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Allahyari P, Abbas Torki S, Aminnezhad Kavkani B, Mahmoudi Z, Mousavi Hoseini MS, Moradi M, Alami F, Keshavarz Mohammadian M, Bahoo Sele Bani S, Abbasi Mobarakeh K, Shafaei H, Khoshdooz S, Hajipour A, Doaei S, Gholamalizadeh M. A systematic review of the beneficial effects of prebiotics, probiotics, and synbiotics on ADHD. Neuropsychopharmacol Rep 2024; 44:300-307. [PMID: 38623929 PMCID: PMC11144606 DOI: 10.1002/npr2.12437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/15/2024] [Accepted: 03/22/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Children with attention deficit hyperactivity disorder (ADHD) may benefit from probiotics and prebiotics, but the effects are unclear. To determine whether probiotics and prebiotics affect children with ADHD, a systematic review was conducted. METHODS The present systematic review analyzed cohort studies and randomized controlled trials that examined whether prebiotics and probiotics are associated with ADHD. Seven randomized controlled trials and two cohort studies met our inclusion criteria. RESULTS Research on Lactobacillus rhamnosus GG (LGG) probiotic supplementation showed that children with ADHD had better emotional, physical, social, and school functioning, and a higher health-related quality of life compared to the placebo group. The studies also showed that Synbiotic 2000 reduces markers of intestinal and vascular inflammation in children with ADHD, in part through increasing SCFA levels. CONCLUSION The use of probiotics and prebiotics as adjuvants therapy in patients with ADHD is beneficial. Further studies with longer duration, including more participants and a variety of age groups, and using various evaluation techniques such as in vivo observation are required to examine the effects of prebiotics and probiotics on ADHD.
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Affiliation(s)
- Pooneh Allahyari
- Department of Exercise Physiology, Faculty of Physical Education and Sport SciencesIslamic Azad University, Central Tehran BranchTehranIran
| | - Saheb Abbas Torki
- Department of Nutrition, Faculty of Nutrition SciencesShiraz University of Medical SciencesShirazIran
| | | | - Zahra Mahmoudi
- Department of Nutrition, Science and Research BranchIslamic Azad UniversityTehranIran
| | | | - Mahdi Moradi
- Department of Clinical PsychologyPayame Noor UniversityTehranIran
| | - Farkhondeh Alami
- Student Research Committee, Department of Nutrition, Faculty of MedicineUrmia University of Medical SciencesUrmiaIran
| | | | | | - Khadijeh Abbasi Mobarakeh
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food ScienceIsfahan University of Medical SciencesIsfahanIran
| | - Hanieh Shafaei
- Shahid Beheshti College of MidwiferyGilan University of Medical SciencesRashtIran
| | - Sara Khoshdooz
- Shahid Beheshti College of MidwiferyGilan University of Medical SciencesRashtIran
| | - Azadeh Hajipour
- School of HealthQazvin University of Medical SciencesQazvinIran
| | - Saeid Doaei
- Reproductive Health Research Center, Al‐Zahra HospitalGuilan University of Medical SciencesRashtIran
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Garon-Carrier G, Tiraboschi GA, Bernard JY, Matte-Gagné C, Laurent A, Lemieux A, Fitzpatrick C. Unraveling the effects of maternal breastfeeding duration and exclusive breast milk on children's cognitive abilities in early childhood. Front Public Health 2023; 11:1225719. [PMID: 38106907 PMCID: PMC10722166 DOI: 10.3389/fpubh.2023.1225719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/14/2023] [Indexed: 12/19/2023] Open
Abstract
Background This study investigated the putative associations between mothers' use of exclusive breast milk and the duration of breastfeeding with child cognitive development. Methods This study is based on 2,210 Canadian families with children assessed longitudinally from age 4 to 7 years on their memory-span and math skills. These cognitive abilities were measured with standardized tasks. Breastfeeding practices were collected via maternal reports. We applied propensity scores to control the social selection bias for breastfeeding. Results Results adjusted for propensity scores and sample weight revealed no significant differences between non-breastfed children with those being non-exclusively breastfed for 5 months or less, and with children being exclusively breastfed for 9.2 months on average, on their early math skills and memory-span. We found that children who were non-exclusively breastfed for 6.8 months on average had a slightly higher levels of memory-span at age 4 than children who were never breastfed, and this small but significant difference lasted up to age 7. Conclusion Our findings suggest no significant differences between children being exclusively breastfed and those fed with formula on their early math skills and memory-span. The encouragement of breastfeeding to promote child cognitive school readiness may, in some case (non-exclusive breastfeeding for more than 5 months), show a small but long-lasting advantage in early memory-span.
