Our Trip To Ghana

IMG_4959For those of you who don’t know, Kate (my clinical assistant) and I recently took a trip to Ghana in West Africa. A Ghana-based group called Autism Action Ghana (AAG) invited us to come evaluate and treat children with autism. Our trip was a resounding success. From the people we met, to our experience in the country, to the children we helped, we were received with open arms. I hope you’ll enjoy this account of our experience.

More About AAG (Information from AAG)IMG_5016
Autism Action Ghana is a registered, Non-Governmental Organization, founded in 2014 by Peter and Dr. Araba Fordjor after their 2 ½ year-old son was diagnosed with Autism Spectrum Disorder (ASD). Having been told there was no hope, they were even more awestruck by the lack of support, information and resources that accompanied the diagnosis and the hopelessness and despair that they faced on their lonesome journey.
Autism Action Ghana (AAG) seeks to create awareness of Autism Spectrum Disorders in a bid to generate understanding of the disorder amongst the general public, shatter the stigma and facilitate early diagnosis. But perhaps most importantly, AAG seeks to provide families with current clinical and behavioral evidence-based interventions and approaches that will directly impact children with autism and equip them to attain their maximum potential.
In Ghana, awareness of autism as a medical or neuropsychiatric disorder that can be treated is lacking. Many children’s symptoms are attributed to poor parenting and spiritual beliefs leading to stigmatization, inappropriate care and denial of their basic rights and opportunities.
How Did This Come To Be?
Many have asked me how we came to be invited to treat these children half a world away. It’s a bit of a long, convoluted story so I’ll try to make it short. The Vreeland Clinic had a previously existing patient with ties to Ghana. She put us in contact with a woman whose child had autism. Through this connection, Dr. Fordjor heard of us. Several patients actually traveled from Ghana to see us in Vermont. Eventually, Dr. Fordjor invited us to come to Ghana to see those who were unable to make the journey. After much careful thought, we decided this was an opportunity we could not miss.
AAG offered to cover my costs to get to Ghana and all costs while I was there (lodging, food, etc.) I decided that in order to be effective, I would need some help. I was going to need someone else there to help me with patient flow, note taking, dietary questions, etc. I knew there would be A LOT of questions from the parents, and I simply wouldn’t have time to answer all their questions and see all of the patients without help. That’s why Kate was on the trip. She helped coordinate patient flow, wrote down instructions, took notes, discussed dietary changes, and counseled patients on all the changes they were going to have to make to be successful. Now that we’re back and I have some perspective, there is absolutely no way I could have done this alone. I would have not been nearly as successful without Kate there.
Our Journey
Our journey really began months before we left. We needed to be vaccinated for yellow fever. Both Kate and I elected to get the hepatitis A vaccine as well given the ease with which it is transmitted and the effectiveness of the vaccine (98%). We also wanted to do what we could to offset the costs for AAG. I came up with the idea of starting a GoFundMe page. Using the great power of crowd funding, we were able to raise $9,575. This allowed us to see every single child at no cost and help greatly offset the costs AAG would have to absorb to set up the weeklong clinic. Our goal was to raise this money so AAG could use its funds in other helpful ways, and I’m certain we achieved that goal.
Leading up to our departure on April 22nd there was a lot of planning, but I’ll spare you the boring details. AAG took care of everything on their end. They booked our hotel accommodations, secured a room (with an air conditioner!) for us to see the children in, and even secured someone to cook all of our meals while we were there. It was a blessing not to have to worry about that! We booked the flights on our end. We took a short flight from Burlington, VT to JFK airport in New York. Then we had a direct flight from JFK to Accra, Ghana. AAG contacted Delta (our air carrier from NYC to Accra) and they kindly upgraded our seats to Delta Comfort Plus free of charge. The extra legroom and food was nice on the 10-hour flight. 
Our flight from JFK was uneventful and we landed in Ghana at about 7AM on the 23rd. We were both a little tired, but very happy to be in Africa. We exited the plane and I immediately noticed how hot it was! The humidity is always high in Ghana so it makes it feel even hotter. As we made our way into the airport, we were screened for Ebola by means of a thermal camera. Basically, they’re looking to see if you have a fever. We passed the test. Then we went through customs and grabbed our bags.
Dr. Fordjor and her husband, Peter, met us at the airport. As we discussed our travel and how hot we felt it was, they remarked that it had been quite hot recently even for them! We departed the airport and they took us to breakfast. I’m not sure what I was expecting, but we had a very nice buffet breakfast at a local hotel. There were eggs, omelets to be made, French toast, potatoes, etc. It was quite good and it felt nice to have some food in our bellies. They dropped us off at our hotel and provided us with a Wi-Fi hotspot so we’d have Internet service wherever we went. This is so nice to have!
Our hotel was great. We each had a room with air conditioning and a refrigerator. Strangely, they did not provide towels, washcloths, or, of all things, a trash can. Fortunately, Kate and I each brought a towel thinking we might make it to the beach one day. We never made it to the beach, but the towels sure did come in handy. We also did not have any hot water, but we did okay without it. It was somewhat nice in the evening to take a cool (cold?) shower.
