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Published on Leave a comment on All Babies Have Fungi Living In Them

A new study has summarized what we know about fungi that live in and on babies - and yes, we all have fungi both on and within us. It's called the mycobiome. In healthy individuals all the microbes (bacteria, viruses, fungi, etc) live in balanced microbial communities, but the communities can become "out of whack" (dysbiosis) for various reasons, and microbes that formerly co-existed peacefully can multiply and become problematic. Or other pathogenic microbes can enter the community, and the person becomes ill.

In healthy adults, approximately 0.1% of the microbes in the adult intestine are fungi, from approximately 60 unique species. Most species live peacefully in the body, and some fungi even have health benefits (e.g., Saccharomyces boulardii prevents gastrointestinal disease). Some fungi that many view as no good and involved with diseases (e.g., Candida and Aspergillus) are also found normally in healthy people. Studies show that normally infants also have fungi. Some fungi that live in the baby's gut (thus detected in fecal samples) are Candida (including C. albicans), Saccharomyces, and Cladosporium. The researchers (from the Univ. of Minnesota) point out that the study of fungi in babies has been neglected and much more research needs to be done.

Whether an infant is born vaginally or through cesarean delivery (C-section) affects the composition of the baby's bacterial communities over the first 6 months of life. And similarly, it looks like when the baby passes through the birth canal, the baby is exposed to the mother's mycobiota (fungi), and then these colonize in the infant's gut. Babies born by C-section have some differences in their fungi, such as being colonized by the mother's skin fungi (such as Malassezia fungi). After birth, a parent kissing and touching the baby (skin to skin contact) also transmits microbes, including fungi, to the baby.

Whether a baby drinks breast milk or formula strongly affects the infant's bacteria within the GI tract. For example, breast-fed infants have more Bifidobacteria and Labctobacilli in their gut compared to formula-fed infants. One study found about 700 species of bacteria in breast milk. Thus, scientists think that human breast milk also influences the infant gut mycobiota (fungi), although this research still needs to be done.

Whether a baby is born prematurely or at term (gestational age) is important. For infants born prematurely, intestinal fungi can cause big problems, such as an overgrowth in the gut. For example, 10% of premature babies get invasive, systemic Candidiasis, and about 20% die. Some factors leading to this are: a naïve immune system, bacterial communities out of whack (dysbiosis) due to antibiotic exposure, and use of parenteral nutrition (because this doesn't contain all the microbes from the mother that are in breast milk). In premature infants, beneficial fungi such as S. boulardii, may help to regulate the growth of opportunistic fungal colonizers such as Candida.

it is clear that whether the baby received antibiotics is important. The bacterial community of infants is altered by exposure to antibiotics in both term and preterm infants. For example, in a lengthy study over the first 3 years of life, infants receiving multiple courses of antibiotics had bacterial community changes following antibiotics and their gut bacterial microbiome became less diverse (fewer species). Although most commonly used antibiotics do not directly act on fungi, anti-bacterial antibiotic exposure is associated with alterations to the mycobiota (fungi) -  such as increased rates of fungal colonization, fungal overgrowth, and changes in the fungal community. For ex., premature infants exposed to cephalosporin antibiotics have an increased risk for invasive Candidiasis (a fungal overgrowth).

Out of whack (dysbiotic) microbial communities, incuding fungi, are found in IBD (intestinal bowel diseases) in children. They have more of some fungi (e.g. Pichia jadinii and Candida parapsilosis) and less of Cladosporium cladosporiodes, and an overall decrease in fungal diversity in the gut, as compared to healthy children.

From BMC Medicine: Infant fungal communities: current knowledge and research opportunities

The microbes colonizing the infant gastrointestinal tract have been implicated in later-life disease states such as allergies and obesity. Recently, the medical research community has begun to realize that very early colonization events may be most impactful on future health, with the presence of key taxa required for proper immune and metabolic development. However, most studies to date have focused on bacterial colonization events and have left out fungi, a clinically important sub-population of the microbiota. A number of recent findings indicate the importance of host-associated fungi (the mycobiota) in adult and infant disease states, including acute infections, allergies, and metabolism, making characterization of early human mycobiota an important frontier of medical research. This review summarizes the current state of knowledge with a focus on factors influencing infant mycobiota development and associations between early fungal exposures and health outcomes. We also propose next steps for infant fungal mycobiome research....

Published on Leave a comment on Should Pregnant Women Be Warned To Avoid Licorice?

Avoid eating licorice during pregnancy? That licorice is a food to avoid during pregnancy (or only eat in tiny amounts) will be news to many. Most people think of licorice (or liquorice) as a candy, but it can also be used as a herbal medicine that can have negative health effects, especially in large doses (e.g, high blood pressure, loss of potassium). The licorice flavor comes from the root of the plant (licorice root). Licorice contains glycyrrhizin, which is in black licorice candy, and in some chewing gums, ice creams, syrups, soft drinks, supplements, herbal teas, and other products.