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Affiliation(s)
| | - Gabriel Arantes Tiraboschi
- Département de Psychoéducation, Université de Sherbrooke, Sherbrooke, QC, Canada
- Département d’enseignement au préscolaire et primaire, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jonathan Y. Bernard
- Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS)Université Paris Cité and Université Sorbonne Paris Nord, Paris, France
| | | | - Angélique Laurent
- Département d’enseignement au préscolaire et primaire, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Annie Lemieux
- Département de Psychoéducation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Caroline Fitzpatrick
- Département d’enseignement au préscolaire et primaire, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of childhood education, University of Johannesburg, Johannesburg, South Africa
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Gupta S, Taylor SN. Nutrition Management of High-Risk Neonates After Discharge. Clin Perinatol 2023; 50:653-667. [PMID: 37536770 DOI: 10.1016/j.clp.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Nutrition management of the high-risk infant after hospital discharge is complicated by the infant's dysfunctional or immature oral feeding skills, nutritional deficits, and the family's feeding plan. Although evidence is limited, available studies point to developing an individualized nutritional plan, which accounts for these factors; protects and prioritizes the family's plan for breastfeeding; and promotes an acceptable growth pattern. Further research is needed to identify the type and duration of posthospital discharge nutrition to optimize high-risk infant neurodevelopment and body composition. Attention to infant growth, lactation support, and safe feed preparation practices are critical in the transition to home.
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Affiliation(s)
- Shruti Gupta
- Department of Pediatrics, Yale School of Medicine, PO Box 208064, New Haven, CT 06520, USA
| | - Sarah N Taylor
- Department of Pediatrics, Yale School of Medicine, PO Box 208064, New Haven, CT 06520, USA.
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Belfort MB, Knight E, Chandarana S, Ikem E, Gould JF, Collins CT, Makrides M, Gibson RA, Anderson PJ, Simmer K, Tiemeier H, Rumbold A. Associations of Maternal Milk Feeding With Neurodevelopmental Outcomes at 7 Years of Age in Former Preterm Infants. JAMA Netw Open 2022; 5:e2221608. [PMID: 35816314 PMCID: PMC9280396 DOI: 10.1001/jamanetworkopen.2022.21608] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE Maternal milk feeding may have unique long-term neurodevelopmental benefits in very preterm infants. OBJECTIVE To examine the extent to which maternal milk feeding after very preterm birth is associated with cognitive, academic, and behavioral outcomes at school age. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study assessed 586 infants born at less than 33 weeks' gestation at 5 Australian perinatal centers and enrolled in the Docosahexaenoic Acid for Improvement of Neurodevelopmental Outcomes study (January 1, 2001, to December 31, 2005) who were evaluated at a corrected age of 7 years. The statistical analysis was completed on January 19, 2022. EXPOSURES Maternal milk intake, including mean volume (milliliters per kilogram per day) during neonatal hospitalization and total duration (in months). MAIN OUTCOMES AND MEASURES Neurodevelopmental outcomes at 7 years of age were (1) IQ (Wechsler Abbreviated Scale of Intelligence), (2) academic achievement (Wide Range Achievement Test, Fourth Edition), (3) symptoms of attention-deficit/hyperactivity disorder (ADHD) (Conners Third Edition ADHD Index, parent reported), (4) executive function (Behavior Rating Inventory of Executive Functioning, parent reported), and (5) behavior (Strengths and Difficulties Questionnaire, parent reported). RESULTS A total of 586 infants (mean [SD] gestational age at birth, 29.6 [2.3] weeks; 314 male [53.6%]) born to 486 mothers (mean [SD] age, 30.6 [5.5] years; 447 [92.0%] White) were included. Mean (SD) maternal milk intake in the neonatal intensive care unit was 99 (48) mL/kg daily, and mean (SD) maternal milk duration was 5.1 (5.4) months. Mean (SD) full-scale IQ was 98.5 (13.3) points. After covariate adjustment, higher maternal milk intake during the neonatal hospitalization was associated with higher performance IQ (0.67 points per additional 25 mL/kg daily; 95% CI, 0.10-1.23 points), reading scores (1.14 points per 25 mL/kg daily; 95% CI, 0.39-1.89 points), and math scores (0.76 points per 25 mL/kg daily; 95% CI, 0.14-1.37 points) and fewer ADHD symptoms (-1.08 points per 25 mL/kg daily; 95% CI, -1.96 to -0.20 points). Longer duration of maternal milk intake was associated with higher reading (0.33 points per additional month; 95% CI, 0.03-0.63 points), spelling (0.31 points per month; 95% CI, 0.01-0.62 points), and math (0.30 points per month; 95% CI, 0.03-0.58 points) scores. Maternal milk was not associated with improved full-scale IQ, verbal IQ, executive function, or behavior. Most associations were stronger among infants born at lower gestational ages, particularly less than 30 weeks (interaction P values <.01). CONCLUSIONS AND RELEVANCE In this cohort study of preterm infants, maternal milk feeding during the neonatal hospitalization and after discharge were associated with better school-age performance IQ and academic achievement and with a reduction in ADHD symptoms, particularly among infants born at less than 30 weeks' gestation.
