation helps brain development. However, only animal studies currently show a strong link between choline and improved cognitive function. The paper doesn't define the ideal amount of supplementation, but says most human studies use supplements providing up to 930mg choline daily – an amount equivalent to the choline in roughly six chicken's eggs – with no adverse effects reported.

There may also be some people that require more choline than the recommended daily amounts, says Øyen – including post-menopausal women, for example, who have lower levels of oestrogen, and people with fatty liver disease.

We also know, Derbyshire says, that, due to the genetic differences from one person to another, some people may have higher requirements for choline. (Derbyshire has previously consulted for and advised The Meat Advisory Panel, Marlow Foods (Quorn), the Health Supplement Information Service and the British Egg Information Service, among other organisations).

Peanuts contain high levels of choline, with 61-66mg per 100g of peanut butter (Credit: Getty Images)

When we eat foods containing choline, it's very easily absorbed into our blood, says Jiang, which should go some way to ensuring we're consuming enough choline.

However, several studies show that many of us aren't getting enough. One study found that only 11% of American adults consume the recommended daily amount.

Eggs are one of the most potent dietary sources of choline, and there is some concern that those who choose to follow a vegan diet may not be getting enough of this nutrient – though there are many plant-based sources and choline supplements are widely available in developed countries.

One study found that people who eat eggs have almost twice the usual choline intake compared with those who don't, leading the researchers to conclude that consuming the daily adequate amount of choline was "extremely difficult" without eating eggs or taking a supplement.

But the EFSA's recommendation of 400mg of choline per day is achievable for most people if you plan your diet carefully, says Jiang. Some vegan sources of choline include tofu (28mg of choline per 100g), peanut butter (61-66mg per 100g) and soy beans (120mg per 100g).

Anyone concerned they're not getting enough choline can take a daily supplement, Øyen says. In the meantime, she adds, there needs to be more animal and human research to better understand the mechanisms behind some of choline's health benefits.

However "clinicians are becoming more aware of [choline]", says Derbyshire. While it often seems to be slightly overlooked, she is hopeful that choline will soon start to enjoy the limelight.

--

https://www.bbc.com/future/article/20250408-choline-the-underappreciated-nutrient-thats-vital-for-our-brains

The surprising science of breast milk - BBC

Scientists are discovering the extraordinary power of human milk and the benefits it brings to infants, but there are also some hidden contaminants that can lurk in breast and formula milks.

FAMILY TREE | FOOD

By Anna Turns23rd June 2022

(Image credit: Wikimedia Commons)

Throughout the first year of their lives, I breastfed my two children without the use of infant formula. Breast milk has been shown to be an ideal source of nutrition for babies, with many benefits for their developing brains, immune systems and digestive tracts, and I was glad to be able to offer them that boost. But when I had my blood tested for persistent toxic chemicals while researching a book on pollution, I discovered that some pesticides banned more than 40 years ago could still be detected in my body. There is also evidence that low levels of some chemical contaminants can be passed from a mother into her breast milk. Yet formula milk is also prone to contamination with toxic chemicals or potentially harmful bacteria, which have led to high-profile food scares and recalls in recent years.

It made me wonder what's really in the first foods our children consume – from the most beneficial ingredients, to hidden, undesirable or even toxic ones. And given what we know about some of the dangers, what can be done to improve all the available options for babies, be they breast- or formula-fed, and offer them the best possible start in life?

The milk that changes every day

Breast milk is considered the top choice for a baby's first food (the World Health Organization recommends that infants should be exclusively breastfed for the first six month of life). It mainly consists of water, fat, protein, as well as vitamins, minerals, digestive enzymes and hormones. It is rich in maternal antibodies, and has anti-infective properties. Breast milk is also a dynamic, adaptable food – it is fattier in the afternoon and evening than in the morning, for example. It also varies during a feed. When the baby latches onto the breast, the first gush of milk, or foremilk, is thin and high in lactose, making it thirst-quenching and easy to drink. The so-called hindmilk that follows is creamier and fattier, making it more filling. This dynamic aspect is one reason why breast milk is hard to replicate, despite considerable advances in the quality of infant formula.