In 2016, the government of Finland warned against consuming licorice (including black licorice and salty licorice) during pregnancy. In the United States, the FDA does not warn pregnant women about eating licorice or licorice root. The National Institutes of Health (NIH) recommends that pregnant women avoid consuming large amounts of licorice root in food or taking it as a supplement. But how about small amounts of licorice? And what are possible effects during pregnancy?

A recent study in Finland compared children (average age of 12 1/2 years) whose mothers had either consumed little to no licorice during pregnancy or had consumed large amounts of licorice (high glycyrrhizin levels were calculated as more than 500 milligrams per week). Note that 500 mg glycyrrhizin is equal to 250 grams or 8.8 oz licorice. The researchers found that children whose mothers ate large amounts of licorice during pregnancy  were about 7 points lower on IQ tests, had poorer memory, and had higher rates of attention deficit/hyperactivity disorder problems than those whose mothers had eaten little or no licorice during pregnancy. High-consumption group girls had earlier and more advanced puberty, and were taller and heavier than those in the low-licorice group.

The researchers wrote that glycyrrhizin results in "glucocorticoid overexposure", which may affect the developing fetus, and the effects persist into early adolescence. The study researchers concluded that pregnant women should be informed that consumption of licorice and other food products containing glycyrrhizin may be associated with harm to their developing baby. A little licorice candy here and there during pregnancy seems to be OK (so don't panic!), but licorice or licorice root is not something that should be eaten or drunk (e.g.,in a tea) regularly. From Science Daily:

Pregnant women should avoid liquorice

A new Finnish study supports food recommendations for families with children in that women should avoid consuming large amounts of liquorice during pregnancy. The limit for safe consumption is not known. In the study, youths that were exposed to large amounts of liquorice in the womb performed less well than others in cognitive reasoning tests carried out by a psychologist. The difference was equivalent to approximately seven IQ points. Those exposed to liquorice also performed less well in tasks measuring memory capacity, and according to parental estimates, they had more ADHD-type problems than others. With girls, puberty had started earlier and advanced further.

The Glaku study carried out by the University of Helsinki, the National Institute for Health and Welfare and the Helsinki and Uusimaa hospital districts compared 378 youths of about 13 years whose mothers had consumed "large amounts" or "little/no" liquorice during pregnancy. In this study a large amount was defined as over 500 mg and little/no as less than 249 mg glycyrrhizin per week. These cutoffs are not based on health effects. 500 mg glycyrrhizin corresponds on average to 250 g liquorice.

Researchers suggest that pregnant women and women planning pregnancy should be informed of the harmful effects that products containing glycyrrhizin -- such as liquorice and salty liquorice -- may have on the fetus. In Finland, this is already reality. In January 2016, the National Institute for Health and Welfare published food recommendations for families with children, in which liquorice was placed in the 'not recommended' category for pregnant women. According to the recommendations, occasional consumption of small amounts such as a portion of liquorice ice cream or a few liquorice sweets is not dangerous.

As a result of animal experiments, the biological mechanism of the effects of liquorice is well known. Glycyrrhizin intensifies the effects of stress hormone cortisol by inhibiting the enzyme that inactivates cortisol. While cortisol is essential to the development of a fetus, it is detrimental in large amounts. It has long been known that glycyrrhizin causes higher blood pressure and shorter pregnancies in humans, but such long-lasting effects on the fetus have not been proven before. [Original study.]

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Published on 1 Comment on A Lot of Fast Food Packaging Contains Harmful Chemicals

Another study is adding to the evidence that food packaging  is frequently coated  with harmful chemicals - called perfluorinated chemicals or PFCs. The chemicals are used because they resist grease and stains, but unfortunately they then leach into the food, and when people eat the food - it gets into them. The evidence is also growing that these chemicals have all sorts of harmful health effects, including endocrine disruption (they are hormone disruptors) - even in low doses. They are linked to kidney and testicular cancer, high blood cholesterol levels, thyroid problems, development and immune system problems, low birth weights, and decreased sperm quality. (See earlier post) The list keeps growing each year.

Researchers tested about 400 pieces of food packaging from 27 fast food chains,  including McDonald’s, Burger King, Taco Bell, Chick-Fil-A, Quiznos, Starbucks, and Dunkin’ Donuts (see how they scored). Overall, about 33 percent of the packages contained fluorine (a chemical not found in paper, but is an indicator of perfluorinated chemicals present to make the packaging grease and stain resistant). What is even more disturbing is that when the researchers more closely examined 20 samples to find out exactly what fluorinated compounds they contained - they found that 6 of the more rigorously tested packages contained PFOA (which was used in Teflon). PFOA was phased out for use in the USA years ago due to it being so long-lasting in the environment and its serious health effects, but other countries still produce it. Unfortunately, even the replacement chemicals  seem to be similarly harmful (not surprising because of the chemical similarities), and they also persist in the environment.

