Specific inflammatory genes located on chromosome 21, in triplicated form, influence the inflammatory state of the Down Syndrome (DS) brain. These genes include: CXADR, ADAMTS1, ADAMTS5, TIAM1, SOD1, IFNAR2, IFNAR1, IFNGR2, RIPK4, CBS, S100B, PRMT2. Targeting gene overexpression using nutrition and phytotherapy is essential to reduce inflammation in the DS brain which leads to brain injury and the development of Alzheimer’s Disease later in life.
A recent article published in the Journal of Pediatric Research (2014) indicated that nutrition and a healthy gut microbiome are essential for the growth and maturation of a typical infant brain. Apart from gene overexpression, it’s important to consider the impact nutrition and gut health, also known as epigenetics, have on the developing DS brain.
- Nutrient intake during infancy influences brain growth, maturation and neurodevelopment which continues into childhood and adolescence. Nutrition has the potential to protect an infant from brain injury.
- Inflammation and infection cause injury to white matter, a common form of brain injury in preterm infants. Nutrients which support the immune system with anti-inflammatory effects also protect the brain.
- The gut microbiome is thought to interact with the brain through immune, endocrine and neural pathways. Nutrients that enhance the gut microbiota also exert benefits on the developing brain. Probiotics, prebiotics, oligosaccharides and specific amino acids are potentially neuroprotective.
Nutrition for the Newborn
Research on fetal malnutrition has demonstrated long-lasting effects on mental development and psychiatric health. Nutritional deficits in infancy may impede brain growth and maturation.
The impact of early nutrition on head growth in infancy and later neurodevelopment has been reported in several studies. Adequate amounts of protein and carbohydrate balance in infancy influences cognition, which lasts into adolescence.
In a large British randomized controlled trial, preterm infants supplemented with nutrients such as macronutrients, vitamins and trace elements; zinc, calcium and iodine in the first four weeks of life showed significantly larger brain volumes (caudate nucleus) at 16 years of age compared with preterm infants fed a standard formula diet. Both at ages 5 – 8 and 16 years of age, preterm children in the high nutrient group demonstrated a significantly higher verbal intelligence quotient.
Infection in the Newborn
Brain injury and disturbances in brain development in pre-term infants can be caused by infection. Infection during infancy leads to systemic inflammation associated with circulatory problems, resulting in decreased blood flow to the brain. Brain injury which results from this is caused by inflammation and ischemia (restricted blood supply to tissues).
Nutritional supplements reduce systemic infection and inflammation, alleviate brain injury and promote brain development. Balancing the immune system also has benefits for the developing brain via the gut-microbiome-brain axis.
The Gut-Brain connection
The gut microbiome communicates with the brain via immune, endocrine and neural pathways. It is well known that the relationship between intestinal microbes and the immune system are essential for development and regulation of immune function. Only recently, research established the importance of the gut microbiome on normal brain function. An exciting find was that repopulation of gut flora early in life normalised behaviour patterns and neuroregulation in mice, whereas this effect couldn’t be established in adulthood. These results suggests there is a critical period of time when intestinal microbes can influence brain development and enduring brain function.
Signals from the immune system are thought to play a key role in the way the gut microbiome influences brain development. There is a large amount of evidence which shows the immune system has an important effect on brain development. The gut is thought to interact with the brain via immune cells, cytokines and chemokines (substances and signalling proteins secreted by the immune system). Cytokine receptors have been found on neurons and glial cells in the brain. Additionally, immune related signalling molecules regulate brain processes and vice versa.
*Note: children with Down Syndrome aren’t supplemented with glutamine directly as it converts rapidly to GABA. Instead, we use alpha-ketoglutarate a glutamine precursor which allows the body to regulate the amount of glutamine it produces.
Children supplemented with glutamine developed larger brains, hippocampus and brainstem volume compared to controls. Glutamine improves gut integrity and reduces the growth of bacteria, resulting in less infections and less injury to white brain matter. Studies show that glutamine reduces infection and inflammation with a protective effect on the brain. Glutamine improved infant nutritional status by improving gut resilience, leading to better growth, increasing white brain matter and brain development. Several trials have demonstrated an increase in weight gain, length and head growth following glutamine supplementation.
Probiotics protect the brain in infants. Probiotics are beneficial for the developing brain due to their alteration of the immune response, reducing inflammation and preventing injury to white brain matter. Additionally, they are beneficial for the gut-microbiome-brain axis.
“Probiotics are micro-organisms that colonize the gut and provide health benefits to the host through improved gut mucosal barrier integrity, regulation of appropriate bacterial colonization, enhanced mucosal IgA response, and immunomodulation, leading to an increase in anti-inflammatory cytokines and a decrease in pro-inflammatory cytokines.”
A decade of research shows that probiotics reduce the risk of large intestine injury and all-cause mortality in infants. Supplementation with probiotics is routine practice in clinics and level 3 Neonatal Intensive Care Units globally, including Finland, Japan, Columbia, Denmark, Italy, Germany, New Zealand, and Australia. The level of safety of probiotic supplementation is indicated, with serious adverse events rarely occurring.
It is generally accepted that adequate nutrition is crucial for brain growth and development in infants. In addition, probiotic supplements provide protective effects for the developing brain. Specific nutritional supplements reduce the development of postnatal infection and large intestine injury due to their favourable effects on the immune system. Immune boosting and a reduction in inflammation to the brain has beneficial effects on development through the gut-immune-brain axis.
Nutritional interventions are safe, inexpensive, free of side effects and can be easily implemented and have become particularly interesting strategies for brain protection.