"Human milk varies over the course of lactation, over the course of a day, from the start to the end of the feed, and to some extent on maternal factors such as her diet," says Mary Fewtrell, a professor of paediatric nutrition at University College London, who published a peer-reviewed study of lactation. "That all makes it difficult to decide on a precise amount that should be included in a formula whose composition doesn't change with the baby's age."

Fewtrell highlights non-nutrient ingredients in breast milk such as hormones, cells (including stem cells), microRNAs (small strands of genetic material), which give it unique properties. "We still don't fully understand the role of all these components but… quite probably they allow the mother to transmit information to the infant about her own experiences and the environment, which is why breastfeeding is sometimes described as 'personalised nutrition'."

A Yanomami mother breastfeeds her baby as she waits at a health care centre in Brazil (Credit: Andressa Anholete / Getty Images)

However, while more than 80% of babies in the US are breastfed at the start of their life, according to the Centers for Disease Control and Prevention, that rate falls to 58% at six months. Health authorities have tried to increase that rate, for example by offering more breastfeeding support to mothers. Diagnosing and treating conditions such as tongue-tie in babies can also help. But in the meantime, parents who do use formula may also wish to understand more about it, including what might be done to improve it.

"Whilst human milk is the biological norm for human infants and provides benefits for both mother and infant, some women may be unable to breast-feed or choose not to do so, and some choose to partly breast-feed," says Fewtrell. "For young infants, the only safe alternative if an infant is not breast-fed (or not fully breast-fed) is an infant formula which is designed to meet the nutritional needs of infants and support normal growth and development." Flexibility is expected – there's no "one size fits all" approach to infant nutrition, she says.

Towards better formula

The manufacture of infant formula has come a long way over recent decades. Throughout the 19th and early 20th centuries, bottle-feeding was not a safe option. In orphanages during the early 1900s, as many as 80% of bottle-fed babies died during the first year of life due to infections from unsterilised bottles, or malnourishment. Since infant formula was first commercially produced in 1865 using just four key ingredients (cows' milk, wheat and malt flour, and potassium bicarbonate), its nutritional contents have been refined in remarkable ways.

So what's in formula today?

Multiple fat sources are often used in formula, including cows' or goats' milk (often skimmed, which isn't as fatty as breast milk) and vegetable oils such as palm, sunflower or rapeseed, plus fatty acids. One fatty acid called DHA (docosahexaenoic acid, a type of omega-3 fat), which plays an important role in infant development, is now a mandatory ingredient in the European Union.

In breast milk, the main carbohydrate is lactose. In formula, this is usually added into the skimmed dairy milk powder base. Maltodextrin (a carbohydtrate derived from maize or potatoes) is also added. In the UK, glucose (a sugar) isn't routinely added but in the US, glucose sugars such as corn syrup are more commonly used. One problem is that this can increase the risk of dental decay in infants when their teeth come through.

The major breast milk proteins are whey and casein, which change in proportion as the baby grows, plus lactoferrin which is found at higher concentrations in colostrum, the first milk a mother produces after birth. The protein quantity and composition differs in formulas based on cows' and goats' milk, which have a higher casein to whey ratio than human milk. Plant-based ones are often made with soya protein. Formula also contains a mix of vitamins (including A, D, B and K), minerals such as calcium, magnesium, iron, zinc and many other trace elements.

Breast milk is a dynamic, adaptable food, and varies over the course of a day and even from the start to the end of a feed (Credit: Getty Images)

Unfortunately, formula can also contain lurking, unwelcome ingredients: just like I discovered pollutants in my own body, toxic substances can make their way into infant formula, too. 

Heavy metal mix

In 2017, the Clean Label Project, a US-based not-for-profit that tests products for toxic substances such as pesticides and heavy metals, found that almost 80% of 86 infant formula samples tested positive for arsenic. It also discovered that soy-based formulas had seven times more cadmium, a carcinogenic metal found in batteries, than other formulas.