It should be pointed out that perfluorinated chemicals are also used in products such as stain and water resistant coatings on clothing, upholstery, carpeting and floor waxes. They are in non-stick coatings in pots and pans. The chemicals leach or migrate out of products and degrade very slowly — thus showing up in air, household dust, water, dirt, wildlife, and people. Yes, studies show that almost everyone in the U.S. has these chemicals in their blood, and unfortunately some of them can stay in the body for years. PFCs pass from mothers to their babies during pregnancy, and in breast milk after birth. Exposure to perfluorinated chemicals from fast food packaging is of big concern for children, because one-third of U.S. children consume fast food daily, and children may be especially susceptible to the adverse health effects.

Yes, we are surrounded by a sea of harmful chemicals that are tough to avoid, but we should at least try to minimize our exposure. Fast food restaurants should be encouraged to use nontoxic alternatives (e.g., aluminum foil or wax paper) - after all, the study showed that there is packaging out there without these chemicals.

What can we do to avoid PFCs? 1) Try to avoid or eat less fast food and food that comes in "grease-proof" containers. 2) Don't use non-stick pots and pans - use stainless steel instead. 3) Try to avoid clothing, upholstered furniture, and carpets with stain and water-resistant coatings. 4) Don't use microwave popcorn bags, and try to avoid microwaving foods in their packaging - use a glass dish instead. 5) Don't use dental floss such as Oral-B Glide dental floss (uses PFC), and use unwaxed or natural wax floss instead. 6) Avoid personal care products that contain ingredients that include the words “fluoro” or “perfluoro". *Please check out the Environmental Working Group site for more information (here and here).

From Science Daily: Extensive use of fluorinated chemicals in fast food wrappers: Chemicals can leach into food

Americans may be consuming fast food wrapped in paper treated with perfluorinated chemicals (PFCs) -- the same chemicals used in stain-resistant products, firefighting materials and nonstick cookware, according to a new study published in the journal Environmental Science & Technology.

Researchers tested more than 400 samples of packaging materials, including hamburger and sandwich wrappers, pastry bags, beverage cups and French fry containers, and found evidence of fluorinated compounds called per- and polyfluoroalkyl substances (PFASs). Of the materials tested, these chemicals were found in 56 percent of dessert and bread wrappers, 38 percent of sandwich and burger wrappers and 20 percent of paperboard.

Previous studies have shown that these PFASs can migrate, contaminating the food and, when consumed, accumulating in the body....Previous studies have linked PFASs to kidney and testicular cancers, thyroid disease, low birth weight and immunotoxicity in children, among other health issues. The chemicals have an especially long half-life and take many years before just 50 percent of the intake leaves the human body. The results are concerning when considering the role of fast food in the American diet. The National Center for Health Statistics reported one-third of U.S. children consume fast food daily.

Samples were collected from a total of 27 fast food restaurant chains including McDonald's, Burger King, Chipotle, Starbucks, Jimmy Johns, Panera and Chick-Fil-A, in and around Boston, San Francisco, Seattle, Washington, D.C., and Grand Rapids, Michigan. The study did not include takeout containers, such as Chinese food boxes or pizza boxes. [Original study]

Published on Leave a comment on Study Finds Fecal Transplants Improve Autism and Gut Symptoms in Children

For years it has been known that most children with autism spectrum disorder (ASD) have all sorts of gastrointestinal (GI) problems (e.g., constipation, diarrhea, stomach pain, food intolerance), and the more severe the autism, the more severe the GI problems. Recent studies suggested that a major factor in this are abnormal gut bacteria, with the gut microbial community out of whack (dysbiosis). Previous studies looking at the gut microbiome of children with autism have shown lower diversity and lower amounts (abundances) of certain bacteria in children with autism compared to neurologically normal (neurotypical) children.

A recent study of children with autism spectrum disorder found that giving the children a fecal microbiota transplant (FMT) led to significant and lasting improvements in both gastrointestinal (GI) symptoms and autism-related behaviors and symptoms. A fecal microbiota transplant (FMT) is a transplant of fecal matter from a healthy donor to the recipient. A fecal microbial transplant contains approximately a thousand bacterial species that live in a healthy gut, as well as other microbes such as viruses and fungi. FMTs have so far been an amazingly successful treatment for recurrent Clostridium difficile infections, and are now being looked at as promising treatments of chronic inflammatory diseases such as inflammatory bowel disease.

The researchers were surprised to see an 80% improvement in gastrointestinal symptoms, especially abdominal pain, indigestion, diarrhea, and constipation. They also saw about a 25% improvement in autism related behaviors and symptoms which persisted for 8 weeks after treatment stopped, which is when the study ended. One measurement of adaptive behaviors (such as communication, daily living skills, and socialization) found that the average developmental age increased by 1.4 years after treatment. The researchers also found that there was a "rebalancing" of the gut microbes following treatment. They found evidence of "successful partial engraftment of donor microbiota and beneficial changes in the gut environment" - meaning they could see that donor microbes were living in the gut. Also, overall bacterial diversity increased (which is good) and the abundance of certain bacteria increased (including Bifidobacterium, Prevotella, and Desulfovibrio), and these changes persisted until the end of the study.

