Lack of Food Variety Puts Kids with Autism at Risk for Poor Nutrition

The strong preference kids with autism have for certain foods places them at risk for nutritional deficiencies because their diets lack sufficient variety, according to research presented at this year's Pediatric Academic Societies meeting in Baltimore.

Researchers said screening children for the amount of variety of food in their diets may be a good clinical marker to predict which children might be at risk for nutrition problems. Kids with low food variety scores who are at risk could then be referred to dieticians or therapists to help them expand food choices and improve nutrition, said Michelle Zimmer, M.D., lead investigator and a pediatrician in the division of Developmental and Behavioral Pediatrics at Cincinnati Children's.insert beginning span tag hereThe study is one of two presented by Dr. Zimmer and colleagues this year at PAS that deal with autism, the second one showing that the red blood cells of children with autism have low levels of a fatty acid linked to cognitive function. This finding, the researchers report, warrants further research into how the low fatty acid levels may trigger biochemical changes in the brain linked to autism.

The team found that levels of docosahexanoic acid and total omega-3 fatty acids were significantly lower in the red blood cells of autistic children than in normally developing children. Omega-3 fatty acids are nutritionally important substances considered vital to the normal development of children.

Evidence of abnormal fatty acid metabolism in children with autism runs counter to at least one previous study that suggested no difference between normally developing and autistic children. The different results between studies may be explained by the current research focusing on an older group of children, Dr. Zimmer said.

"The fatty acid docosahexanoic is linked to other mental health issues, and this raises questions about whether there are functional issues in neural cells involving a deficiency of essential fatty acids," said Dr. Zimmer. "The main point of the study is we cannot rule that fatty acids are part of the story of what is going on with kids who have autism."

Dr. Zimmer said its possible older children with autism have had more time to use up their bodies' stores of omega-3 fatty acids and are unable to replenish those stores. The 21 children with autism in this study were between the ages of 3 and 18 years, as were the 20 age-matched normally developing children and 10 if their siblings who served as control subjects.

The research team is conducting a larger study with more children to verify its PAS findings. Dr. Zimmer said another study is also under design to give essential omega-3 fatty acids, such as docosahexanonic acid, to children with autism to see what impact it has on brain chemistry and/or the disorder.

Increasing foods rich in omega-3 fatty acids in the diets of autistic children has been suggested by some researchers as potentially beneficial, Dr. Zimmer said. Although doing so would not have a negative impact on the children, until studies are conducted it isn't known what affect, if any, it might have, she added. Also, given the findings of the previous study on the lack of food variety among kids with autism, augmenting their diets could be challenging.

Most of the 19 autistic children in the food study had much lower food variety scores in their diets than typically developing children. A majority of the children with autism also suffered from nutritional deficiencies. The researchers concluded children with autism and low food variety scores are at risk for mild and serious nutritional deficiencies.

Researchers participating in studies were from the division of Developmental and Behavioral Pediatrics and division of Neurology at Cincinnati Children's. Researchers from the department of Pathology at the University of Cincinnati participated in the study on food variety.

The PAS meeting is the largest international meeting focused on research in child health. It is sponsored by the American Academy of Pediatrics, the American Pediatric Society, the Society for Pediatric Research, and the Ambulatory Pediatric Association.

Cincinnati Children's Hospital Medical Center is one of America's top three children's hospitals for general pediatrics and is highly ranked for its expertise in digestive diseases, respiratory diseases, cancer, neonatal care, heart care and neurosurgery, according to the annual ranking of best children's hospitals by U.S. News & World Report. One of the three largest children's hospitals in the U.S., Cincinnati Children's is affiliated with the University of Cincinnati College of Medicine and is one of the top two recipients of pediatric research grants from the National Institutes of Health. For its achievements in transforming healthcare, Cincinnati Children's is one of six U.S. hospitals since 2002 to be awarded the American Hospital Association-McKesson Quest for Quality Prize (r) for leadership and innovation in quality, safety and commitment to patient care. The hospital is a national and international referral center for complex cases, so that children with the most difficult-to-treat diseases and conditions receive the most advanced care leading to better outcomes. Additional information can be found at www.cincinnatichildrens.org.

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Most Popular: Red and Processed Meat Increase Risk of Death

Eating red meat and processed meat modestly increases risk of death from cancer or heart disease. In a pool of 500,000 study participants, the top 20% consumers of red meat and processed meats had higher rates of death than the 20% that consumed the least amount of red and processed meats.

