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Dr. Sheetal Gandhi
Brain development
&
infant nutrition
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- 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 receivesfrom the world after birth -
determine these later
connections.
Brain : facts..
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Brain : facts..
During braindevelopment,
2.5 lacs of neurons
may be
added in oneminute !!
-By 2 yrs of age,
brain attends
80 % of adult size.
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Use it or lose it.
Early experiences
including deprivationactually change thestructure of thebrain.
There is wiring for
speech, motor,vision, and feelings.
Parents are thebrains first and
most importantteacher.!!
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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 RelativeMethylation,
fMRI functional MRI
tDCS - Transcranial direct current stimulation
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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
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A Healthy Start
Good nutrition is key to the child'sgrowth and development at every age:
Physically
Socially
Emotionally
Cognitively Linguistically
Prolonged child malnutrition can impairmental development :
Directly: compromising thestructural development of thebrain.
Indirectly: suppressing the childsmotor activities and thus lesseningenvironmental stimulation.
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Facts : Brain Development
Brain development thattakes place prenatallyand in the first year oflife is more rapid andextensive than
previously suspected;
Brain development ismuch more vulnerable
to environmentalinfluence than we eversuspected;
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Facts : Brain Development
The influence of earlyenvironment on braindevelopment is longlasting;
The environment affects
not only the number ofbrain cells and numberof connections amongthem, but also the waythese connections are"wired;"
Early stress has anegative impact on braindevelopment.
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Brain : multifacts
Braindevelopment
Environment
& family
economics
Genetic
composition
Nutrition
Education
Social
factors
Prematurity /
LBW
Perinatal events
Antenatal eventsMaternal mental status
Postnatal
events
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Malnutrition: multi-effects
MalnutritionAnalyticalthinking
Learning
Behaviour
Education
Social
adaptability
Communication
Cognition
Environmental
adaptability
Physical
development
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Malnutrition
Malnutrition impairs brain
development by- decreasing the number of
cell replication cycles,
- reducing total brain DNA,- restricting dendritic
arborization thus reducing theconnections between neurons.
- disturbing sleep-wake cycles& neuro-vegetative activitiesduring sleep
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Malnutrition
Intrauterine malnutrition and early postnatalmalnutrition specially affect brain cell number.
The development of the cerebellum is mostaffected 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.
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At the DNA level
DNAmetabolism
&
repair
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
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Nutritional genomics of Genome stability
DNA damageDNA repair or
anti-oxidant
enzyme defect
Gene- diet
interaction
Micro-nutrient
deficiency
Gene-oxidant
interactionOxidative
stress
Birth defects
Brain malformations
Mental retardation
Cognitive &
psycho-social
problems
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Nutrition & Intelligence
The
Definition
ofIntelligence
is
controversial. !!!
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Diet & Neurotransmitters
Chemical secretions that affect the formation,maintenance, activity, and longevity of synapsesand neurons
Excite or inhibit function
Over 50 neurotransmitters identified:
Endorphins
Serotonin
DopamineMelatonin
Noradrenaline
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Dietary factor Neuro-transmitter Found in
Aspartic acid Aspartate peanuts, potatoes, eggs and
grain
Glutamic acid Glutamate flour and potatoes
Choline Acetyl choline eggs, liver and soybeans
Phenyl-alanine Dopamine beets, soybeans, almonds,
eggs, meat and grains
Tryptophan Serotonin eggs, meat, milk, bananas,
yogurt and cheese
Tyrosine Nor-epinephrine milk, meat, fish and legumes
Diet & neuro-transmitters
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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 anoverwhelming environmental threat
fearfulness, anxiety,
obsessive- compulsiveness
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Noradrenalin: An Alarm Hormone
- High levels trigger over-arousaland tendency toward impulsive hot
blooded acts of violence.
- Low levels trigger cold blooded acts.
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Micro-nutrients
Iodine
Iron
Zinc Magnesium
Mangenese
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Iodine
Iodine deficiency is the most important andwidespread nutrient deficiency:
It causes endemic cretinism associated withdeaf-mutism and cerebral palsy.
Iodine deficiency during pregnancy causesboth maternal and fetal hypothyroxinemia,resulting in irreversible impairment of brain
development at a critical stage. Critical period2nd3rd trimestor
Duration of hypothyroidism important.
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0 12 wks birth 1 yr
PHASE I
Thyroxine-Dependent-Human Brain Development
PHASE II PHASE III
Neuronal differentiation, Axonal outgrowth,Dendritic ontogeny, synaptosis,Cerebellar neurogenesis, Gliogenesis
Myelinogenesis
Cerebral neurogenesis & migration
0 12 wks birth 1 yr
Maternal T4 Fetal T4 Neonatal T4
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Adult
-Multinodular
goiter and its
consequences
In utero
-Abortion
-Endemic
cretins
Neonates
-Stillbirths
-Increased
perinatal
mortality
- congenital
hypothyroidism
Preschool age
-Mental deficiency
-Psychomotor
defect
School age
-Goiter
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Cretinism
1-10 %
5-30 %
Some Brain Damage
30-70 %
loss of Energy /
Learning difficulties
due to
Hypothyroidism
IDD ICEBERG
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Zinc
There is a close
association between
zinc and folic acid in the
diet, and zinc is thoughtto be involved in the
absorption of folic acid
both of them may be
involved in prevention
of neural tube defects.