The next day was Sunday and our only completely free day to explore Accra. AAG provided us with a driver. His name was Robert, and he took us all over Accra. We saw many sites from the very busy, modern downtown district, to a fishing village in which no one had running water, sewage, or electricity. The people living in the fishing village hand carved their wooden boats and used them to catch small fish in the ocean. The fish were then spread out over the ground to dry out, then they were smoked and brought to the market to sell. The fishing village was directly in the shadows of the Jamestown fort, a very large castle-like structure that was once used to imprison the locals before they were shipped off the Europe and the United States as slaves. The pier they led the slaves to where large boats waited to take them to other parts of the world still stands today.
We also visited a local market where we bought several souvenirs for our families. Haggling is the name of the game there. Our guide to us to reduce the price they were offering by a factor of 4 and that would likely be a good deal. It was kind of intense, but perhaps because culturally we did not understand the bargaining nature. It’s just how they do business in the markets. To us it sounded very much like arguing, but we were assured it was just business.
We had a nice lunch on the coast where we were right on the ocean. It was hot, so some food and water felt quite nice. After lunch we continued our exploration, driving around some more. Eventually, we went by the US Embassy. It was fun to see. We headed back to our hotel and got prepared for the start of our long week of seeing patients.
The Patients
We spent Monday-Friday seeing patients from 8AM to 6PM. They were long days, but they were worth it. In all, we were able to see 44 patients, most who had been diagnosed with autism. We saw just a handful that were not.
I think the overall theme from the week was about the stigma that is attached to autism in Ghana. We were told about it, but until we started seeing patients and were exposed to it, we could not fully understand the depth of it. Many, particularly the men, believe a child with developmental challenges reflects poorly on the family. Or in the case of men, it reflects poorly on them. This is such a powerful stigma, men may completely abandon their family if they have a child on the spectrum. It is hard for us in the US to imagine, but I bet if you dig deep enough you can see it here too.
People have asked me, “What exactly can you do for autism? Is it really treatable?” The answer is a resounding, “Yes!” With autism spectrum disorders comes a host of documented changes in the way their central nervous systems and their metabolisms work. There are changes in the circuitry of their brains that, when assessed properly, can be improved through eye exercises, light and sound therapy, balance exercises, tactile exercises, PT, OT, speech therapy, primitive reflex remediation, and the list goes on and on. The list of exercises that can rewire the brain is endless. You are only limited by your imagination!
So, our job was to determine what exercises would be most beneficial for each patient.  I did this by putting each child through a comprehensive neurologic exam looking at eye movements, primitive reflex testing, balance tests, etc. This allowed me to pinpoint which areas of the brain are struggling and recommend the correct therapy. Each parent was given a list of 3-5 exercises to begin to work on with their child. It is very common for children on the spectrum to skip developmental milestones as they grow. Commonly, they do not crawl or they crawl for only a very short period of time. We saw this in about 80% of the children we attended. Therefore, one of the main exercises we recommended was to properly establish a cross crawl pattern of gait in each child. This is done by having the child alternate touching their opposite knee to their elbow. They do this for 2 minutes, twice per day, and it abolishes the homolateral crawl pattern their brain is stuck in. Remediating primitive reflexes like this helps the brain organize itself in a way that is more efficient and allows for better brain function.
Metabolically, children with ASD are known to have changes in gastrointestinal function characterized by bacterial and/or yeast and fungal overgrowth, changes in the efficiency with which they produce energy, or changes in the efficiency with which they detoxify environmental and endogenous toxins. As some of the children had stool and metabolic testing prior to our arrival, we were able to see this firsthand. One thing that struck me was the large use of antibiotics. Most of the children had 2-3 courses per year from the time they were born through the age of 3 or 4. Knowing the effects of the gut on the brain, this was especially concerning to me. The testing confirmed my concerns and revealed massive bacterial and yeast overgrowth. Metabolic testing confirmed many of the children had a reduced capacity to produce energy and detoxification pathway weakness. For the children who were unable to get the testing done, my clinical experience combined with the knowledge of the research guided my therapeutic recommendations. The recommendations for this are generally in the form of supplements. Most, if not all of the parents had contacts in the US or the UK to send them the supplements we were recommending. While we were there I met a pharmacist who wanted to set up a local pharmacy to sell the supplements we were recommending. This is an exciting prospect and I hope we can set that up.
Dietary changes were also recommended. The diet was shifted to a very low fermentable diet in order to reduce microbial overgrowth in the GI tract. This was a difficult shift for them to undertake. Much of the Ghanaian diet is high in starch, which means it is also generally quite fermentable. Shifting away from this caused a bit of anxiety for the parents, but they were willing to make the shift if it meant an improvement for their child.
All of the parents have access to me via email and we’ve seen a pretty steady stream of questions coming in since we returned. Additionally, we can connect via phone or Skype in the future if need be.
The experience was a good one. I think we learned as much from them as they did from us. I hope to continue our relationship with AAG in whatever form that takes. Until we have the chance to return, we’ll continue to monitor these wonderful children from afar and make the necessary adjustments to help them reach their maximum potential.