So, how much is too much?  The higher meat consumption group tended to eat at least 6-10 times more meat than those in the lowest meat consumption category.  (62.5 grams vs. 9.8 grams per 1,000 calories in the case of red meat, and 22.6 grams vs. 1.6 grams per 1,000 calories in processed meat.)

In contrast, a higher intake of white meat appeared to be associated with a slightly decreased risk for overall death and cancer death.

Though researchers have yet to conclude specific causes and correlations between high-meat diets and death, many of us may consider practicing more restraint when it comes to eating red meat and processed meats.


From the article:

Individuals who eat more red meat and processed meat appear to have a modestly increased risk of death from all causes and also from cancer or heart disease over a 10-year period, according to a report in the March 23 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. In contrast, a higher intake of white meat appeared to be associated with a slightly decreased risk for overall death and cancer death.

"Meat intake varies substantially around the world, but the impact of consuming higher levels of meat in relation to chronic disease mortality [death] is ambiguous," the authors write as background information in the article. Rashmi Sinha, Ph.D., and colleagues at the National Cancer Institute, Rockville, Md., assessed the association between meat intake and risk of death among more than 500,000 individuals who were part of the National Institutes of Health-AARP Diet and Health Study. Participants, who were between 50 and 71 years old when the study began in 1995, provided demographic information and completed a food frequency questionnaire to estimate their intake of white, red and processed meats. They were then followed for 10 years through Social Security Administration Death Master File and National Death Index databases.

During the follow-up period, 47,976 men and 23,276 women died. The one-fifth of men and women who ate the most red meat (a median or midpoint of 62.5 grams per 1,000 calories per day) had a higher risk for overall death, death from heart disease and death from cancer than the one-fifth of men and women who ate the least red meat (a median of 9.8 grams per 1,000 calories per day), as did the one-fifth of men and women who ate the most vs. the least amount of processed meat (a median of 22.6 grams vs. 1.6 grams per 1,000 calories per day).

When comparing the one-fifth of participants who ate the most white meat to the one-fifth who ate the least white meat, those with high white meat intake had a slightly lower risk for total death, death from cancer and death from causes other than heart disease or cancer.

"For overall mortality, 11 percent of deaths in men and 16 percent of deaths in women could be prevented if people decreased their red meat consumption to the level of intake in the first quintile [one-fifth]. The impact on cardiovascular disease mortality was an 11 percent decrease in men and a 21 percent decrease in women if the red meat consumption was decreased to the amount consumed by individuals in the first quintile," the authors write. "For women eating processed meat at the first quintile level, the decrease in cardiovascular disease mortality was approximately 20 percent."

There are several mechanisms by which meat may be associated with death, the authors note. Cancer-causing compounds are formed during high-temperature cooking of meat. Meat also is a major source of saturated fat, which has been associated with breast and colorectal cancer. In addition, lower meat intake has been linked to a reduction in risk factors for heart disease, including lower blood pressure and cholesterol levels.

"These results complement the recommendations by the American Institute for Cancer Research and the World Cancer Research Fund to reduce red and processed meat intake to decrease cancer incidence," the authors conclude. "Future research should investigate the relation between subtypes of meat and specific causes of mortality."

"The publication by Sinha et al is timely," writes Barry M. Popkin, Ph.D., of the University of North Carolina, Chapel Hill, in an accompanying editorial. "There is a global tsunami brewing, namely, we are seeing the confluence of growing constraints on water, energy and food supplies combined with the rapid shift toward greater consumption of all animal source foods."

"Not only are components of the animal-source foods linked to cancer, as shown by Sinha et al, but many other researchers have linked saturated fat and these same foods to higher rates of cardiovascular disease," Dr. Popkin writes. "What do we do?"

Because there are health benefits to eating some red and white (although not processed) meats, the consensus is not for a complete shift to vegan or vegetarian diets, Dr. Popkin concludes. "Rather, the need is for a major reduction in total meat intake, an even larger reduction in processed meat and other highly processed and salted animal source food products and a reduction in total saturated fat." 

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Staying Healthy in a Tough Economy

With the economy in a state of decline, it is difficult for many Americans to afford health care. Visits to doctors are down 10 percent to 15 percent and many individuals are not taking their medicines as prescribed. However, there are certain measures that can be taken to lessen the burden while facing tough economic times.