The researchers caution that this was a small trial, that there could be placebo effects, and so the results should be "cautiously interpreted and viewed as preliminary." But nonetheless, the results are exciting. Really exciting. From Science Daily:

Autism symptoms improve after fecal transplant, small study finds

Children with autism may benefit from fecal transplants -- a method of introducing donated healthy microbes into people with gastrointestinal disease to rebalance the gut, a new study has found. Behavioral symptoms of autism and gastrointestinal distress often go hand-in-hand, and both improved when a small group of children with the disorder underwent fecal transplant and subsequent treatment. In the study of 18 children with autism and moderate to severe gastrointestinal problems, parents and doctors said they saw positive changes that lasted at least eight weeks after the treatment. Children without autism were included for comparison of bacterial and viral gut composition prior to the study.

Previous research has established that children with autism typically have fewer types of some important bacteria in their guts and less bacterial diversity overall -- a difference that held true in this study. That could be because many of them are prescribed a lot of antibiotics in the first three years of life, the research team wrote in the study.

Parents of the children not only reported a decrease in gut woes including diarrhea and stomach pain in the eight weeks following the end of treatment: They also said they saw significant changes for the better when it came to behavioral autism symptoms in their sons and daughters, who ranged from 7 to 16 years old....One of those tools showed the average developmental age increased by 1.4 years after treatment. 

Researchers also were able to document a rebalancing of the gut following treatment. At the end of the study, the bacterial diversity in the children with autism was indistinguishable from their healthy peers. The study also included a unique viral analysis by Ohio State scientists, made possible because of previous work in the world's oceans. Gregory, who is particularly interested in the interplay between viruses and bacteria, used genetic testing to examine the viral diversity in the guts of the treated children. It rebounded quickly, and became more similar to the donor's microbiome. "Those donor viruses seemed to help," she said.

Fecal transplantation is done by processing donor feces and screening it for disease-causing viruses and bacteria before introducing it into another person's gastrointestinal tract. In this study, the researchers used a method called microbiota transfer therapy, which started with the children receiving a two-week course of antibiotics to wipe out much of their existing gut flora. Then, doctors gave them an initial high-dose fecal transplant in liquid form. In the seven to eight weeks that followed, the children drank smoothies blended with a lower-dose powder. [Original study.]

Published on Leave a comment on Study Finds Flame Retardants On Hands Of All Toddlers

Flame retardants are in many products around us, both in and out of the home, but there is much concern over their health effects on humans. Older flame retardants (PBDEs) were phased out by 2013, but it turns out that the newer replacements (TBB and TBPH, including Firemaster 550) also get into people and also have negative health effects. So it shouldn't be a surprise that every single toddler tested in a study in New York City showed evidence of flame retardants on their hands (both the old kind and newer replacements), and that they had more on their hands than their mothers. Flame retardants were also found in all house dust samples. Since they are linked to many negative health effects, you really, really want to minimize the amounts in your body.

More and more research is finding health problems with flame retardants because they are "not chemically bound" to the products in which they are used - thus they escape over time. and get into us via the skin (dermal), inhalation (from dust), and ingestion (from certain foods and dust on our fingers). And because flame retardants are persistant, they bioaccumulate (they build up over time). They can be measured in our urine and blood. Evidence suggests that flame retardants may be endocrine disruptors, carcinogenic, alter hormone levels, decrease semen quality in men, thyoid disruptors, and act as developmental neurotoxicants (when developing fetus is exposed during pregnancy)  so that children have lowered IQ and more hyperactivity behaviors.

Where are flame retardants found? All around us, and in us. They are so hard to avoid because they're in electronic goods, in upholstered furniture, polyurethane foam, carpet pads, some textiles, the foam in baby items (car seats, bumpers, crib mattresses, strollers,nursing pillows, etc.), house dust, building insulation, and on and on. What to do? Wash hands before eating. Try to use a vacuum cleaner with a HEPA filter. Try to avoid products that say they contain "flame retardants". Only buy upholstered furniture with tags that say they are flame retardant free. From Science Daily:

NYC toddlers exposed to potentially harmful flame retardants

Evidence of potentially harmful flame retardants on the hands and in the homes of 100 percent of a sample of New York City mothers and toddlers has been uncovered by researchers. The study also found that on average toddlers in New York City had higher levels of common flame-retardants on their hands compared to their mothers.

Researchers at the Columbia Center for Children's Environmental Health (CCCEH) within the Mailman School of Public Health report evidence of potentially harmful flame retardants on the hands and in the homes of 100 percent of a sample of New York City mothers and toddlers. The study also found that on average toddlers in New York City had higher levels of common flame-retardants on their hands compared to their mothers. The Center's previous research has linked early life exposure to a common class of flame-retardants called PBDEs with attention problems and lower scores on tests of mental and physical development in children.