Two years later, researchers from the Clean Label Project and the department of neurology at the University of Miami published a study into the heavy metal content of 91 infant formulas. They found that 22% of infant formula samples tested exceeded the lead exposure limit set by Californian state law, while 23% exceeded the state's limit for cadmium. The study concluded that "low-level heavy metal contamination is widespread" in baby foods and formulas and that "further research is needed to understand the long-term health effects of this chronic daily low-level heavy metal exposure in babies". Another study of baby foods in Sweden found that the dietary cadmium exposure of children fed infant formula was up to 12 times higher than those who are breast fed, although the levels were still within weekly tolerable limits set by the WHO and FAO.

Food safety regulators insist they are actively trying to tackle the issue of heavy metals in baby foods

Jackie Bowen, an environmental biologist and executive director of Clean Label Project, co-authored the study. She campaigns for greater transparency about the hidden contaminants that end up in our food, including infant formula. According to Bowen, food safety regulation can miss those contaminants since it focuses primarily on microbial pathogens such as E. coli that cause acute, short-term food poisoning.

Food safety regulators, however, insist they are actively trying to tackle the issue of heavy metals in baby foods. The US Food and Drug Administration (FDA), for example, insists it routinely monitors baby foods for toxic elements and takes action if they present a health concern. It says it is working with food companies and other stakeholders in an attempt to reduce the levels of heavy metals and other toxic substances in baby foods to as low as possible. But a recent report by the Committee on Oversight and Reform at the US House of Representatives criticised the FDA and food companies for not doing enough.

The FDA, however, says it is continuing to issue guidance to industry that will help lead to "meaningful and lasting reductions in exposure to toxic elements from foods", alongside its sampling and enforcement work.

"As parents and caregivers ourselves, we recognise and understand concerns about toxic elements and how they could impact the health of children," a spokesperson told the BBC.

"Consumers are increasingly concerned about how the foods they eat are linked to long-term chronic diseases like cancer or infertility that can take decades to manifest," explains Bowen who adds that, in the US, this food safety regulation is 'silent' when it comes to heavy metal contamination. "There's a growing divide between the court of law and the court of public opinion of what it means for food to be safe.".

Heavy metals like cadmium and lead naturally occur in the Earth's crust, so it's impossible to totally eliminate them. But human activities such as mining, fracking, industrial agriculture and the use of waste water for irrigation, exacerbate the presence of heavy metals in air, water and soil in the form of pollution, Bowen argues. Unlike microbial pathogens which can be destroyed by high heat and other methods, there's no way to get rid of such contaminants once they are in a product, she says. Instead, the problem has to be addressed at the start of the process, by beginning with clean, uncontaminated soil. After all, formula starts with farming, since key ingredients come from dairy livestock or crops.

"If you want a high-quality finished product, that comes from high-quality ingredients. That comes from healthy nutritious soils and that comes from good environmental policy that isn't going to allow for that level of pollution that contributed to the problem," says Bowen who explains that certain formula ingredients are at higher risk of heavy metal contamination. Soy, a mainstream plant-based substitute for cows' milk, tends to bioaccumulate heavy metals, as does hemp, whereas pea protein doesn't have that same tendency.

A dad bottle-feeds his son in a pre-school class in Beijing (Credit: Gou Yige/AFP via Getty Images)

Hidden formula contaminants are only one part of the problem. Powdered formula gets mixed with tap water to create infant milk. That poses a health risk in areas where that water is contaminated by old, flaking lead pipes, which happened in Flint, Michigan, for example (lead exposure can also affect breastfeeding mothers). While lead piping is gradually being replaced, water testing typically focuses on microbes, rather than high levels of heavy metals, Bowen says.

"It's one thing to solve the problem for infant formula, but unless you solve heavy metal contamination of the drinking water that gets mixed with powdered milk to give to baby, you're only fixing half the problem," she says. "What are we doing to prevent these problems in the first place?"

The US Food and Drug Administration's Closer to Zero action plan, which aims to reduce exposure to arsenic, lead, cadmium and mercury from foods eaten by babies and young children, could be one step towards cleaner food.

Common formula ingredients such as palm and soy have also raised wider environmental concerns, because their production often involves destruction of native forest habitat. For some, the solution is to use organic formula ingredients and source them as locally as possible. In Australia, for example, formula maker Bubs sources milk from local goat farms and cattle, which they say helps them ensure the traceability of the ingredients they use.