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Fat, sugar cause bacterial changes that may relate to loss of cognitive function

A study at Oregon State University indicates that both a high-fat and a high-sugar diet, compared to a normal diet, cause changes in gut bacteria that appear related to a significant loss of “cognitive flexibility,” or the power to adapt and adjust to changing situations. This effect was most serious on the high-sugar diet, which also showed an impairment of early learning for both long-term and short-term memory. The findings are consistent with some other studies about the impact of fat and sugar on cognitive function and behavior, and suggest that some of these problems may be linked to alteration of the microbiome — a complex mixture in the digestive system of about 100 trillion microorganisms. The research was done with laboratory mice that consumed different diets and then faced a variety of tests, such as water maze testing, to monitor changes in their mental and physical function, and associated impacts on various types of bacteria. The findings were published in the journal Neuroscience, in work supported by the Microbiology Foundation and the National Science Foundation. “It’s increasingly clear that our gut bacteria, or microbiota, can communicate with the human brain,” said Kathy Magnusson, a professor in the OSU College of Veterinary Medicine and principal investigator with the Linus Pauling Institute. “Bacteria can release compounds that act as neurotransmitters, stimulate sensory nerves or the immune system, and affect a wide range of biological functions,” she said. “We’re not sure just what messages are being sent, but we are tracking down the pathways and the effects.” Mice have proven to be a particularly good model for studies relevant to humans, Magnusson said, on such topics as aging, spatial memory, obesity and other issues. In this research, after just four weeks on a high-fat or a high-sugar diet, the performance of mice on various tests of mental and physical function began to drop, compared to animals on a normal diet. One of the most pronounced changes was in what researchers call cognitive flexibility. “The impairment of cognitive flexibility in this study was pretty strong,” Magnusson said. “Think about driving home on a route that’s very familiar to you, something you’re used to doing. Then one day that road is closed and you suddenly have to find a new way home.” A person with high levels of cognitive flexibility would immediately adapt to the change, determine the next best route home, and remember to use the same route the following morning, all with little problem. With impaired flexibility, it might be a long, slow, and stressful way home. This study was done with young animals, Magnusson said, which ordinarily would have a healthier biological system that’s better able to resist pathological influences from their microbiota. The findings might be even more pronounced with older animals or humans with compromised intestinal systems, she said. What’s often referred to as the “Western diet,” or foods that are high in fat, sugars and simple carbohydrates, has been linked to a range of chronic illnesses in the United States, including the obesity epidemic and an increased incidence of Alzheimer’s disease. “We’ve known for a while that too much fat and sugar are not good for you,” Magnusson said. “This work suggests that fat and sugar are altering your healthy bacterial systems, and that’s one of the reasons those foods aren’t good for you. It’s not just the food that could be influencing your brain, but an interaction between the food and microbial changes.”