Beginning in the 1970s, manufacturers added PBDEs, persistent brominated flame-retardants, to couches, textiles, electronics and other consumer products to comply with flammability standards. They began phasing out PBDEs in 2004 and started using newer alternative flame-retardants, including TBB and TBPH, which are components of the commercial mixture Firemaster 550®. TBB and TBPH are brominated flame retardants for which little is known about their health effects in humans, though they have been linked to reduced fertility and endocrine disruption in animal models.

Researchers visited the homes of 25 mother-child pairs enrolled in the CCCEH Sibling-Hermanos birth cohort, which began in 2008. When children were 3 years old, dust was collected from their homes and hand wipes were collected from the mother and child; these samples were analyzed for flame retardant compounds....Results are consistent with other studies, which demonstrate that toddlers tend to have higher exposure to flame retardants when compared with adults, likely because of the amount of time they spend on the floor.

Published on Leave a comment on Many Countries Ban Spanking, But 19 States Allow Physical Punishment In Schools

A new law in France just banned spanking of children, making it 52 countries in the world that ban spanking of children. Yet in the United States we go so far in the other direction that nineteen states still allow spanking and other forms of physical punishment in school. Of these 19 states, 15 expressly permit it while another four do not prohibit it. According to Federal data, more than 109,000 students were paddled, hit, or physically punished in some way in schools during 2013-2014. Seven Southern states account for 80 percent of in-school corporal punishment in the U.S.: Mississippi, Texas, Alabama, Arkansas, Georgia, Tennessee and Oklahoma.

The National Association of School Psychologists explains corporal punishment as "the intentional infliction of pain or discomfort and/or the use of physical force upon a student with the intention of causing the student to experience bodily pain so as to correct or punish the student's behavior." In other words, it is a spanking, beating, paddling (hitting with a paddle!), or physical abuse.

Also, a recent study found that "black children are twice as likely as white children to be subject to corporal punishment" at school. This is partly because black children tend to live in states where such punishments are allowed, and also because black students are more likely to be singled out for corporal punishment by educators. In Mississippi, white students were physically disciplined at a rate of 4.7 beatings per every 100 students, but among black students, the rate was 8.1 per every 100 students.

Ironically, while Texas is one of the states that allows corporal punishment, research on spanking from the University of Texas (and Univ. of Michigan) found that: the more children are spanked, the more likely they are to defy their parents and to experience increased anti-social behavior, aggression, mental health problems, and cognitive difficulties. These findings are from reviewing 50 years of research on spanking. In other words, study after study found that spanking, corporal punishment, paddling, beatings, physical abuse, or whatever you want to call it - results in negative long-term effects. It causes harm. So why is the USA so damn backward in 2017 that this is still being practiced in schools? The place where children are supposed to be safe, where adults are supposed to be role models, where children are supposed to learn right from wrong. Eh...

From the Washington Post: The States Where Teachers Still Beat Kids

In America's South, the beatings will continue. A new study published today finds that seven Southern states account for 80 percent of in-school corporal punishment in the U.S.: Mississippi, Texas, Alabama, Arkansas, Georgia, Tennessee and Oklahoma. The research by Dick Startz, an economics professor at U.C. Santa Barbara, and released by the Brookings Institution's Brown Center used data from the Department of Education's Civil Rights Division to determine the breakdown.

Corporal punishment at school is illegal in 31 states. Of the 19 that technically allow it, many do not appear to practice it at all, according to Startz' numbers. But some states are use the practice relatively often. In Mississippi there were more than six instances of corporal punishment -- defined as "paddling, spanking, or other forms of physical punishment imposed on a student" -- for every 100 public school students during the 2011-2012 school year. In other words, one out of every 17 public school students in Mississippi can expect to get beaten by a school administrator during a typical school year.

The persistence of corporal punishment is schools is all the more puzzling when you consider the research: "Many studies have shown that physical punishment — including spanking, hitting and other means of causing pain — can lead to increased aggression, antisocial behavior, physical injury and mental health problems for children," the American Psychological Association wrote in 2012. The American Academy of Pediatrics "strongly opposes" the practice. So does the United Nations. These groups agree that the evidence is clear: beating children does far more harm than good.

From University of Texas News: Risks of Harm from Spanking Confirmed by Analysis of Five Decades of Research

The more children are spanked, the more likely they are to defy their parents and to experience increased anti-social behavior, aggression, mental health problems and cognitive difficulties, according to a new meta-analysis of 50 years of research on spanking by experts at The University of Texas at Austin and the University of Michigan. The study, published in this month’s Journal of Family Psychology, looks at five decades of research involving over 160,000 children.

