Brain development & infant nutrition

Dr. Sheetal Gandhi

Brain : facts..
- 100 billion or so neurons. - 50 trillion connections between them. - The 400 miles of capillaries in the human brain have a surface area of approximately 100 square feet. - Basic wiring is determined by genes. In early infancy, connections increase 20-fold suggesting that experience -all the signals that a baby receives from the world after birth determine these later connections.

Brain : facts..
During brain development, 2.5 lacs of neurons may be added in one minute !! -By 2 yrs of age, brain attends 80 % of adult size.

Use it or lose it. Early experiences including deprivation actually change the structure of the brain. There is wiring for speech, motor, vision, and feelings. Parents are the brains first and most important teacher.!!

Tools to handle brain

Transcranial magnetic stimulation CHARM analysis - high throughput platform for analysis of DNA methylation across the human genome Comprehensive High-Throughput Arrays for Relative Methylation, fMRI functional MRI tDCS - Transcranial direct current stimulation

Transcranial magnetic stimulation

MRI-compatible transcranial magnetic stimulation coil
Produces magnetic field

Induces electric current in underlying neurons

Increases firing by the neurons

Increased firing by connected neurons

More oxygenated blood drawn to the region of increased firing

fMRI

Map of connectivity can be drawn

A Healthy Start
Good nutrition is key to the child's

growth and development at every age: Physically Socially Emotionally Cognitively Linguistically mental development : Directly: compromising the structural development of the brain. Indirectly: suppressing the childs motor activities and thus lessening environmental stimulation.

Prolonged child malnutrition can impair

Facts : Brain Development

Brain development that

takes place prenatally and in the first year of life is more rapid and extensive than previously suspected; much more vulnerable to environmental influence than we ever suspected;

Brain development is

Facts : Brain Development

The influence of early

environment on brain development is long lasting; The environment affects not only the number of brain cells and number of connections among them, but also the way these connections are "wired;" Early stress has a negative impact on brain development.

Brain : multifacts
Nutrition Antenatal events Maternal mental status

Genetic composition
Environment & family economics

Brain development

Perinatal events

Prematurity / LBW

Education Social factors

Postnatal events

Malnutrition: multi-effects
Behaviour Learning Communication Analytical thinking Cognition

Malnutrition

Physical development

Education Social adaptability

Environmental adaptability

Malnutrition
Malnutrition impairs brain development by - decreasing the number of cell replication cycles, - reducing total brain DNA, - restricting dendritic arborization thus reducing the connections between neurons. - disturbing sleep-wake cycles & neuro-vegetative activities during sleep

Malnutrition
Intrauterine malnutrition and early postnatal malnutrition specially affect brain cell number. The development of the cerebellum is most affected by nutritional deprivation around the time of birth.

Synaptic connectivity is particularly affected if malnutrition occurs after birth but before the third year of life.

At the DNA level

Genetic code Dietary factors( micro-nutrients)

Vit. C, E Vit. B2, B6, B12 Folic acid Niacin Zn, Fe, Mg, Mn
-- Cofactors -- Enzymatic reactions -- Substrates in metabolism

DNA metabolism & repair

Nutritional genomics of Genome stability

Micro-nutrient deficiency

Birth defects

Gene- diet interaction

DNA repair or anti-oxidant enzyme defect Brain malformations

DNA damage
Mental retardation Cognitive & psycho-social problems

Gene-oxidant interaction
Oxidative stress

Nutrition & Intelligence The Definition of Intelligence is

controversial. !!!

Diet & Neurotransmitters

Chemical secretions that affect the formation, maintenance, activity, and longevity of synapses and neurons Excite or inhibit function Over 50 neurotransmitters identified: Endorphins Serotonin Dopamine Melatonin Noradrenaline

Diet & neuro-transmitters

Dietary factor Aspartic acid Glutamic acid Choline Neuro-transmitter Aspartate Glutamate Acetyl choline Found in peanuts, potatoes, eggs and grain flour and potatoes eggs, liver and soybeans

Phenyl-alanine
Tryptophan Tyrosine

Dopamine
Serotonin Nor-epinephrine

beets, soybeans, almonds, eggs, meat and grains

eggs, meat, milk, bananas, yogurt and cheese milk, meat, fish and legumes

Serotonin: An Impulse Modulator

Low levels = an adaptation to a threatening environment impulsive, aggressive behavior Normal levels = clear thinking, social success High levels = response to an overwhelming environmental threat fearfulness, anxiety, obsessive- compulsiveness

Noradrenalin: An Alarm Hormone

- High levels trigger over-arousal and tendency toward impulsive hot blooded acts of violence.

