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Zhu J, Xu P, Yan W, Hu Y, Guo H, Chen F, Bigambo FM, Wang X. The influence of multivitamins on neurological and growth disorders: a cross-sectional study. Front Nutr 2024; 11:1465875. [PMID: 39385784 PMCID: PMC11463060 DOI: 10.3389/fnut.2024.1465875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 09/11/2024] [Indexed: 10/12/2024] Open
Abstract
Background While vitamin deficiencies can pose serious health consequences for the body, excessive intake of vitamins can also lead to health risks. However, there is limited data about the impact of multivitamins on neurological and growth disorders. This study aimed to investigate the relationship between multivitamins and neurological and growth disorders. Methods A cross-sectional study was conducted with 16,921 subjects who visited the Children's Hospital of Nanjing Medical University from 2019 to 2021. The subjects were categorized into two groups based on their health status including 9,368 cases (4,484 with neurological disorders and 4,884 with growth disorders) and 7,553 healthy controls. Statistical tests including the T-test, Wilcoxon Rank Sum test, and Chi-Square test were employed to compare the groups, and logistic regression and Weighted Quantile Sum (WQS) regression were used to identify associations. Results In the adjusted logistic regression, serum 25 hydroxyvitamin D [25(OH)D], vitamin B2, and vitamin B9 were associated with decreasing risks of neurological disorders, whereas vitamin A, vitamin B1, and vitamin B12 were associated with increasing risks of neurological disorders. Nevertheless, vitamin A and vitamin B2 were associated with increasing risks of growth disorders. In the WQS model, nine multivitamins were positively associated with risks of neurological disorders, and Vitamins D and C were weighted the most. In addition, the inverse association but not statistically significant was observed between multivitamins and growth disorders, particularly growth retardation revealed a negative association, and some individual growth disorders revealed positive associations including obesity and malnutrition. Conclusion In general, the study observed that multivitamins may be associated with neurological and growth disorders either positive or negative depending on the type of disorder.
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Affiliation(s)
- Jiaxiao Zhu
- Department of Pediatrics, Nanjing Medical University, Nanjing, China
| | - Penghong Xu
- Department of Emergency, Pediatric Intensive Care Unit, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Wu Yan
- Clinical Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yahui Hu
- Pharmaceutical Sciences Research Center, Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Hongli Guo
- Pharmaceutical Sciences Research Center, Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Feng Chen
- Pharmaceutical Sciences Research Center, Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing, China
| | | | - Xu Wang
- Clinical Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China
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Carrazana R, Espinoza F, Ávila A. Mechanistic perspective on the actions of vitamin a in autism spectrum disorder etiology. Neuroscience 2024; 554:72-82. [PMID: 39002756 DOI: 10.1016/j.neuroscience.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 05/07/2024] [Accepted: 07/08/2024] [Indexed: 07/15/2024]
Abstract
Vitamin A (VA) has many functions in the body, some of which are key for the development and functioning of the nervous system, while some others might indirectly influence neural function. Both hypovitaminosis and hypervitaminosis A can lead to clinical manifestations of concern for individuals and for general global health. Scientific evidence on the link between VA and autism spectrum disorder (ASD) is growing, with some clinical studies and accumulating results obtained from basic research using cellular and animal models. Remarkably, it has been shown that VA deficiency can exacerbate autistic symptomatology. In turn, VA supplementation has been shown to be able to improve autistic symptomatology in selected groups of individuals with ASD. However, it is important to recognize that ASD is a highly heterogeneous condition. Therefore, it is important to clarify how and when VA supplementation can be of benefit for affected individuals. Here we delve into the relationship between VA and ASD, discussing clinical observations and mechanistic insights obtained from research on selected autistic syndromes and laboratory models to advance in defining how the VA signaling pathway can be exploited for treatment of ASD.
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Affiliation(s)
- Ramón Carrazana
- Neurodevelopmental Biology Unit, Biomedical Sciences Research Laboratory, Basic Sciences Department, Faculty of Medicine, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Francisca Espinoza
- Neurodevelopmental Biology Unit, Biomedical Sciences Research Laboratory, Basic Sciences Department, Faculty of Medicine, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Ariel Ávila
- Neurodevelopmental Biology Unit, Biomedical Sciences Research Laboratory, Basic Sciences Department, Faculty of Medicine, Universidad Católica de la Santísima Concepción, Concepción, Chile.