Source: Fat, sugar cause bacterial changes that may relate to loss of cognitive function — ScienceDaily

 

 

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3 Things That Happen To Your Brain With Leaky Gut

Gut health is essential for overall health. That connection is fairly easy to make. But what about your brain? Can the health of your gut really affect your brain? The answer is a resounding yes! Here are three things that happen to your brain when you have a leaky gut.

  1. Depression – the bacteria that naturally exist in our GI tract are mostly beneficial. However, if metabolic byproducts and cell constituents are able to escape the gut they cause a potent inflammatory response. This happens through a “leaky gut.” The resulting response alters levels of inflammatory hormones called cytokines. These cytokines have the ability to communicate with the brain and eventually change neurotransmitter levels. This change in neurotransmission actually begins to rewire the brain leading the changes in how we think and feel. Most often, people begin to feel depressed. 3.02-brain-on-fire
  2. An Inflamed Brain – through the mechanisms just mentioned, not only do your neurotransmitters and thoughts/feelings change, your brain becomes inflamed. This signals the immune cells within the brain, called glial cells, to become very active. This may sound like a good thing, but it’s not. As a result of being activated glial cellsgenerate more inflammation and create oxidative stress. This means the glial cells begin breaking down the brain. This may increase your risk of brain fog, fatigue, depression, anxiety, cognitive decline, and possibly even neurodegenerative disorders like Parkinson’s disease and Alzheimer’s disease.
  3. Blood Brain Barrier Breakdown – there is a barrier than exists that separates what is circulating in our blood from our brain. Only things that are beneficial for the brain are supposed to have access to it. The blood brain barrier is an exceptionally important structure. With increased inflammation from a leaky gut and glial activation, the blood brain barrier breaks down. Now toxic byproducts, inflammatory hormones, and other noxious chemicals have free access to the brain. This is a disastrous consequence that interferes with brain function leading to a multitude of symptoms which include depression, brain fog, anxiety, and more. Leaky gut leads to a leaky blood brain barrier!

Gastrointestinal health is essential for brain health. Knowing how to fix the gut can lead to dramatic improvements in how you feel cognitively and emotionally.

For much more information and strategies to improve your gut and brain health join me for a FREE webinar on Tuesday, November 10th at 7:30PM called “The Gut-Brain Connection – Mood, Food, and More!” We’ll explore the amazing connection between gut health and brain health and give you tips and tricks to make both healthy.

Dr. Vreeland is a nationally recognized expert and author in functional medicine and will present information that will be life changing! You don’t want to miss this event!

Click here to register: http://www.anymeeting.com/PIID=EC51D98085463A

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4 Unconventional Things You Didn’t Know Were Making You Fat

The human body is a strange and wondrous place. There are many reasons why a person might gain weight. Eating the wrong kind of food, the wrong amount of food, or not enough exercise are well established reasons. However, there are some no-so-common reasons that might play a role as well.

Road Traffic Noise

Exposure to a combination of road traffic, rail, and aircraft noise may pose the greatest risk of acquiring a spare tire — otherwise known as central obesity, and thought to be one of the most harmful types of fat deposition around the body. In a recent study researchers assessed how much road traffic, rail, and aircraft noise 5075 people living in five suburban and rural areas around Stockholm, Sweden, had been exposed to since 1999. The analysis indicated no link between road traffic noise and BMI. But there was an association between road traffic noise and waist size, with a 0.21 cm increase for every additional 5 dB increase in exposure, although this was only significant among women. Similarly, there was a link to waist:hip ratio, with a change of 0.16 for every 5 dB increase in noise exposure to road traffic; this association was stronger in men.

What gives? Noise exposure may be an important physiological stressor and bump up the production of the hormone cortisol, high levels of which are thought to have a role in fat deposition around the middle of the body, researchers suggest. Additionally, noise exposure might disrupt sleep, another known factor to contribute to weight gain.