While many individuals are dealing with cutbacks, it is important that health care remain a top priority, says A. Mark Fendrick, M.D., professor of internal medicine at the University of Michigan Medical School and professor of health management and policy at the U-M School of Public Health.

Approximately one in nine individuals is cutting pills, taking them every other day or doing something the doctor did not recommend. Fendrick says, "Cutting back on health care without consulting your clinician is a very risky decision. It may not only have an impact on your health, but also have a worsening economic consequence that will lead to greater costs down the road when minor health concerns become major health issues."

Fendrick suggests that people continue to follow up with their recommended screenings and immunizations and consult their clinicians before cutting back on health care. Although these preventative measures may cost you now, they are among the most important investments you can make to protect your health and may save you money in the long run.

There are affordable programs available to help individuals facing economic difficulties. Ask your doctor's office or search online for information about decreasing or eliminating the costs of health insurance and prescription medications.

During an economic crisis, individuals with and without insurance tend to use the emergency room as a form of primary care. However, doing so could take a spot from someone who truly needs emergency care, while also compromising your own care.

"You should really think about going to your primary care physician who knows your medical history, coordinates your follow up care and interacts with other doctors to make sure you're getting the highest quality care possible at the lowest cost," says Fendrick.

While the economy is forcing individuals to make difficult choices Fendrick puts it in perspective: "Remember your health is your most important asset, not your money."

Tips for healthy health care spending:

1. Continue to adopt healthy lifestyles: diet and exercise can help stave off many diseases.
2. Ask your doctor if prescription medications are available in generic forms.
3. Keep up-to-date with recommended screening tests, such as mammograms, colonoscopies or immunizations.

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Thanksgiving on a Budget: Seven Easy Ways to Save Money and Calories

Newswise — Rising costs at the grocery story will be especially painful for many families this Thanksgiving as they get ready for the biggest meal of the year.

“Food is an important part of holidays, and this is especially true for Thanksgiving,” said Jennifer Ebelhar McDaniel, a registered dietician and assistant professor of nutrition and dietetics at Saint Louis University.

“There’s a lot of pressure to serve a big, traditional Thanksgiving meal, but for many people that’s just not financially feasible this year.”

Fortunately, McDaniel says there are seven easy ways to slice your grocery bill without cutting the fun out of the holiday

1. Compose your shopping list one week in advance. This gives you time to search for sales, use coupons, etc. In addition, shopping off a list saves you extra trips to the grocery store (wasted gas) and unnecessary purchases.

2. Don't try to serve it all. You don't need to serve everybody's favorite dish. Choose one protein (usually a turkey), one starch (sweet potato dish), one vegetable and one dessert.

3. Know serving sizes. Make sure the recipes you create are modified for the correct number of people invited.

Read tips 4-7 after the jump!

4. Use frozen vegetables where you can. If you are preparing a recipe like broccoli and cheese casserole, choose frozen vegetables instead of fresh. Frozen vegetables are usually cheaper and offer the same nutrient quality.

5. Buy the whole bird. Usually it is cheaper to purchase the whole turkey rather than buy the pieces separately. Plus, leftover turkey tastes great in a turkey casserole, turkey burritos, turkey and cranberry sandwich, and you can use the bones for soups.

6. Ask for help. Offer to make one or two things and delegate the rest. To add a little fun into your potluck, ask your guests to bring copies of their recipe to share.

7. Skip the paper products. While paper plates and plastic utensils are easier than washing dishes, they are expensive and bad for the environment.

At the risk of sounding like the Grinch who stole Thanksgiving, McDaniel says there are several benefits to cutting back this year, even if it’s not financially necessary. First, in addition to saving money, you’ll also save calories.

“A typical Thanksgiving feast may include as many as 10 options. Even if you take just a little of each, the calories can really add up,” she said. “By limiting the number of dishes offered, your family will be less likely to overeat.”

But perhaps the biggest benefit of simplifying your Thanksgiving meal, McDaniel says, is that it will allow you to focus on your family and all you have to be thankful for.

“The holidays weren’t meant to be stressful. By simplifying your meal, you’ll have more time to relax and enjoy the time with your family,” she said.

Long a leader in educating health professionals, Saint Louis University began its nursing program in 1928 and offered its first degree in an allied health profession in 1929. Today the Doisy College of Health Sciences offers degrees in nursing, physical therapy, clinical laboratory science, nutrition and dietetics, health informatics and information management, medical imaging and radiation therapeutics, occupational science and occupational therapy, and physician assistant education. The college's unique curriculum prepares students to work with health professionals from all disciplines to ensure the best possible patient care.