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Affiliation(s)
- Mandy B. Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Emma Knight
- South Australian Health and Medical Research Institute Women and Kids, Adelaide, Australia
- University of Adelaide School of Public Health, Adelaide, Australia
| | - Shikha Chandarana
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Prevention and Community Health, Milken Institute of Public Health, George Washington University, Washington, DC
| | - Emmanuella Ikem
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jacqueline F. Gould
- South Australian Health and Medical Research Institute Women and Kids, Adelaide, Australia
| | - Carmel T. Collins
- South Australian Health and Medical Research Institute Women and Kids, Adelaide, Australia
| | - Maria Makrides
- South Australian Health and Medical Research Institute Women and Kids, Adelaide, Australia
| | - Robert A. Gibson
- South Australian Health and Medical Research Institute Women and Kids, Adelaide, Australia
| | - Peter J. Anderson
- Department of Pediatrics, The University of Melbourne, Royal Children’s Hospital, Victoria, Australia
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Karen Simmer
- Centre for Neonatal Research and Education, School of Pediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Henning Tiemeier
- University of Adelaide School of Public Health, Adelaide, Australia
| | - Alice Rumbold
- South Australian Health and Medical Research Institute Women and Kids, Adelaide, Australia
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Präventionskonzepte in der Frühgeborenenmedizin. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01486-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rodrigues C, Zeitlin J, Carvalho AR, Gonzaga D, Barros H. Behavioral and emotional outcomes at preschool age in children born very preterm: The role of breast milk feeding practices. Early Hum Dev 2022; 165:105535. [PMID: 35038626 DOI: 10.1016/j.earlhumdev.2021.105535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/10/2021] [Accepted: 12/22/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Breast milk feeding (BMF) improved neurodevelopment in children born very preterm (VPT, <32 weeks of gestation), but knowledge about its effect on other mental health outcomes remains limited. OBJECTIVE To estimate the association of BMF practices with behavioral and emotional problems at preschool age in children born VPT. METHODS We studied 263 children born VPT during 2011-12 and enrolled in the Portuguese EPICE cohort. At the age of 3, information on BMF initiation and duration was collected and behavioral and emotional problems were assessed using the parents' completed Child Behavior Checklist 1.5-5 years (CBCL/1½-5). Children were categorized for all CBCL/1½-5 sub-scales and for Diagnostic and Statistical Manual of Mental Disorders (DSM5)-oriented scales. Risk ratios were estimated to assess the association of BMF with subclinical/clinical problems, fitting a Poisson regression. RESULTS Behavioral or emotional subclinical/clinical problems were found in almost 20% of children (11.8% in the clinical range). BMF was consistently associated with lower adverse behavioral and emotional outcomes, particularly risks of externalizing problems, somatic complaints, aggressive behavior, as well as autism spectrum and attention deficit/hyperactivity symptoms, although the magnitude of the unadjusted risks was attenuated by adjustment for relevant confounders and wider confidence intervals included the null. CONCLUSION Lower exposure to BMF seemed to increase the risk of adverse behavioral and emotional outcomes at preschool age in children born VPT. These results raise questions about explanatory pathways and strengthen evidence underpinning BMF promotion for VPT children.