Feeding the microbiome

In recent years, there has been growing awareness of the important role of the human microbiome, the ecosystem of microorganisms that thrive inside and on our bodies, including in our digestive system. Emily Bloxam, a paediatric dietitian at City Dietitians in London who specialises in neonatal nutrition and allergies, explains that while the nutritional composition of formula is now closer to breast milk than ever before, breast milk is "a key driver" for the development of the baby's gut microbiome. Breast milk components that facilitate this development, such as maternal antibodies and healthy gut bacteria, cannot be artificially manufactured yet. 

"Bifidobacteria is a key probiotic (friendly bacteria) found in breastmilk which colonises an infant's gut during the first 1,000 days of life and aids immune function, while reducing the risk of asthma, eczema and gastrointestinal symptoms," says Bloxam. "Breast milk also contains prebiotics called human milk oligosaccharides (HMOs) which feed the Bifidobacteria allowing their growth."

A mother breastfeeds her child during the "all for breastfeeding" festival in Bogota, Colombia (Credit: Daniel Garzon Herazo/NurPhoto via Getty Images)

Over 150 types of HMOs have been found in breast milk. In fact, the gut microbiomes of breastfed infants have been found to be distinctly different to those of formula-fed babies.

Some hypoallergenic formulas now include prebiotic and probiotic additions which are designed to bring the gut microbiome of milk-allergic infants closer to that of breastfed infants. Newly developed probiotic Bifidobacteria supplements can be mixed with formula or breast milk for babies who have been delivered by C-section and therefore not exposed to some of their mother's gut bacteria during a vaginal delivery. Some HMOs have been chemically engineered for addition to infant formula as well.

However, any added ingredients in formula still lack one distinctive feature of breast milk: the ability to constantly change and adapt. As Bloxam explains, breast milk is in a complex constant state of flux: "The amounts and composition of these beneficial substances vary among women according to a number of factors such as genetics, geographical regions, stages of lactation and diet. Even within one individual, breast milk composition changes daily to meet the infant's needs."

Lab-grown milk?

One way to potentially mimic some of those properties may be to grow breast-milk-producing cells in a laboratory, something scientists are beginning to explore.

BioMilq, a North Carolina-based start-up, was set up by cell biologist Leila Strickland after she struggled to produce enough breast milk for her first child. Her team take cells from human breast tissue and breast milk before growing them in flasks in the lab. They are fed a mix of nutrients and vitamins, then incubated inside a bioreactor, where the cells start secreting the milk components that are found in natural human milk. However, BioMilq is still a few years at least away from market. Also, lab-grown milk would still not be as individually tailored to a baby's fluctuating needs as their own mother's milk.

Other biotech companies are also working on lab-grown milk projects that could change how we think of manufactured infant formula in the future. In Singapore, Turtle Tree Labs is culturing cells from various different mammals, including cows, sheep, goats, camels and now humans, to create milk components. In New York, researchers at Helaina, a start-up, are using fermentation processes that programme yeast cells to manufacture functional human milk proteins, which could eventually be added to infant formula and other food products.

We can quite successfully produce formulas to provide adequate and safe nutrition so the baby grows and develops as expected. However I think it would be impossible to ever mimic the 'non-nutrient' components – Mary Fewtrell

However, breast milk is a constantly changing fluid so in a way it's a moving target, with some components still not fully understood, says Fewtrell, the professor of paediatric nutrition at University College London.   

"We can quite successfully produce formulas to provide adequate and safe nutrition so the baby grows and develops as expected," she says. "Indeed, there have been improvements to the composition of formulas in recent years so that they can more closely reproduce the growth patterns and some outcomes seen in breast-fed infants. However I think it would be impossible to ever mimic the 'non-nutrient' components in this complex fluid."

As for my investigation into my own body's toxic load, and the harmful chemicals that were perhaps present in my breastmilk, Bloxam, the dietician, reassures me:  "I'd encourage breastfeeding wherever possible as the benefits for mother and baby would far outweigh any risks [from contamination]." 