- Low levels trigger cold blooded acts.

Micro-nutrients
Iodine Iron Zinc Magnesium Mangenese

Iodine
Iodine deficiency is the most important and widespread nutrient deficiency: It causes endemic cretinism associated with deaf-mutism and cerebral palsy. Iodine deficiency during pregnancy causes both maternal and fetal hypothyroxinemia, resulting in irreversible impairment of brain development at a critical stage. Critical period 2nd 3rd trimestor Duration of hypothyroidism important.

Thyroxine-Dependent-Human Brain Development

PHASE I

PHASE II

PHASE III

0
Maternal T4

12 wks
Fetal T4

birth
Neonatal T4

1 yr 1 yr

12 wks Cerebral neurogenesis & migration

birth

Neuronal differentiation, Axonal outgrowth, Dendritic ontogeny, synaptosis, Cerebellar neurogenesis, Gliogenesis

Myelinogenesis

In utero -Abortion -Endemic

Neonates

Preschool age -Mental deficiency -Psychomotor defect

School age Adult -Multinodular goiter and its consequences -Goiter

cretins
-Stillbirths -Increased perinatal mortality - congenital hypothyroidism

IDD ICEBERG
Cretinism 1-10 %

5-30 % Some Brain Damage

30-70 % loss of Energy / Learning difficulties due to Hypothyroidism

Zinc
There is a close association between zinc and folic acid in the diet, and zinc is thought to be involved in the absorption of folic acid both of them may be involved in prevention of neural tube defects.

Nutrition during pregnancy

Folic acid deficiency (Biotech Week, 2004)
Anencephaly = irregular brain formation Stem cell division Lifelong brain impairment

The fatty issue

Brain 2/3 is composed of fats.
Animal life first originated in the sea

Abundance of omega-3 fatty acids

Essential components of our eyes' photo- receptors and our brain's cell membranes.

The fatty issue

omega-6 fatty acids

omega-3 and omega-6 fatty acid families existed on earth together

new set of species with bigger brains

Omega 3 & 6..

Alpha-linolenic acid (ALA) - ALA is the foundation of the "omega-3" family of fatty acids. Food sources - flax seeds, chia seeds, walnuts, sea vegetables, and green leafy vegetables. Linoleic acid (LA) - LA is the foundation of the "omega-6" family of fatty acids. Food sources of - cold-pressed sunflower, safflower, corn, and sesame oils.

Oleic acid
Myelin - 30% protein and 70% fat. Main fatty acid in myelin is oleic acid, which is also the most abundant fatty acid in human milk and in our diet. Healthy mono-unsaturated fats are found in olive oil, avocados, peanuts, walnuts, almonds, pecans, chicken, beef, eggs, as well as in sesame, palm, corn, sunflower, and soybean oils.

The DHA & AA

From ALA and LA, our brain can make (docosahexaenoic acid) DHA and (arachidonic acid) AA - the longer chained fatty acids that are incorporated in its cell membranes. These more complex fatty acids are also available, preformed, directly from food. This is important, because the brain's ability to assemble these fatty acids can be compromised by stress, infections, alcohol, excess sugar, and vitamin or mineral deficiencies factors common today.

DHA
DHA - most abundant fat in the brain. DHA & AA - crucial to the optimal development of the brain and eyes. During pregnancy the mother supplies the developing fetus with these fatty acids, and she continues to provide this important brain food to her infant through breast milk. Loss in DHA concentrations in brain cell membranes correlates with cognitive impairment, depression. neurodegenerative disorders such as Parkinson's and Alzheimer's appear to exhibit membrane loss of fatty acids.

The fatty issue

Low essential fatty acids in fetal umbilical cords correlate to low birth weight, small head circumference, and low placental size. imbalance of omega-3 and omega-6 fatty acids may lead to a variety of mental disorders, including hyperactivity, depression and schizophrenia. This imbalance can be corrected by eating more omega-3-rich fish and flax seed oil, by eating less sugar, and by completely avoiding trans fatty acids found in partially-hydrogenated oils, margarine, and shortening.