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Affiliation(s)
- Carina Rodrigues
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.
| | - Jennifer Zeitlin
- Université de Paris, CRESS, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), INSERM, INRA, F-75004 Paris, France
| | - Ana Raquel Carvalho
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Diana Gonzaga
- Centro Materno-Infantil do Norte, Centro Hospital Universitário do Porto, Porto, Portugal
| | - Henrique Barros
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
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Deng X, Yang M, Wang S, Zhou B, Wang K, Zhang Z, Niu W. Identification and Characterization of Influential Factors in Susceptibility to Attention Deficit Hyperactivity Disorder Among Preschool-Aged Children. Front Neurosci 2022; 15:709374. [PMID: 35173570 PMCID: PMC8841729 DOI: 10.3389/fnins.2021.709374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 12/23/2021] [Indexed: 11/13/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is the most common childhood-onset neurodevelopmental disorder. Currently, increasing amounts of attention have been focused on the epidemiologic profiling of ADHD in children, viewed as a continuously distributed risk dimension throughout the whole lifespan. This study aimed to identify and characterize potential influential factors susceptible to ADHD-related symptoms among preschool-aged children. A comprehensive questionnaire was self-designed for both children and their parents or guardians and was distributed to 30 kindergartens from Beijing and Hebei, collecting potential influential factors in susceptibility to ADHD. ADHD was assessed by the Conner’s Abbreviated Symptom Questionnaire (C-ASQ), and 7,938 children were analyzed. Least absolute shrinkage and selection operator (LASSO) regression and hierarchical degree of adjustment were used to control possible covariates. Five factors, namely, children’s secondhand smoking exposure, breastfeeding duration, sleep mode, maternal pregnancy smoking exposure, and parental self-rating for patience, were identified to be independently and significantly associated with ADHD susceptibility. Meanwhile, dose–response relationships were observed between breastfeeding duration, parental self-rating for patience, and ADHD-related symptoms. Finally, a nomogram model was created for predicting ADHD susceptibility based on significant and conventional attributes under each criterion.
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Affiliation(s)
- Xiangling Deng
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Min Yang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Shunan Wang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Bo Zhou
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Kundi Wang
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
- *Correspondence: Kundi Wang,
| | - Zhixin Zhang
- International Medical Services, China-Japan Friendship Hospital, Beijing, China
- China-Japan Friendship Hospital, Institute of Clinical Medical Sciences, Beijing, China
- Zhixin Zhang,
| | - Wenquan Niu
- International Medical Services, China-Japan Friendship Hospital, Beijing, China
- China-Japan Friendship Hospital, Institute of Clinical Medical Sciences, Beijing, China
- Wenquan Niu,
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Itoh A, Tanaka N, Fukunaga S, Nakano-Doi A, Matsuyama T, Nakagomi T, Tsuji M. Bifidobacterium breve during infancy attenuates mobility in low birthweight rats. Pediatr Int 2022; 64:e15209. [PMID: 35938576 DOI: 10.1111/ped.15209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/25/2022] [Accepted: 04/05/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Children with low birthweight (LBW) have a higher risk for developing attention-deficit/hyperactivity disorder, for which no prophylactic measure exists. The gut microbiota in infants with LBW is different from that in infants with normal birthweight and is associated with attention-deficit/hyperactivity disorder. Oral supplementation with Bifidobacterium has several health benefits, such as suppressing inflammation. METHODS We examined the effect of gavage supplementation with Bifidobacterium breve M-16V from postnatal days 1-21 in a rat model of intrauterine hypoperfusion. RESULTS The open-field test at 5 weeks of age (equivalent to human pubertal age) showed that rats in the LBW-vehicle group were marginally hyperactive compared with rats in the sham group, while rats in the LBW-B.breve group were significantly hypoactive compared with rats in the LBW-vehicle group. The gut microbiota in the LBW-vehicle group exhibited a profile significantly different from that in the sham group, whereas the gut microbiota in the LBW-B.breve group did not exhibit a significant difference from that in the sham group. Anatomical/histological evaluation at 6 weeks of age demonstrated that the brain weight and the cerebral areas on coronal sections were reduced in the LBW groups compared with the sham group. Probiotic supplementation did not ameliorate these morphological brain anomalies in LBW animals. The percentage of Iba-1+ cells in the brain was not different among the LBW-B.breve, LBW-vehicle, and sham groups. CONCLUSION Bifidobacterium breve supplementation during early life is suggested to have the potential to help children with LBW attenuate hypermobility in adolescence.