Still it appears I'm not the only one wondering about the ingredients in my own milk. Stephanie Canale, previously a family medical doctor, is the founder of Lactation Lab in California, a private company that analyses breast milk for nutritional content as well as environmental toxics. Mothers send in frozen samples of their breast milk to check the levels of various ingredients including minerals and vitamins. The idea is that they can then adapt their diet accordingly.

Canale says that when we look at a baby's nutrition, we need to include everything from prenatal vitamins to the food a breastfeeding mother consumes and the meals a weaning baby eats. Formula may be one part of that mosaic, in families where it is used. 

"It's this holistic approach," says Canale who would like to see stricter regulations in the US about the contents of formula. "I'm from Canada and it still surprises how much high-fructose corn syrup is present in US products, including formula. Moms are going to drive this change by saying we need to be better aware of what is going into these products, especially formula because that child is eating the same thing every single day – there's no variation [like there is naturally with breast milk]."

In the case of the toxic chemicals – whether they find their way into breast milk or into formula – the question is clearly not just about how we can provide our children with safe nutrition. It is also about how we can provide them and future generations with a safe, liveable environment, and reduce pollution along the entire food chain. One answer, surely, is to start by using fewer harmful chemicals in the first place.

* Listen to My Toxic Cocktail, Anna Turns's investigation for BBC Radio 4's Costing the Earth series on BBC Sounds. Go Toxic Free: Easy and Sustainable Ways to Reduce Chemical Pollution by Anna Turns is out now

--

This article was updated on 27 June to include a quote from the FDA.

FAMILY TREE

This article is part of Family Tree, a series of features that explore the issues and opportunities that families face all over the world. You might also be interested in other stories about a baby's first months:

• What really happens when babies are left to cry it out?
• The science of healthy baby sleep
• How dangerous is tongue-tie?

You can also climb new branches of the Family Tree on BBC Worklife.

https://www.bbc.com/future/article/20220622-whats-really-inside-babies-first-foods

Gut bacteria found to reverse autism-related social behavior

The mouse study joins a growing set of research that links the gut microbiome to the brain.

16th June 2016 in Life Sciences



Published today in Cell, the study found that the addition of the bacteria Lactobacillus reuteri, which is commonly found in human breast milk, increased the likelihood that previously antisocial mice would interact with each other. Lead author Shelly Buffington told us how the study could translate to the treatment of Autism Spectrum Disorder (ASD) and other neurodevelopmental disorders in humans.

ResearchGate: Can you explain your study and the significance of your findings?

Shelly Buffington: We found that a maternal high-fat diet in mice alters offspring social behavior and induces long-term changes in the offspring gut microbiome. We performed a series of co-housing experiments and fecal microbiota transplants into germ-free mice to determine if the alterations in the high-fat diet offspring microbiome were causative factors underlying their impaired social behavior. Our results suggested that there were one or more bacterial species in the regular mouse gut that are important for normal social behavior that were missing or underrepresented in the maternal high-fat diet gut microbiome. We used whole genome shotgun sequencing to analyze the composition of the regular vs. maternal high-fat diet offspring gut microbiome. These data revealed a marked shift in microbial ecology at the species level.

The most underrepresented species in the maternal high-fat diet gut microbiome was Lactobacillus reuteri. This finding was very intriguing because Lactobacillus reuteri had previously been shown to increase the levels of the hormone oxytocin, which has been dubbed “the social hormone” as there is a lot of evidence that it plays an important role in modulating social behaviors in mammals. We then tested whether the introduction of Lactobacillus reuteri into the gut of maternal high-fat diet offspring was enough to reverse their social deficits. When we next assessed their social behavior, we found that it was restored. We found that treatment with Lactobacillus reuteri significantly increased the number of oxytocin-producing cells in the brains of maternal high-fat diet offspring and restored, what we believe to be, social interaction-related plasticity in a key reward area of the brain.

Our results suggest that maternal diet-induced changes in the gut the microbiome can affect offspring social behavior and that single species reconstitution of Lactobacillus reuteri can rescue these deficits. Furthermore, they add to a growing literature showing that the gut microbiome is an important player when it comes to behavior and that probiotics may hold therapeutic potential for the treatment of behavioral symptoms associated with neurodevelopmental disorders.

RG: Can you explain the method you used to reach these findings?