Too Many Food Choices

A new study in mice by researchers in the Virginia Tech College of Agriculture and Life Sciences and the Edward Via College of Osteopathic Medicine has shown that the environment in which a child lives may be an equal if not stronger force in determining obesity than their mother’s diet. Researchers found that having too many food choices increases the obesity problem. In fact, researchers found that having a choice of a high-fat and low-fat diet does not help — offspring in this situation tended to eat even more. Their findings were recently released in the journal Endocrinology. “We like variety,” said Deborah Good, an author of the paper and an associate professor of human nutrition, foods, and exercise at Virginia Tech. “But when there is a choice, we eat more than when there is not any variety.” Moral of the story? Simple is better for our waistlines.

The Inability To Stay Warm

A new study suggests that a biological inability to create sufficient core body heat could be linked to the obesity epidemic. The study found that obesity is associated with a significant reduction of body core temperature during daytime hours. Journal Editor Francesco Portaluppi explains that the reduced ability of obese people to spend energy as heat compared to lean individuals could result in long term weight gain (about 2 kg (4.5 lb.)) per year, depending on the lifestyle. “Since body core temperature represents a marker of energy expenditure, results from this study suggest that a diurnal thermogenic handicap can play a crucial role in favoring weight gain in obese subjects,” said article co-author Pietro Cortelli, MD, Ph.D. The fix? Generate more body heat. And how does one do that? Exercise of course!

Environmental Pollution

A team of Spanish scientists, which includes several researchers from the University of Granada, has confirmed that there is a relation between the levels of certain environmental pollutants that a person accumulates in his or her body and their level of obesity. Subjects with more pollutants in their bodies tend to have higher levels of cholesterol and triglycerides, which are important risk factors for cardiovascular disease. The research has analyzed the levels of pollutants accumulated in adipose tissue (fat) in nearly 300 men and women, who were attended in the surgery services of two hospitals in the province of Granada (Spain). The substances analyzed, known as persistent organic pollutants (POPs), can remain in the environment for years, even decades, without degrading.

“Humans are exposed to POPs mainly through diet. Besides, POPs accumulate gradually in body fat, and this is the reason why the median levels in our study give us an idea of an individual’s accumulated exposition over a number of years,” says Juan Pedro Arrebola, the main author of the article. There is evidence that human exposure to certain chemical substances called “obesogenic” could favor the growth and proliferation of adipocytes (fat cells), and provoke therefore an increase in body fat.

Do your best to avoid exposing yourself unnecessarily to chemicals that might be problematic. Perhaps the most powerful way to do this is avoid processed food which is loaded with these chemicals from their own packaging.

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How to develop healthy eating habits in a child: Start early and eat your vegetables

A healthy diet promotes success in life — better concentration and alertness, better physical health that translates into good mental and emotional health.

But even the best intentioned parents can expect food fights with their children, said Tanda Kidd, associate professor of human nutrition and extension specialist at Kansas State University. Developing good eating habits in your children is worth the effort, she said.

Good eating habits also are a front-line defense against obesity, a scourge of the nation that happens when a child eats many more calories than he or she uses up.

Nearly 1 in 4 children ages 2 to 5 is overweight or obese, said Paula Peters. An obese child is at risk for developing diabetes, high blood pressure, asthma and sleep apnea. Peters is an associate professor of human nutrition and assistant extension director for family and consumer sciences at Kansas State University.

“No parent wants her child to be sick. No parent wants her child to feel like an outsider in social situations, or be teased or bullied because of her weight,” Kidd said.

Peters and Kidd both conduct research in the area of childhood obesity prevention.

A primary key to teaching a child to make healthy food choices, Peters said, is to start early.

“Give the child a wide variety of healthy food options and let her choose which and how much to eat. A child may start by eating nothing or eating too much, but she has an innate ability to know when she’s hungry and when she’s full.”

A child learns about new foods at a time when she is exploring the world around her. And she learns to make decisions for herself.

Make the selection nutrient dense — not calorie dense. That means fruits and vegetables, not cookies for snacks. A glass of soda and a glass of 100 percent juice may have the same number of calories, but a juice is a healthier choice because it does not contain added sugars, said Kidd, a registered dietitian.

Soda and other sugar-sweetened drinks have empty calories, meaning they are “empty” of nutritional value.