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B-Vitamin Deficiency May Cause Vascular Cognitive Impairment

Newswise — A deficiency of B-vitamins may cause vascular cognitive impairment, according to a new study. Researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University used an experimental model to examine the metabolic, cognitive, and microvascular effects of dietary B-vitamin deficiency. Their findings appear in the August 26, 2008 issue of Proceedings of the National Academy of Sciences (PNAS).

“Metabolic impairments induced by a diet deficient in three B-vitamins -folate, B12 and B6- caused cognitive dysfunction and reductions in brain capillary length and density in our mouse model,” says Aron Troen, PhD, the study’s lead author. “The vascular changes occurred in the absence of neurotoxic or degenerative changes.”

Troen, who is an assistant professor at Tufts University’s Friedman School of Nutrition Science and Policy, explains, “Mice fed a diet deficient in folate and vitamins B12 and B6 demonstrated significant deficits in spatial learning and memory compared with normal mice.” Troen and colleagues observed similar but less pronounced differences between normal mice and a third group of mice that were fed a diet enriched with methionine.

“The B-vitamin-deficient mice also developed plasma homocysteine concentrations that were seven-fold higher than the concentrations observed in mice fed a normal diet,” adds Troen. Homocysteine is produced by the breakdown of a dietary protein called methionine. B-vitamins, including folate, vitamin B12, and vitamin B6, are required to convert homocysteine back to methionine, thereby reducing the blood concentration of homocysteine.

Studies have linked elevations in plasma homocysteine with an increased risk for cognitive impairment. “However,” Troen says, “it has not been determined that homocysteine is directly responsible. Based on the findings of our study, we theorize that a deficiency of B-vitamins induces a metabolic disorder that manifests with high homocysteine, as well as cerebral microvascular dysfunction.”

Troen and colleagues divided their study mice into three groups and fed each group a different diet for 10 weeks. While the control (comparison) group was fed a normal diet containing methionine and B-vitamins, the other two diets were designed to induce high homocysteine levels but through different metabolic mechanisms. One was methionine-enriched, and the other was deficient in B vitamins. Researchers measured blood concentrations of B-vitamins and homocysteine and assessed the brain anatomy and vasculature. They also evaluated psychomotor function by a battery of age-sensitive tests, such as holding on to a wire and walking a beam, and assessed spatial learning and memory with the Morris water maze, a well-validated and sensitive test of rodent cognitive function.

“It took longer, on average, for the B-vitamin-deficient mice to maneuver the water maze, compared with controls,” says Troen. “Longer latencies were associated with higher plasma homocysteine levels and shorter capillaries, particularly in the brain region called the hippocampus.” Troen adds, “Despite the vascular changes, the brain anatomy appeared normal, and there was no evidence of a cellular proliferation process called gliosis, which typically accompanies neurodegeneration.”

Irwin Rosenberg, MD, director of the Nutrition and Neurocognition Laboratory at the HNRCA, notes, “The elevated levels of homocysteine that were associated with vascular cognitive impairment in the mice in our study are comparable to the levels that are associated in older adults with an increased risk for Alzheimer’s disease and cerebrovascular disease, the latter of which manifests with conditions such as stroke and atherosclerosis. These findings may indicate that microvascular changes mediate the association between high homocysteine levels and human age-related cognitive decline.”

Troen and colleagues write that their study helps to “…define more precisely the mechanisms underlying cerebral microvascular disease, independent of or prior to the onset of irreversible neurodegeneration.” According to Troen, this work, which was funded by the U.S. Department of Agriculture, “may provide a model system in which to study the role of the brain's microvascular circulation in cognitive function.”

Troen AM, Shea-Budgell M, Shukitt-Hale B, Smith DE, Selhub J, Rosenberg IH. Proceedings of the National Academy of Sciences. 2008 (Aug. 26); 105 (34): 12474-12479. “B-vitamin deficiency causes hyperhomocysteinemia and vascular cognitive impairment in mice.”

The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University is the only independent school of nutrition in the United States. The school’s eight centers, which focus on questions relating to famine, hunger, poverty, and communications, are renowned for the application of scientific research to national and international policy. For two decades, the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University has studied the relationship between good nutrition and good health in aging populations. Tufts research scientists work with federal agencies to establish the USDA Dietary Guidelines, the Dietary Reference Intakes, and other significant public policies.

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