Trans fats..
Dietary trans fatty acids found their way into the myelin of brain cells, where they changed the electrical conductivity of the cells. Furthermore, when the diets were already deficient in omega-3 ALA (alpha-linolenic acid), then the incorporation of trans fats was apparently doubled.

Trans fats in breast milk

In a Canadian study of human breast milk, trans fatty acids (TFAs) averaged 7.2% of the total fatty acids. Partially hydrogenated vegetable oils were determined to be the major source of these unnatural fats. Also, levels of LA (linoleic) and ALA were inversely related to the total TFAs, indicating that the elevation of TFAs in Canadian human milk is at the expense of essential omega-3 and omega-6 fatty acids.

Trans fats
Trans fatty acids found in foods like french fries, margarine, potato chips and anything else with partially hydrogenated oil disrupt communication in our brain. These altered fats will pack more tightly together into the cell membrane, making it more saturated and rigid less flexible and less able to function properly. Trans fatty acids are rarely found in nature and are mostly man made.

Breast milk magic

IQs of breast-fed babies are higher than that of formulafed babies. nutrients in breast milk and maternal bonding have beneficial effects on IQ.

Infants deprived of breast milk are likely to have lower IQ, lower educational achievement.

Breast milk magic

Breast milk - the long-chain polyunsaturated fatty acids (LC PUFAs) - play important roles in brain development. The most well-known is docosahexanoic acid (DHA). DHA helps the brain manufacture myelin. Breast milk - Cholesterol - important for brain development. Like DHA, cholesterol is crucial to the production of myelin. At present, infant formulas do not contain cholesterol.

Breast milk magic

Adding DHA (docosahexaenoic acid) and AA (arachidonic acid) to infant formula significantly boosted the average intelligence scores in a group of children.

Every wife probably thinks that

.her husband is MORON.

If breast feeding improves IQ .should

Moron husbands Be more frequently put on breast..??

Acetyl-L-carnitine
Acetyl-L-carnitine is able to cross into the brain more effectively than regular carnitine. Acts as a powerful antioxidant and increases levels of acetylcholine. It is acetylcholine which becomes deficient in the brains of Alzheimers.

Acetyl-L-carnitine
Prevents hypoxic brain damage - very helpful for stroke victims. Reduces the amounts of damaged fats such as lipofuscin in the brains of aged - useful in the prevention and treatment of free-radical mediated diseases such as Alzheimers and Parkinsons disease.

Acetyl-L-carnitine
Increases levels of nerve growth factor (NGF)also increases the ability of the body to use NGF more effectively. Helps maintain the myelin sheath around the nerves Helps to preserve the genetic information (DNA and RNA) in our cells.

Iron frame for brain..

ID during gestation/lactation alters neurometabolism, neurotransmitters, myelination, and gene/protein profiles before and after iron repletion at weaning.

Iron frame for brain..

Human infants with iron deficiency anemia test lower in cognitive, motor, social-emotional, and neurophysiologic development than comparison group infants Iron therapy does not consistently improve developmental outcome, with long-term differences observed.

Iron frame for brain..

The acquisition of iron by the brain is an agerelated and brain-region-dependent process with tightly controlled rates of movement of iron across the blood-brain barrier. Dopamine receptors and transporters are altered as are behaviors related to this neurotransmitter. brain iron deficiency in early life has multiple consequences in neurochemistry and neurobiology.

Take home message..

Pay close attention to maternal

diet & health. Encourage breast feeding. Look for foods with lower levels of saturated fats & trans fats. Micro-nutrients especially I,Fe, Mg, Mn, Zn & vitamins especially vit B2,6,12 , folic acid, niacin, vit C, E are important dietary components. Know what your child is eating & set a good example. Balance the food with physical activity.

Like Beer bars..

Dr. Munnabhai will set up Nutri- bar..

where Pregnant Bipasha will demand for a nutri-cocktail which will make her daughter
as beautiful as Madhubala as intelligent as V. Anand as graceful as Rekha as humble as Amitabh &.. & &.

At the end..
To define
optimal growth &

nutrition is
as difficult as

finding a perfect
HUSBAND..

Perfect HUSBAND..
B-rave I-ntelligent G-entle P-olite E-nergetic N-utty I-ndustrious S-ensitive Well.you may only read the capital letters &. achieve perfection!!!