According to the Centers for Disease Control, empty calories from foods high in added sugars, such as ice cream, cookies, candy, fruit drinks and some breakfast cereals and solid fats such as donuts, pastries, hot dogs, sausages, bacon and regular ground beef, contribute to 40 percent of daily calories for children and adolescents ages 2 to 18 years.

Kidd and Peters offer other suggestions:

• Do not use food as a reward for good behavior or other achievements. Kidd suggested other awards like reading a book together or playing a child’s favorite game.

• Eat your veggies, Dad. A child learns food habits — what to eat, how much to eat, when to eat, where to eat — from parents.

• Eat with your children so they can see you making good food choices.

• Be aware of what a child is eating away from home. Peters said that more than 25 percent of children ages 2 to 4 are in day care 20 to 40 hours a week. Check out meals and snacks offered to your child.

• Limit screen time — television — that encourages “mindless” eating.

• Avoid putting a child on a diet, even if he or she is slightly overweight. “That sets up the child for issues such as eating disorders later in life,” Kidd said. Instead, offer healthier food options and increase physical activity.

Kidd and Peters also encourage parents to teach their children about healthy food choices in other ways:

• Planning and taking a trip to the grocery store gives a child ownership in food choices. Reading labels and comparing costs offer other lessons.

• Plant a garden. Peters said a child is more likely to eat vegetables he or she helped grow and harvest.

• Cook together. During special time with Mom or Dad in the kitchen the child will learn more than cooking skills.

Kidd and Peters are concerned about both food deserts and food swamps. The former defines area where fresh foods are hard to get, perhaps because grocery stores are far from the family home.

Food swamps describes areas that are so crowded with fast food options that making healthy eating choices is more challenging.

They also stress the vital role that physical activity plays in childhood health. Although there is no specific recommendation for kids ages 2-5 years old, parents should offer opportunities several times a day for active play. However, kids 6 and over are encouraged to be physically active at least 60 minutes each day, Kidd said.

“Parenting styles and family characteristics affect what a child eats, of course,” Peters said. “So do community, demographic and societal characteristics such as school physical education programs, access to recreational facilities, school lunch programs and neighborhood safety.

“Weight gain is an indicator of an unhealthy society,” she said. “We have to focus on ways to be healthier.”

Week of the Young Children, sponsored by the National Association for the Education of Young Children April 12-18, focuses on the foundation for a child’s success in school and later life.

via How to develop healthy eating habits in a child: Start early and eat your vegetables — ScienceDaily.

Dr. Court’s Comments:

I agree with everything written above with one exception. I do not believe fruit juice should be a regular part of a child’s diet. On occasion, it’s fine. However, the vast majority of time, water should be the choice. Parents often are concerned that their children are somehow “missing” something if they aren’t given juice or sweet snacks. They are missing something; they’re missing the opportunity for cavities. They’re missing the increased risk of being overweight or obese. They’re missing out on poorer brain function. They’re missing out on learning healthy habits.

In all seriousness though, parents are legitimately concerned about depriving their children of delicious treats. However, this is purely the parents’ perspective, not the child’s. If the parent believes they would miss those treats themselves (most likely because of their own upbringing and food choices), of course they’re going to believe their children would miss them too. Here’s the caveat though. Children only know what you teach them. They won’t miss out on anything if they’re taught to love the healthy food. They’ll feel just as fulfilled and loved with the good food as they would feel with the unhealthy food.

This is not to suggest treats should never be given. They must, however, be just that – treats. Making a regular habit of bad food choices sets up a child for a lifetime of health issues.

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Omega-3: Intervention for childhood behavioral problems? — ScienceDaily

At the forefront of a field known as “neurocriminology,” Adrian Raine of the University of Pennsylvania has long studied the interplay between biology and environment when it comes to antisocial and criminal behavior. With strong physiological evidence that disruption to the emotion-regulating parts of the brain can manifest in violent outbursts, impulsive decision-making and other behavioral traits associated with crime, much of Raine’s research involves looking at biological interventions that can potentially ward off these behavioral outcomes.

A new study by Raine now suggests that omega-3, a fatty acid commonly found in fish oil, may have long-term neurodevelopmental effects that ultimately reduce antisocial and aggressive behavior problems in children.

He is a Penn Integrates Knowledge Professor with appointments in the School of Arts & Sciences and the Perelman School of Medicine.