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Conti MV, Santero S, Breda C, Basilico S, de Filippo G, Luzzi A, Voto L, Cavagnola R, Tomasinelli CE, Cena H. Autism Spectrum Disorder and collective catering service: results of the pilot study FOOD-AUT. Front Nutr 2024; 10:1298469. [PMID: 38268678 PMCID: PMC10806223 DOI: 10.3389/fnut.2023.1298469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/28/2023] [Indexed: 01/26/2024] Open
Abstract
Objective Individuals with Autism Spectrum Disorder (ASD) often exhibit a low dietary diversity due to food selectivity that leads them to a marked preference for high-energy-density food, exposing them to risk of malnutrition. Despite these aspects, specific recommendations and targeted menus for this population are missing. The pilot study FOOD-AUT addresses this issue by developing canteen menus meeting the nutritional and sensory needs of adults with ASD, aiming to reduce their food selectivity, and consequently improving their health. Methods The project, funded by Gruppo Pellegrini S.p.A, was conducted at the daycare service of Sacra Famiglia Onlus Foundation, between March-2022 to March-2023. The study was divided into two phases. Observational phase: a comparison was made between the enrolled subjects' nutritional needs and the nutrient content of the administered menus during the daycare service. Then mealtime compliance was assessed using standardized meal evaluation forms, both quantitative and qualitative. Intervention phase: canteen menus targeted to the individuals' nutritional and sensory needs were administered and their acceptability was evaluated. Results Twenty-two individuals with ASD, aged 19-48, 72.7% males, were enrolled. Overweight and obesity prevalence were 54.5 and 18.2%, respectively. The observational phase showed how the most accepted foods had specific sensorial characteristics in line with the scientific literature. Adapting the menus improved food acceptance and reduced food waste. Conclusion The results highlighted the need for adapted menus and greater attention to the way meals are delivered and consumed to improve nutritional status and therefore health of this population at increased risk of malnutrition. Clinical trial registration ClinicalTrial.gov, unique identifier: NCT05978895.
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Affiliation(s)
- Maria Vittoria Conti
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Sara Santero
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Chiara Breda
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Sara Basilico
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Giorgia de Filippo
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Alessia Luzzi
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- School of Nutrition Science, University of Milan, Milan, Italy
| | - Luana Voto
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Rebecca Cavagnola
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Chiara Elena Tomasinelli
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Clinical Nutrition Unit, General Medicine, ICS MAUGERI IRCCS, Pavia, Italy
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Ornoy A, Echefu B, Becker M. Valproic Acid in Pregnancy Revisited: Neurobehavioral, Biochemical and Molecular Changes Affecting the Embryo and Fetus in Humans and in Animals: A Narrative Review. Int J Mol Sci 2023; 25:390. [PMID: 38203562 PMCID: PMC10779436 DOI: 10.3390/ijms25010390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
Valproic acid (VPA) is a very effective anticonvulsant and mood stabilizer with relatively few side effects. Being an epigenetic modulator, it undergoes clinical trials for the treatment of advanced prostatic and breast cancer. However, in pregnancy, it seems to be the most teratogenic antiepileptic drug. Among the proven effects are congenital malformations in about 10%. The more common congenital malformations are neural tube defects, cardiac anomalies, urogenital malformations including hypospadias, skeletal malformations and orofacial clefts. These effects are dose related; daily doses below 600 mg have a limited teratogenic potential. VPA, when added to other anti-seizure medications, increases the malformations rate. It induces malformations even when taken for indications other than epilepsy, adding to the data that epilepsy is not responsible for the teratogenic effects. VPA increases the rate of neurodevelopmental problems causing reduced cognitive abilities and language impairment. It also increases the prevalence of specific neurodevelopmental syndromes like autism (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). High doses of folic acid administered prior to and during pregnancy might alleviate some of the teratogenic effect of VPA and other AEDs. Several teratogenic mechanisms are proposed for VPA, but the most important mechanisms seem to be its effects on the metabolism of folate, SAMe and histones, thus affecting DNA methylation. VPA crosses the human placenta and was found at higher concentrations in fetal blood. Its concentrations in milk are low, therefore nursing is permitted. Animal studies generally recapitulate human data.
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Affiliation(s)
- Asher Ornoy
- Department of Morphological Sciences and Teratology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel; (B.E.); (M.B.)
- Department of Medical Neurobiology, Hebrew University Hadassah Medical School, Jerusalem 9112102, Israel
| | - Boniface Echefu
- Department of Morphological Sciences and Teratology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel; (B.E.); (M.B.)
| | - Maria Becker
- Department of Morphological Sciences and Teratology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel; (B.E.); (M.B.)