Gershoff and co-author Andrew Grogan-Kaylor, an associate professor at the University of Michigan School of Social Work, found that spanking (defined as an open-handed hit on the behind or extremities) was significantly linked with 13 of the 17 outcomes they examined, all in the direction of detrimental outcomes. “The upshot of the study is that spanking increases the likelihood of a wide variety of undesired outcomes for children. Spanking thus does the opposite of what parents usually want it to do,” Grogan-Kaylor says.

Gershoff and Grogan-Kaylor tested for some long-term effects among adults who were spanked as children. The more they were spanked, the more likely they were to exhibit anti-social behavior and to experience mental health problems. They were also more likely to support physical punishment for their own children, which highlights one of the key ways that attitudes toward physical punishment are passed from generation to generation. The researchers looked at a wide range of studies and noted that spanking was associated with negative outcomes consistently and across all types of studies.... 

Published on Leave a comment on Baby Teethers Found To Contain BPA and Other Endocrine Disruptors

 Uh oh....A recent study found that every baby teether tested (and they tested 59 teethers), including all those labeled "BPA free", leached various parabens, bisphenols (including BPA or bisphenol A), and other endocrine disrupting chemicals. Infants chew and suck teethers to soothe the pain from their teeth emerging in the first year of life.

The researchers tested for 26 chemicals in three different types of teethers (solid plastic, gel-filled, and water-filled), and found parabens and bisphenols leaching from all of them. To see what leaches from the teethers, they placed the teethers into water - this is similar to what happens when babies mouth teethers and their saliva is exposed to chemicals in the teethers. The gel filled teethers leached the most chemicals overall. Even though 48 of the 59 teethers were labeled “BPA-free,” the results showed that the labels were misleading, because in this study BPA migrated (leached out) from all the teethers.

Endocrine disrupting chemicals can interfere with natural hormone function and are linked to a wide assortment of health problems (see posts on them). Even though the levels of the chemicals found were low, it is important to remember that effects from endocrine disrupting chemicals (hormone disruptors) are from very low levels. So exposing developing infants to these chemicals is of concern. What was disturbing is that these study results were far worse than a small study of teethers in Europe where the standards regarding endocrine disrupting chemicals are stricter than in the US. What should be done? Manufacturers should design products without using problem ingredients right from the start. Problem solved! From Science Daily:

Baby teethers soothe, but many contain low levels of BPA

Bisphenol-A (BPA), parabens and antimicrobials are widely used in personal care products and plastics. The U.S. and other governments have banned or restricted some of these compounds' use in certain products for babies and kids. But the compounds' presence in and leaching from teethers hasn't been thoroughly investigated. Now a study in the ACS journal Environmental Science & Technology reports that all tested plastic teethers contained BPA and other endocrine-disruptors that leached at low levels.

Studies have shown that in animals, endocrine-disrupting compounds (EDCs) -- which include BPA, parabens and antimicrobials -- can potentially interfere with hormones and have harmful developmental, reproductive and neurological effects. As a result, the European Commission in 2011 restricted the use of BPA in baby bottles. The U.S. followed suit a year later, banning it from baby bottles, and also from children's drinking cups....But very few if any studies have investigated whether the compounds are used to make teethers and if the compounds leach out of these products, which are designed to soothe babies' gums when their teeth come in. Kurunthachalam Kannan and colleagues wanted to see if the products contained EDCs and if the compounds could migrate out.

The researchers analyzed 59 solid, gel-filled or water-filled teethers purchased online in the U.S. for 26 potential endocrine-disrupting chemicals. Although most of the products were labeled BPA-free or non-toxic, all of them contained BPA. In addition, the researchers detected a range of different parabens and the antimicrobials triclosan and triclocarban in most of the teethers....Based on estimates of average use time and the body weight of a 12-month-old baby, calculations suggest that exposure to BPA and other regulated EDCs in teethers would be lower than the European standards for temporary tolerable daily intake levels. However, these thresholds are set for individual compounds. Current regulations do not account for the accumulation of multiple EDCs, note the researchers. Additionally, not all chemicals measured in the study are regulated.

Published on Leave a comment on Is Autism Spectrum Disorder Linked To Pregnancy Flu Shots or The Flu?

A big concern nowadays is why some children develop autism, specifically autism spectrum disorder (ASD). Autism spectrum disorder is considered a life-long neurodevelopmental disorder that is thought to affect 1 out of 68 American children. While the causes of ASD are unknown in most cases, some studies report an association (higher risk) between a pregnant woman's infections and fever during pregnancy and risk of ASD in the baby, while other studies don't find such an association. Some studies also looked at the timing of infections during pregnancy, but again results have been mixed. A viral infection during the first trimester is associated with increased risk in some studies, while other studies report an increased risk with a second- or third-trimester bacterial infection.  So it has been unclear whether a flu (influenza) infection or flu vaccination during pregnancy is linked to autism spectrum disorder or not. Is there a link or not?