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Affiliation(s)
- Ayaka Itoh
- Department of Food and Nutrition, Kyoto Women's University, Kyoto, Japan
| | - Nao Tanaka
- Department of Food and Nutrition, Kyoto Women's University, Kyoto, Japan
| | - Sachiko Fukunaga
- Department of Food and Nutrition, Kyoto Women's University, Kyoto, Japan
| | - Akiko Nakano-Doi
- Laboratory of Neurogenesis and CNS Repair, Institute for Advanced Medical Sciences, Hyogo College of Medicine, Nishinomiya, Japan.,Department of Therapeutic Progress in Brain Diseases, Institute for Advanced Medical Sciences, Hyogo College of Medicine, Nishinomiya, Japan
| | - Tomohiro Matsuyama
- Department of Therapeutic Progress in Brain Diseases, Institute for Advanced Medical Sciences, Hyogo College of Medicine, Nishinomiya, Japan
| | - Takayuki Nakagomi
- Laboratory of Neurogenesis and CNS Repair, Institute for Advanced Medical Sciences, Hyogo College of Medicine, Nishinomiya, Japan.,Department of Therapeutic Progress in Brain Diseases, Institute for Advanced Medical Sciences, Hyogo College of Medicine, Nishinomiya, Japan
| | - Masahiro Tsuji
- Department of Food and Nutrition, Kyoto Women's University, Kyoto, Japan
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Prenatal exposure to persistent organic pollutants and metals and problematic child behavior at 3-5 years of age: a Greenlandic cohort study. Sci Rep 2021; 11:22182. [PMID: 34772976 PMCID: PMC8589846 DOI: 10.1038/s41598-021-01580-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 10/04/2021] [Indexed: 12/18/2022] Open
Abstract
High levels of persistent organic pollutants (POPs) and heavy metals are found in Arctic populations. POP and heavy metals are linked to impaired cognitive development. This study examined associations between prenatal POP and metals exposure and problematic child behavior using the Strength and Difficulties Questionnaire (SDQ). POPs and metals were measured in 102 pregnant Greenlandic women. During follow-up at 3–5 years, parents answered an assisted questionnaire including children’s SDQ scores. Associations were analyzed using linear and logistic regression analyses and adjusted for maternal plasma cotinine, educational level and age at delivery. In the adjusted analyses, the medium tertile of hexachlorobenzene (β = 3.06, p = 0.010), β-hexachlorocyclohexane (β = 3.58, p = 0.004) and trans-nonachlor (β = 2.06, p = 0.082) were positively associated with SDQ scores. The continuous cis-nonachlor (OR = 1.09, p = 0.079), dichloro-diphenyl-dichloroethylene (OR = 1.01, p = 0.077), trans-nonachlor (OR = 1.01, p = 0.091), and sum Organochlorine-Pesticides (OR = 1.00, p = 0.094) were positively associated with abnormal SDQ score and the continuous mirex (OR = 1.28, p = 0.096), oxychlordane (OR = 1.04, p = 0.066), and trans-nonachlor (OR = 1.02, p = 0.071) with abnormal hyperactivity score. We found no consistent evidence of associations between polychlorinated biphenyls, perfluoroalkylated substances and heavy metals and problematic behavior. Prenatal organochlorine pesticide exposure associated significantly with problematic behavior in 3–5 year old children.
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Current Evidence on the Role of the Gut Microbiome in ADHD Pathophysiology and Therapeutic Implications. Nutrients 2021; 13:nu13010249. [PMID: 33467150 PMCID: PMC7830868 DOI: 10.3390/nu13010249] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 12/14/2022] Open
Abstract
Studies suggest that the bidirectional relationship existent between the gut microbiome (GM) and the central nervous system (CNS), or so-called the microbiome–gut–brain axis (MGBA), is involved in diverse neuropsychiatric diseases in children and adults. In pediatric age, most studies have focused on patients with autism. However, evidence of the role played by the MGBA in attention deficit/hyperactivity disorder (ADHD), the most common neurodevelopmental disorder in childhood, is still scanty and heterogeneous. This review aims to provide the current evidence on the functioning of the MGBA in pediatric patients with ADHD and the specific role of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) in this interaction, as well as the potential of the GM as a therapeutic target for ADHD. We will explore: (1) the diverse communication pathways between the GM and the CNS; (2) changes in the GM composition in children and adolescents with ADHD and association with ADHD pathophysiology; (3) influence of the GM on the ω-3 PUFA imbalance characteristically found in ADHD; (4) interaction between the GM and circadian rhythm regulation, as sleep disorders are frequently comorbid with ADHD; (5) finally, we will evaluate the most recent studies on the use of probiotics in pediatric patients with ADHD.
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