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Conti MV, Breda C, Basilico S, Luzzi A, Voto L, Santero S, De Filippo G, Cena H. Dietary recommendations to customize canteen menus according to the nutritional and sensory needs of individuals with autism spectrum disorder. Eat Weight Disord 2023; 28:66. [PMID: 37526770 PMCID: PMC10393838 DOI: 10.1007/s40519-023-01590-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/13/2023] [Indexed: 08/02/2023] Open
Abstract
Individuals with autism spectrum disorders (ASD) are often characterized by food-selectivity, food-neophobia and a marked preference for mild flavor, semi-liquid foods with pale colors. Therefore, they adopt a monotonous dietary pattern, and they prefer ultra-processed food, leading to a high risk of developing malnutrition. In Italy, where 75,072 individuals are diagnosed with ASD, center-based services play a crucial role in their daily management. Despite the centrality of nutrition in maintaining a good state of health, even more for vulnerable subjects, no validated protocol at collective catering level has been developed yet. The manuscript presents customized dietary recommendations aimed at managing the meals for individuals with ASD at collective catering service, derived from a non-systematic literature review exploring food behaviors and nutritional needs in individuals with ASD. Simple practical tips for mealtimes, such as eating together, proper seating, lighting, smell control, presenting food in a simple manner and using the same type of tableware at each meal, to meet the needs of individuals with ASD, were described. The proposal could represent a starting point in developing official guidelines aimed at ASD individuals, in collective catering service.Level of Evidence: Level V.
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Affiliation(s)
- Maria Vittoria Conti
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, Italy.
| | - Chiara Breda
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, Italy
| | - Sara Basilico
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, Italy
| | - Alessia Luzzi
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100, Pavia, Italy
- Post Graduate Course in Food Science and Human Nutrition, Università Statale di Milano, 20122, Milan, Italy
| | - Luana Voto
- Department of Translational Medical Science, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- ImmunoNutritionLab at the CEINGE-Biotecnologie Avanzate s.c.ar.l Research Center, University of Naples Federico II, 80131, Naples, Italy
| | - Sara Santero
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, Italy
| | - Giorgia De Filippo
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, Italy
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100, Pavia, Italy
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Kacimi FE, Ed-Day S, Didou L, Azzaoui FZ, Ramchoun M, Arfaoui A, Boulbaroud S. Narrative Review: The Effect of Vitamin A Deficiency on Gut Microbiota and Their Link with Autism Spectrum Disorder. J Diet Suppl 2023; 21:116-134. [PMID: 36905650 DOI: 10.1080/19390211.2023.2179154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023]
Abstract
Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders defined by a lack of social behaviors, repetitive behaviors and nonverbal interactions, such as limited eye contact, facial expression, and body gesturing. It is not a single condition, but rather a multi-factorial disorder caused by hereditary and non-genetic risk factors, as well as their interaction. According to several studies, the gut microbiota may have a role in the pathophysiology of autism spectrum disorder. Various studies have found differences in the composition of the gastrointestinal (GI) microbiota in children with ASD compared to unaffected siblings and/or healthy unrelated controls. The processes that relate the gut microbiota to brain dysfunctions (the gut-brain axis) in ASD are yet to be fully understood. However, the differences in the gastrointestinal composition might be due to vitamin A deficiency because vitamin A (VA) plays a role in the regulation of the intestinal microbiota. This narrative review discusses the impact of vitamin A deficiency on the gut microbiota composition and tries to understand how this may contribute for the development and severity of ASD.
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Affiliation(s)
- Fatima Ezzahra Kacimi
- Biotechnology and Sustainable Development of Natural Resources Unit, Polydisciplinary Faculty, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - Soumia Ed-Day
- Equip of Clinic and Cognitive Neurosciences and Health, Laboratory of Biology and Health, Department of Biology, Faculty of Science, Ibn Tofail University, Kenitra, Morocco
| | - Latifa Didou
- Equip of Clinic and Cognitive Neurosciences and Health, Laboratory of Biology and Health, Department of Biology, Faculty of Science, Ibn Tofail University, Kenitra, Morocco
| | - Fatima Zahra Azzaoui
- Equip of Clinic and Cognitive Neurosciences and Health, Laboratory of Biology and Health, Department of Biology, Faculty of Science, Ibn Tofail University, Kenitra, Morocco
| | - Mhamed Ramchoun
- Biotechnology and Sustainable Development of Natural Resources Unit, Polydisciplinary Faculty, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - Asma Arfaoui
- Biotechnology and Sustainable Development of Natural Resources Unit, Polydisciplinary Faculty, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - Samira Boulbaroud
- Biotechnology and Sustainable Development of Natural Resources Unit, Polydisciplinary Faculty, Sultan Moulay Slimane University, Beni Mellal, Morocco
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