Buffington: We used a powerful combination of techniques including behavioral tests, 16S ribosomal RNA gene sequencing, whole genome shotgun sequencing, immunofluorescence microscopy, electrophysiology, and pharmacological approaches to study the link between maternal diet-induced changes in the offspring gut microbiome and behavior. Our study is one of the first to combine a species-level analysis of the composition of the gut microbiome not only with behavioral assessment but also with functional analysis of plasticity in the brain.

ResearchGate: Do you know why the gut microbiome has such an impact on the brain?

Buffington: Communication between gut microbiota and the brain is complex –we don't fully understand it yet, but we do know it's bidirectional and multifaceted. No system works in isolation, there's a significant amount of molecular cross-talk. One of the primary mediators between the gut and the brain is the vagus nerve, which provides two-way communication. Many, but not all, probiotics that alter the brain and behavior in animal models depend on the integrity of the vagus nerve.

Another way gut microbiota can affect brain function is through stimulation of the immune system, altering the levels of both pro- and anti-inflammatory cytokines in the bloodstream. Dietary changes, for example, can compromise intestinal barrier integrity creating a route for bacterial products to enter the circulation and induce inflammation. Gut bacteria also generate metabolic byproducts, including short-chain fatty acids, which have been shown to modulate brain function and behavior, as they breakdown dietary constituents. Certain species of gut bacteria even produce neurotransmitters including GABA, serotonin, dopamine, and acetylcholine as well as neurotransmitter precursors. Elucidating the mechanisms by which the gut modulates brain activity and vice versa is an exciting, active area of investigation that holds great promise for identifying novel therapeutic targets.

RG: What spurred you to look into the connection between the gut and the brain in the treatment of Autism-related antisocial behaviors?

Buffington: There has been a lot of great work published recently showing that bidirectional communication exists between the gut and the brain. This communication pathway is colloquially termed the “gut-brain axis.” Human epidemiological studies have shown that maternal obesity increases the risk of neurodevelopmental disorders in offspring. The same has been found in non-human primates.

In addition, many ASD patients co-present with gastrointestinal disorders, suggesting that they may have an imbalance in gut microbiota which contributes to their intestinal issues. When we observed abnormal social behavior in our maternal high-fat diet mice, we hypothesized that changes in the maternal microbiome could in turn alter the offspring gut microbiome and that these alterations could underlie their behavioral deficits.

RG: What kind of behavioral improvements did you find in the mice who had a full restoration of their gut microbiome?

Buffington: We found that the maternal high-fat diet offspring that had been co-housed with mice with a normal microbiome preferred to interact with a mouse over an inanimate object. They also spent more time in contact with a stranger mouse when they were placed together in a neutral arena. Thus, they displayed normal social behavior, for mice.

RG: Do you have any idea how this study could translate to human ASD sufferers?

Buffington: There is a lot of interest in the potential of probiotic treatments for alleviating behavioral symptoms in kids with ASD. The promise of our work lies in the finding that a single bacterial species, Lactobacillus reuteri, was able to reverse social behavioral deficits in maternal high-fat diet offspring. Not only did it restore the behavioral symptoms, but when we looked at the brains of the treated animals, we found that it also increased oxytocin levels. Several studies have suggested that oxytocin plays an important role in modulating social behavior, not only in rodents, but in humans. Our findings suggest that Lactobacillus reuteri could prove to be useful as a novel, low-risk probiotic for treatment of behavioral symptoms associated with ASD.

Image credit Wiki Media.

https://www.researchgate.net/blog/post/gut-bacteria-found-to-reverse-autism-related-social-behavior

The 10 Point Plan for Preventing Cancer

World-renowned independent experts gave us the most up-to-date and authoritative information about cancer prevention and survival – as seen from the perspective of conventional medicine

By Lee Euler / October 21, 2018

The World Cancer Research Fund published its Third Expert Report, Diet, Nutrition, Physical Activity and Cancer: A Global Perspective, in May.

World-renowned independent experts gave us the most up-to-date and authoritative information about cancer prevention and survival – as seen from the perspective of conventional medicine, of course.