Along with Raine, the study featured Jill Portnoy a graduate student in the Department of Criminology, and Jianghong Liu, an associate professor in the Penn School of Nursing. They collaborated with Tashneem Mahoomed of Mauritius’ Joint Child Health Project and Joseph Hibbeln of the National Institute on Alcohol Abuse and Alcoholism.

It was published in the Journal of Child Psychology and Psychiatry.

When Raine was a graduate student, he, his advisor and colleagues conducted a longitudinal study of children in the small island nation of Mauritius. The researchers tracked the development of children who had participated in an enrichment program as 3-year-olds and also the development of children who had not participated. This enrichment program had additional cognitive stimulation, physical exercise and nutritional enrichment. At 11 years, the participants showed a marked improvement in brain function as measured by EEG, as compared to the non participants. At 23, they showed a 34 percent reduction in criminal behavior.

Raine and his colleagues were interested in teasing apart the mechanisms behind this improvement. Other studies suggested the nutritional component was worth a closer look.

“We saw children who had poor nutritional status at age 3 were more antisocial and aggressive at 8, 11 and 17,” Raine said. “That made us look back at the intervention and see what stood out about the nutritional component. Part of the enrichment was that the children receiving an extra two and a half portions of fish a week.”

Other research at the time was beginning to show that omega-3 is critical to brain development and function.

“Omega-3 regulates neurotransmitters, enhances the life of a neuron and increases dendritic branching, but our bodies do not produce it. We can only get it from the environment,” Raine said.

Research on the neuroanatomy of violent criminals suggested this might be a place to intervene. Other brain-imaging researchers have shown that omega-3 supplementation increases the function of the dorsolateral prefrontal cortex, a region Raine found to have higher rates of damage or dysfunction in criminal offenders.

Raine’s new study featured a randomized controlled trial where children would receive regular omega-3 supplements in the form of a juice drink. One hundred children, aged 8 to 16, would each receive a drink containing a gram of omega-3 once a day for six months, matched with 100 children who received the same drink without the supplement. The children and parents in both groups took a series of personality assessments and questionnaires at the start.

After six months, the researchers administered a simple blood test to see if the children in the experimental group had higher levels of omega-3 than those in the controls. They also had both parents and children take the personality assessments. Six months after that, the researchers had parents and children take the assessment again to see if there were any lasting effects from the supplements.

The assessments had parents rate their children on “externalizing” aggressive and antisocial behavior, such as getting into fights or lying, as well as “internalizing” behavior, such as depression, anxiety and withdrawal. Children were also asked to rate themselves on these traits.

While the children’s self-reports remained flat for both groups, the average rate of antisocial and aggressive behavior as described by the parents dropped in both groups by the six-month point. Critically, however, those rates returned to the baseline for the control group but remained lowered in the experimental group, at the 12-month point.

“Compared to the baseline at zero months,” Raine said, “both groups show improvement in both the externalizing and internalizing behavior problems after six months. That’s the placebo effect.

“But what was particularly interesting was what was happening at 12 months. The control group returned to the baseline while the omega-3 group continued to go down. In the end, we saw a 42 percent reduction in scores on externalizing behavior and 62 percent reduction in internalizing behavior.”

At both the six- and 12-month check-ins, parents also answered questionnaires about their own behavioral traits. Surprisingly, parents also showed an improvement in their antisocial and aggressive behavior. This could be explained by the parents taking some of their child’s supplement, or simply because of a positive response to their child’s own behavioral improvement.

The researchers caution that this is still preliminary work in uncovering the role nutrition plays in the link between brain development and antisocial behavior. The changes seen in the one-year period of the experiment may not last, and the results may not be generalizable outside the unique context of Mauritius.

Beyond these caveats, however, there is reason to further examine omega-3’s role as a potential early intervention for antisocial behavior.

“As a protective factor for reducing behavior problems in children,” Liu said, “nutrition is a promising option; it is relatively inexpensive and can be easy to manage.”

Follow-up studies will include longer-term surveillance of children’s behavioral traits and will investigate why their self-reports did not match the parental reports.

via Omega-3: Intervention for childhood behavioral problems? — ScienceDaily.