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Nutrition during pregnancy
Folic acid deficiency
(Biotech Week, 2004)
Anencephaly =
irregular brain
formation
Stem cell division
Lifelong brain
impairment
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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- receptorsand our brain's cell membranes.
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The fatty issue
new set of species with bigger brains
omega-6 fatty acids
omega-3 and omega-6 fatty acid families
existed on earth together
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Omega 3 & 6..
Alpha-linolenic acid (ALA) - ALA is thefoundation of the "omega-3" family of fattyacids.
Food sources - flax seeds, chia seeds,
walnuts, sea vegetables, and green leafyvegetables.
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.
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Oleic acid
Myelin - 30% protein and 70% fat.
Main fatty acid in myelin is oleic acid, which isalso 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.
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The DHA & AA
From ALA and LA, our brain can make(docosahexaenoic acid) DHA and (arachidonicacid) AA - the longer chained fatty acids thatare 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 toassemble these fatty acids can be
compromised by stress, infections, alcohol,excess sugar, and vitamin or mineraldeficiencies factors common today.
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DHA
DHA - most abundant fat in the brain.
DHA & AA - crucial to the optimal developmentof the brain and eyes. During pregnancy themother supplies the developing fetus with thesefatty acids, and she continues to provide this
important brain food to her infant through breastmilk.
Loss in DHA concentrations in brain cellmembranes correlates with cognitive
impairment, depression. neurodegenerative disorders such as Parkinson's
and Alzheimer's appear to exhibit membrane lossof fatty acids.
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The fatty issue
Low essential fatty acids in fetal umbilical cords
correlate to low birth weight, small headcircumference, and low placental size.
imbalance of omega-3 and omega-6 fatty acids may
lead to a variety of mental disorders, includinghyperactivity, depression and schizophrenia.
This imbalance can be corrected by eating moreomega-3-rich fish and flax seed oil, by eating less sugar,and by completely avoiding trans fatty acids found inpartially-hydrogenated oils, margarine, and shortening.
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Trans fats..
Dietary trans fatty acids foundtheir way into the myelin ofbrain cells, where they changedthe electrical conductivity of the
cells.
Furthermore, when the dietswere already deficient in
omega-3 ALA (alpha-linolenicacid), then the incorporation oftrans fats was apparentlydoubled.
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Trans fats in breast milk
In a Canadian study of human breast milk,trans fatty acids (TFAs) averaged 7.2% of thetotal fatty acids.
Partially hydrogenated vegetable oils were
determined to be the major source of theseunnatural fats.
Also, levels of LA (linoleic) and ALA were
inversely related to the total TFAs, indicatingthat the elevation of TFAs in Canadian humanmilk is at the expense of essential omega-3and omega-6 fatty acids.
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Trans fats
Trans fatty acids found in foods like french fries,margarine, potato chips and anything else withpartially hydrogenated oil disrupt communicationin our brain.
These altered fats will pack more tightly togetherinto the cell membrane, making it more saturatedand rigid less flexible and less able to function
properly. Trans fatty acids are rarely found in nature and
are mostly man made.
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Breast milk magic
IQs of breast-fed babies arehigher than that of formula-fed babies.
nutrients in breast milk andmaternal bonding havebeneficial effects on IQ.
Infants deprived of breastmilk are likely to have lowerIQ, lower educationalachievement.
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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.
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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.
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Every wife probably thinks that
.herhusbandis
MORON.
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.shouldMoronhusbandsBemore
frequentlyputon
breast..??
If breast feeding improves IQ
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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.
l L
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Acetyl-L-carnitine
Prevents hypoxic brain damage - very helpfulfor stroke victims.
Reduces the amounts of damaged fats such aslipofuscin in the brains of aged - useful in the
prevention and treatment of free-radical
mediated diseases such as Alzheimers andParkinsons disease.
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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.
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Iron frame for brain..
ID during gestation/lactation alters
neurometabolism,neurotransmitters,
myelination, and
gene/protein profiles
before and after iron repletion at weaning.
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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.
I f f b i
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Iron frame for brain..
The acquisition of iron by the brain is an age-
related 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.
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Take home message..
Pay close attention to maternaldiet & health.
Encourage breast feeding. Look for foods with
lower levels of saturated fats &trans fats.
Micro-nutrients especially I,Fe,Mg, Mn, Zn & vitamins especiallyvit B2,6,12 , folic acid, niacin, vitC, E are important dietarycomponents.
Know what your child iseating & set a good example.
Balance the foodwith physical activity.
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Like Beer bars..
Dr. Munnabhaiwill set up
Nutri- bar..
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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
&..
&
&.
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At the end..
To define
optimal growth &nutrition is
as difficult as
finding a perfect
HUSBAND..
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Perfect HUSBAND..B-raveI-ntelligent
G-entle
P-olite
E-nergeticN-utty
I-ndustrious
S-ensitive
Well.you may only read the capital
letters &.
achieve perfection!!!
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