Their detailed analysis – running more than 10,000 pages – is based on three decades of studies involving 51 million people, 3½ million cases of 17 types of cancer.

You will be relieved to learn they boiled this massive pile of documents down to ten recommendations we should follow. And some of the findings are surprising. . .

By following healthy lifestyle recommendations, you can lower the risk of cancer by about one-third to one-half.

The authors also state that you can gain additional protection from cancer by avoiding exposure to environmental pollution and carcinogens encountered in the workplace. But these aspects and others were not covered because they’re beyond the study’s original purpose.

The report confined itself to steps where there was strong evidence – convincing or probable – that a given factor caused or prevented cancer. Where the evidence was “limited but suggestive,” it didn’t make the grade.

1. Keep a healthy weight

If current trends continue, overweight and obesity are expected to overtake smoking as the number one risk factor for cancer. The evidence is considered to be strong and has grown even stronger since the group’s Second Expert Report in 2007.

Metabolic and hormonal abnormalities that come with obesity, such as elevated levels of fasting insulin, estradiol (a strong type of estrogen), and inflammation, all increase cancer risk.

The microenvironment of tissues can be changed by obesity, making them more prone to act as colonization sites for tumors. Obesity is also linked to changes within cancer cells that make them more likely to spread.

In addition, adipose (fat) connective tissue cells promote the establishment and growth of vascular networks (angiogenesis) that support and stimulate tumor growth.

Chromosomes and genes are also more likely to mutate in obese people. This has been demonstrated in human studies of colorectal and endometrial cancer in women, and in cancer of the esophagus in lab studies.

There is now convincing evidence that body fat causes cancers of the esophagus (adenocarcinoma), pancreas, liver, colorectum, breast (postmenopause), endometrium, and kidney. It’s also a probable cause of cancers of the mouth, pharynx, larynx, stomach, gallbladder, ovary, and prostate.

2. Be physically active

Appropriate activity creates a metabolic environment in the body that makes some cancers less likely to occur.

Positive effects of physical activity take effect within the endocrine and immune systems. The result is to lower circulating estrogen, fasting insulin and inflammation, enhance innate and acquired immunity, and promote tumor surveillance.

Keeping active also lessens the chance of becoming overweight or obese. Aerobic exercise decreases oxidative stress (free radical attacks) and enhances DNA repair mechanisms.

Evidence is convincing that physical activity decreases the risk of cancer of the colon, and probably decreases the risk of endometrial and postmenopausal breast cancer.

Vigorous, intense exercise probably decreases the risk of premenopausal breast cancer.

3. Eat a diet rich in wholegrains, vegetables, fruit and beans

Make wholegrains, non-starchy vegetables, fruit, and pulses (legumes) such as beans and lentils a major part of the daily diet.

Fruits and vegetables contain a host of micronutrients that protect against cancer, such as vitamins A, C, E, folate and selenium. Lab studies also demonstrate that many phytochemicals like carotenoids, dithiolthiones, isothiocyanates, flavonoids and phenols have anti-cancer effects.

However, hard evidence is not easy to come by when looking at large population studies, so there was no convincing evidence that eating such a diet is protective.

But a probable decreased cancer risk exists for wholegrains and fiber (colorectal cancer), non-starchy vegetables and fruit (aerodigestive) and dairy foods (colorectal).

There was also convincing evidence for an increased risk from aflatoxin (mold) contamination in certain foods, leading to liver cancer.

Other probable sources of cancer risk were foods preserved by salting (stomach cancer) and Cantonese-style salted fish (cancer of the nasopharynx – the upper part of the throat behind the nose).

4. Limit consumption of ‘fast foods’ and other processed foods high in fat, starches and sugars

An increased glycemic load (raised blood glucose) probably causes endometrial cancer. There was no other strong direct association with any other cancer. Fast foods and a Western-type diet are a concern in the context of cancer because they probably promote weight gain.

5. Limit consumption of red and processed meat

Eat no more than moderate amounts of red meat such as beef, pork and lamb each week (12 – 18 ounces cooked weight). Eat little if any processed meat, such as hot dogs, bacon and ham.

Red meat cooked at high temperatures forms compounds that potentially cause gene mutations. DNA damage can also be caused by the increase in heme iron, a form of iron that circulates in the blood.