Why are pregnant women encouraged to get a flu shot (flu vaccine)? This is because pregnant women have an increased risk of complications from the flu infection. Studies also show that getting a flu vaccine during pregnancy reduces the risk of a preterm birth, a small-for gestational-age child, and a low-birth-weight child, and prevents influenza infection in newborns for up to 6 months.

The researchers of a large study done in California found no association between autism spectrum disorder (ASD) risk and flu (influenza) infection during pregnancy or flu (influenza) vaccination during the second to third trimester of pregnancy. However, there was a suggestion of increased ASD risk among children whose mothers received flu vaccinations during the first trimester (though the researchers say the association was perhaps due to "chance". Bottom line: the study results were reassuring for pregnant women, but if one wanted to be ultra-cautious, then delay getting a flu shot until the second trimester of pregnancy. From Science Daily:

No association between mother's flu in pregnancy, increased child autism risk

A study of more than 196,000 children found no association between a mother having an influenza infection anytime during pregnancy and an increased risk of autism spectrum disorders (ASDs) in children, according to a new study published online by JAMA Pediatrics. The study by Ousseny Zerbo, Ph.D., of Kaiser Permanente Northern California, Oakland, and coauthors included 196,929 children born in the health system from 2000 through 2010 at a gestational age of at least 24 weeks.

Within the group, there were 1,400 mothers (0.7 percent) diagnosed with influenza and 45,231 mothers (23 percent) who received an influenza vaccination during pregnancy. There were 3,101 children (1.6 percent) diagnosed with ASD. The authors report no association between increased risk of ASD and influenza vaccination during the second and third trimesters of pregnancy. There was a suggestion of increased risk of ASD with maternal vaccination in the first trimester but the authors explain the finding was likely due to chance because it was not statistically significant after adjusting for multiple comparisons. The study cannot establish causality and has several limitations, including ASD status determined by diagnoses on medical records and not validated by standardized clinical assessment for all cases. [Original study.]

Published on Leave a comment on Vitamin D and Autism Spectrum Disorder?

This study found impressive results - improvement in autistic behaviors in children diagnosed with autism spectrum disorder (ASD) with four months of daily vitamin D supplementation. Children in the placebo group did not show improvement. A nice aspect of the study was that the children were randomly assigned  to a placebo or a vitamin D group (so that the groups were not self-selected) and it was double-blinded (so no one knew who was getting the vitamins - again to prevent bias). This was a preliminary study - meaning more studies are needed, but it would be amazing if these results hold up... From Science Daily:

Vitamin D supplements may benefit children with autism spectrum disorder

Studies have shown an association between the risk of autism spectrum disorder and vitamin D insufficiency. In this latest study, 109 children with autism spectrum disorder were randomized to receive four months of vitamin D3 supplementation or a placebo."Autism symptoms -- such as hyperactivity, social withdrawal, and others -- improved significantly following vitamin D3 supplementation but not after receiving placebo," said Dr. Khaled Saad, lead author of the Journal of Child Psychology and Psychiatry study.

Excerpts from the original study from  The Journal of Child Psychology and Psychiatry: Randomized controlled trial of vitamin D supplementation in children with autism spectrum disorder

Autism spectrum disorder (ASD) is a frequent developmental disorder characterized by pervasive deficits in social interaction, impairment in verbal and nonverbal communication, and stereotyped patterns of interests and activities. It has been previously reported that there is vitamin D deficiency in autistic children; however, there is a lack of randomized controlled trials of vitamin D supplementation in ASD children.

This study is a double-blinded, randomized clinical trial (RCT) that was conducted on 109 children with ASD (85 boys and 24 girls; aged 3–10 years). The aim of this study was to assess the effects of vitamin D supplementation on the core symptoms of autism in children. ASD patients were randomized to receive vitamin D3 or placebo for 4 months. The serum levels of 25-hydroxycholecalciferol (25 (OH)D) were measured at the beginning and at the end of the study. The autism severity and social maturity of the children were assessed by the Childhood Autism Rating Scale (CARS), .... 
Supplementation of vitamin D was well tolerated by the ASD children. The daily doses used in the therapy group was 300 IU vitamin D3/kg/day, not to exceed 5,000 IU/day. The autism symptoms of the children improved significantly, following 4-month vitamin D3 supplementation, but not in the placebo group. This study demonstrates the efficacy and tolerability of high doses of vitamin D3 in children with ASD.   

Recently, Wang et al. (2016) performed a systematic review and meta-analysis of all studies on serum concentration of 25 (OH)D in ASD (Wang et al., 2016). Eleven studies were included, accounting for a total of 870 ASD patients and 782 healthy controls. Serum levels of 25 (OH)D in participants with ASD were significantly lower than those in controls. They concluded that low vitamin D might serve as a risk factor for autism spectrum disorder (Wang et al., 2016). 