Dr. Court’s Comments:

Fortunately, science is finally studying and understanding that nutrition is a major factor in brain development. This development appears to have a critical window and if this window is missed, it increases the risk of adverse outcomes. As with many other aspects of our health, it is the combination of our unique genetics with our environment. It’s important to provide the best environment possible to give a child the best chance at a healthy life. Modern American diets are notoriously low in omega-3s. According to recent a recent study, the average American consumes between 100-149mg/day of omega-3s from seafood. This is lower than the world average of 163mg/day. All this despite having relatively easy access to foods that contain omega-3s. Don’t like seafood? Consider increasing your consumption of grass-fed products which tend to be high in omega-3s. Also consider taking a fish oil supplement.

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Eight nutrients to protect the brain

Brain health is the second most important component in maintaining a healthy lifestyle according to a 2014 AARP study. As people age they can experience a range of cognitive issues from decreased critical thinking to dementia and Alzheimer’s disease. In the March issue of Food Technology published by the Institute of Food Technologists (IFT), contributing editor Linda Milo Ohr writes about eight nutrients that may help keep your brain in good shape.

1. Cocoa Flavanols: Cocoa flavanols have been linked to improved circulation and heart health, and preliminary research shows a possible connection to memory improvement as well. A study showed cocoa flavanols may improve the function of a specific part of the brain called the dentate gyrus, which is associated with age-related memory (Brickman, 2014).

2. Omega-3 Fatty Acids: Omega-3 fatty acids have long been shown to contribute to good heart health are now playing a role in cognitive health as well. A study on mice found that omega-3 polyunsaturated fatty acid supplementation appeared to result in better object recognition memory, spatial and localizatory memory (memories that can be consciously recalled such as facts and knowledge), and adverse response retention (Cutuli, 2014). Foods rich in omega-3s include salmon, flaxseed oil, and chia seeds.

3. Phosphatidylserine and Phosphatidic Acid: Two pilot studies showed that a combination of phosphatidylserine and phosphatidic acid can help benefit memory, mood, and cognitive function in the elderly (Lonza, 2014).

4. Walnuts: A diet supplemented with walnuts may have a beneficial effect in reducing the risk, delaying the onset, or slowing the progression of Alzheimer’s disease in mice (Muthaiyah, 2014).

5. Citicoline: Citicoline is a natural substance found in the body’s cells and helps in the development of brain tissue, which helps regulate memory and cognitive function, enhances communication between neurons, and protects neural structures from free radical damage. Clinical trials have shown citicoline supplements may help maintain normal cognitive function with aging and protect the brain from free radical damage. (Kyowa Hakko USA).

6. Choline: Choline, which is associated with liver health and women’s health, also helps with the communication systems for cells within the brain and the rest of the body. Choline may also support the brain during aging and help prevent changes in brain chemistry that result in cognitive decline and failure. A major source of choline in the diet are eggs.

7. Magnesium: Magnesium supplements are often recommended for those who experienced serious concussions. Magnesium-rich foods include avocado, soy beans, bananas and dark chocolate.

8. Blueberries: Blueberries are known to have antioxidant and anti-inflammatory activity because they boast a high concentration of anthocyanins, a flavonoid that enhances the health-promoting quality of foods. Moderate blueberry consumption could offer neurocognitive benefits such as increased neural signaling in the brain centers.

via Eight nutrients to protect the aging brain — ScienceDaily.

Reference: Institute of Food Technologists (IFT). “Eight nutrients to protect the aging brain.” ScienceDaily. ScienceDaily, 15 April 2015. <www.sciencedaily.com/releases/2015/04/150415203340.htm>.

Dr. Court’s Comments:

This is a great list. I’d encourage people to consider adding some, if not all, of these to their diet. However, these alone will not be 100% protective. To get much closer to that elusive 100% mark, exercise must be included. The benefits of exercise on the brain are numerous. Exercise is inherently anti-inflammatory. It improves fuel delivery as well as waste removal in the brain. It increases neural feedback which preserves synaptic connections. Remember this fact; 90% of the information coming into the brain on a daily basis is from proprioception. That is, 90% of the information is from our muscles and our joints. A sedentary lifestyle reduces this flow of information, reducing the survivability of neurons in the central nervous system. Exercise also keeps the heart healthy, and a healthy heart means a healthy brain.

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Filed under Brain Health, Diet