Processed meat is usually energy dense, has high amounts of salt which can damage the stomach lining, and the methods used to prepare it generate carcinogens.

Red meat was found to be a probable risk, and processed meat a convincing risk for colorectal cancer. No level of processed meat intake can be considered risk-free.

6. Limit sugar-sweetened drinks

The offending sugars include sucrose, high fructose corn syrup and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.

The report recommends sticking to water, (although they did point out that arsenic in drinking water was a convincing cause of some cancers. Have your water tested if this is a concern in your area.) If you’re a tea or coffee drinker, limit yourself to a maximum of four cups (to limit caffeine consumption), and don’t sweeten it. Coffee probably lowers the risk of cancers of the liver and endometrium.

There is no strong evidence in humans for artificial sweeteners causing cancer, so drinks such as diet soda are acceptable in limited amounts. (I find this conclusion questionable.)

Sugar sweetened drinks are not strongly linked to any cancer but convincingly put on the pounds.

7. Limit alcohol consumption

Their preferred option: Don’t drink at all. The report states that “there is no level of consumption below which there is no increase in the risk of at least some cancers.”

Drinking alcohol increases the production of metabolites that are genotoxic and carcinogenic. These effects come from acetaldehyde, free radicals, changes in hormone metabolism and alcohol’s solvent properties which allow carcinogens to penetrate cells.

A convincing increased risk was attached to cancers of the mouth/pharynx/larynx, esophagus (squamous cell), liver, colorectum, breast (postmenopausal) and a probable greater risk for stomach and premenopausal breast cancer. However, up to two drinks a day probably lowers the risk of kidney cancer. (Considering the other health risks, I would not drink this much merely because it may help one organ.)

8. Do not use supplements for cancer prevention

The report authors accept certain vulnerable groups even in high income countries may need to be helped, at least in the short-term, with supplements, but feel people should aim to eat “nutrient-dense” diets to protect against cancer.

Trials of high dose supplements “have not consistently demonstrated” protective effects and there is “uncertainty as to the effects of dietary supplements on cancer risk.”

Only calcium supplements above 200mg/day offered strong evidence for probably decreasing the risk of colorectal cancer.

NOTE: This is probably the worst recommendation in the report, and flies in the face of tens of thousands of published studies on nutrition. How could the authors be so far off the mark?

The explanation may be something like this: In studies of large populations, it’s almost impossible to determine who used what supplements, and for how long, and whether the supplements were of high quality (NOT the ones you buy at, say, Walmart or Walgreens.) It’s well-known that merely popping a cheap multivitamin provides little benefit, and that’s all it takes to get yourself classified as a “supplement taker.”

9. For mothers, breastfeed your baby if you can

Having been breastfed protects children against weight gain and probably protects the mother against breast cancer.

10. After a cancer diagnosis, follow the above recommendations if possible

The report states that diet, nutrition, physical activity and body fat are increasingly recognized as being important in cancer survival. People diagnosed with cancer should be able to consult with trained health professionals in these fields.

A blueprint to beat cancer

Dr. Kate Allen, the World Cancer Research Fund Executive Director of Science & Public Affairs, commented on their report:

“Our Cancer Prevention Recommendations work together as a blueprint to beat cancer that people can trust, because they are based on evidence that has now proved consistent for decades.”

“We are committed to giving you the most up-to-date and authoritative information about cancer prevention and survival, enabling you to make healthy lifestyle choices in your daily lives to reduce cancer risk.”

Rowan Chlebowski, head of medical oncology at City of Hope National Medical Center, Duarte, California, agreed with the findings of the report:

“I believe that the evidence is strong enough to make a compelling case that people should take the 10 recommendations for cancer prevention seriously.

“A good number of scientific studies support the concept that cancer can be prevented with diet, nutrition, weight management, and physical activity.”

In our last issue, we talked about a building you don’t want to enter, if you value your life. The article is running again below just in case you missed it.

References:

1. https://www.wcrf-uk.org/uk/preventing-cancer/cancer-prevention-recommendations

https://www.cancerdefeated.com/the-10-point-plan-for-preventing-cancer/