In a recent survey, our research group measured 25 (OH)D in 122 ASD children (3–9 years old) and 100 healthy children as controls (Saad, Abdel-Rahman, et al., 2015). The ASD group showed a significantly lower level of serum 25 (OH)D compared with the control group (p < .0001). The study found highly significant inverse correlations between serum 25 (OH)D levels and autism rating scales. In the second part of the previous study (Saad, AbdelRahman, et al., 2015), an open-label trial of 83 subjects who completed a 3-month therapy with high daily doses of vitamin D (300 IU/kg/day) was performed. Collectively, 80.7% of the children with ASD had significantly improved outcome, which was mainly in the sections of the CARS and ABC subscales that measure behavior, stereotypy, eye contact, and attention span (Saad, Abdel-Rahman, et al., 2015). 

Published on Leave a comment on Preventing Food Allergies In Children

Guidelines for how to prevent food allergies in children are changing. Until very recently, it was avoid, avoid, avoid exposing babies or young children to any potential allergens. Remember parents being advised that if an allergy to X (whether pets or food) runs in the family, then absolutely avoid exposing the child to the potential allergen? Well, recent research (here, here, and here) found that the opposite is true - that in the first year of life the baby should be exposed to potential allergens (whether animals or food) which stimulates the child's developing immune system in beneficial ways.

Physicians at a recent conference of allergists said that evidence shows that allergenic foods — including peanuts, eggs, and milk — should be introduced in the first year of life. The new 2017 medical guidelines will recommend introducing small amounts of peanuts (mixed in with other foods), when children are 4 to 6 months of age..

About two years ago a landmark study (LEAP study) found that when infants at a high risk of developing peanut allergy consumed peanuts on a regular basis, their risk of peanut allergy was dramatically reduced. And the opposite was also true: peanut avoidance in the first year of life was associated with a greater frequency of peanut allergy. Which made doctors start to rethink their strategies of how to avoid food allergies. From Medscape:

Allergenic Foods Should Be Introduced to Infants Early

Although the evidence shows that allergenic foods — including peanuts, eggs, and milk — should be introduced in the first year of life, guidelines are lagging behind, said an allergist speaking here at the American College of Allergy, Asthma & Immunology (ACAAI) 2016 Annual Scientific Meeting. Official guidelines to be issued early in 2017 will address only peanuts, recommending introduction when children are 4 to 6 months of age.

"There is now a large body of observation and trial data for other foods, including egg, that show that delaying the introduction of allergenic solids increases the risk of those particular food allergies," said Katrina Allen, MBBS, PhD, from the Murdoch Childrens Research Institute in Melbourne, Australia. Policy changes are needed to help guide parents' decisions, she said. In fact, there is evidence showing that changes to policy — namely, infant-feeding guidelines — mirror the rise in the incidence of food allergies.

Not everyone agrees on exposure amount and timing in the case of egg allergy. In a recent trial, researchers looked at the early introduction of allergenic foods in breast-fed children (N Engl J Med. 2016;374:1733-1743). The prevalence of any food allergy was significantly lower in the early-introduction group than in the standard-introduction group, as was the prevalence of peanut allergy and egg allergy. And a study Dr Allen was involved in, which introduced cooked egg in small amounts, showed that early introduction reduced allergy (J Allergy Clin Immunol. 2010;126:807-813).

However, in a German study, where greater amounts of egg were introduced at 4 to 6 months, early exposure increased the risk for life-threatening allergic reactions (J Allergy Clin Immunol. Published online August 12, 2016). And in the STEP study, there was no change in the number of food allergies in 1-year-old children when egg was introduced early (J Allergy Clin Immunol. Published online August 20, 2016). However, that did not take into account high-risk infants, particularly those with eczema, who are known to have a higher incidence of egg allergy and are likely to see a much greater benefit from the early introduction of egg.

The new peanut guidelines — coauthored by Amal Assa'ad, MD, from the Cincinnati Children's Hospital, who is chair of the ACAAI food allergy committee — will recommend that children with no eczema or egg allergy can be introduced to peanut-containing foods at home, according to the family's preference. And for children with mild to moderate eczema who have already started solid foods, the guidelines say that peanut-containing foods can be introduced at home at around 6 months of age, without the need for an evaluation. However, the guidelines caution, peanut-containing foods should not be the first solid food an infant tries, and an introduction should be made only when the child is healthy. The first feeding should not happen when the child has a cold, is vomiting, or has diarrhea or another illness.

For eggs, there is no official recommendation as of yet....The early introduction of allergenic foods is not the only policy that needs to be changed to lower the incidence of food allergies, Dr Allen told Medscape Medical News. Other factors, particularly environmental factors — mostly written up in observational studies — are contributing to an increasing intolerance to allergenic foods. Policies advocating that kids "get down and dirty," have more exposure to dogs, and bathe less are also warranted....Dr Allen and Dr Assa'ad agree that delaying the introduction of foods such cow's milk and egg until after 12 months is harmful. Guidelines should encourage families to introduce these foods in the first year of life, once solids have commenced at around 6 months, but not before 4 months.