Wednesday, March 18, 2009

Mediterranean diet may help prevent spina bifida

Mediterranean diet may help prevent spina bifida

Reuters Health
Thursday, February 12, 2009
By Anne Harding

NEW YORK (Reuters Health) - Moms-to-be can help prevent their babies from developing a serious spinal cord defect by eating a Mediterranean diet, Dutch researchers say.

Dr. Regine P. M. Steegers-Theunissen of Erasmus Medical Center in Rotterdam and colleagues found that women who ate more fruit, vegetables, healthy oils, fish and whole grains were less likely to give birth to a child with spina bifida.

Folic acid supplementation has been shown to help prevent this birth defect, in which the spinal cord fails to close completely. Some countries, including the United States, now fortify foods with folate to ensure pregnant women are getting enough of the nutrient. But folate isn't the whole story, Steegers-Theunissen told Reuters Health. "It's not only folate which is protective, but it's the whole diet. It's the balance of the diet in which folate is an important component."

In southern Europe, where the Mediterranean diet originated, rates of spina bifida are lower, and the defect is also less common in countries that fortify food with folate, the investigators note in their report.

To investigate whether diet might play a role in spina bifida risk, the researchers studied the diets of 50 women who had given birth to a child with spina bifida and 81 women whose children did not have the birth defect.

Women with the least Mediterranean-like diet were about three times more likely to have had a child with spina bifida, the researchers found. And the more closely a woman's diet adhered to the Mediterranean pattern, the higher her blood levels of folate and vitamin B12.

In the Netherlands, food is not fortified with folate, Steegers-Theunissen noted in an interview. Some of the women in the study, but not all, were taking folic acid supplements. But when the researchers controlled for the effects of the supplements, as well as body mass index (another known risk factor for having a baby with spina bifida), they found the Mediterranean diet independently reduced spina bifida risk.

SOURCE: BJOG, February 200

Low Levels of Vitamin B12 May Increase Risk for Neural Tube Defects

Low Levels of Vitamin B12 May Increase Risk for Neural Tube Defects
Monday, March 2, 2009

Children born to women who have low blood levels of vitamin B12 shortly before and after conception may have an increased risk of a neural tube defect, according to an analysis by researchers at the National Institutes of Health, Trinity College Dublin, and the Health Research Board of Ireland.

Women with the lowest B12 levels had 5 times the risk of having a child with a neural tube defect compared to women with the highest B12 levels.

Women who consume little or no meat or animal based foods are the most likely group of women to have low B12 levels, along with women who have intestinal disorders that prevent them from absorbing sufficient amounts of B12.

Neural tube defects are a class of birth defects affecting the brain and spinal cord. One type, spina bifida, can cause partial paralysis. Another type, anencephaly, is a fatal defect in which the brain and skull are severely underdeveloped.

Researchers have known that taking another nutrient, folic acid, during the weeks before and after conception can greatly reduce a woman’s chances of having a child with a neural tube defect. Folic acid is the synthetic form of the vitamin folate. In the United States, cereal grains are fortified with folic acid to reduce the occurrence of neural tube defects in the U.S. population.

The study appears in the March Pediatrics. The study’s first author was Anne M. Molloy, Ph.D., Trinity College Dublin. Scientists from the Health Research Board of Ireland and two NIH institutes, the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Human Genome Research Institute, also took part in the study.

"Vitamin B12 is essential for the functioning of the nervous system and for the production of red blood cells,” said Duane Alexander, M.D., director of the NICHD. "The results of this study suggest that women with low levels of B12 not only may risk health problems of their own, but also may increase the chance that their children may be born with a serious birth defect."

Ireland has a high rate of neural tube defects, and NIH scientists have frequently collaborated with Irish researchers to gain insight into the causes of this group of disorders.

To conduct the study, the researchers analyzed stored blood samples originally collected during early pregnancy from three groups of Irish women between 1983 and 1990. During that time, pregnant women in Ireland rarely took vitamin supplements. The study authors reasoned that the lack of routine vitamin supplementation would allow them to identify a sufficient number of women with low Vitamin B12 to conduct their analysis.

For their analysis, the researchers classified the women into three groups. The first group consisted of 95 women who were pregnant with a child having a neural tube defect at the time the blood was taken. The second group was composed of 107 women who had previously given birth to a child with a neural tube defect but whose current pregnancy was not affected. Like the first group, women in the third group (a total of 76) were pregnant with a child having a neural tube defect at the time the blood sample was obtained, but were enrolled in a different study than the women in group 1. The researchers measured the Vitamin B12 and folate levels of the women’s blood samples, and compared them to those of control groups whose pregnancies were unaffected by a neural tube defect.

Because low folate levels are a known risk factor for neural tube defects, the researchers used statistical techniques to evaluate the role of Vitamin B12 independently of the role of folate. In all three groups, women with low B12 concentrations (estimated at less than 250 ng/L, before pregnancy) had 2.5-3 times the risk of having a child with a neural tube defect compared to those with higher levels. Women with levels in the deficient range (0-149 ng/L ) were at the highest risk: 5 times that of women with higher levels.

The study authors wrote that it is not known how B12 and folate might interact to influence the formation of the neural tube, the embryonic structure that gives rise to the spine and brain. They noted that the two vitamins are jointly involved with several key biochemical reactions, as well as with the synthesis of DNA. Lack of either Vitamin B12 or folate in any of these chemical processes theoretically could increase the risk of a neural tube defect.

The authors noted that their results needed to be confirmed by other studies among other populations of women. They suggested, however, that women should have Vitamin B12 levels above 300 ng/L before becoming pregnant. (Because B12 levels drop sharply during pregnancy, the researchers adjusted the levels measured during pregnancy to provide a target level for women to achieve before they become pregnant.)

Because Vitamin B12 comes from foods of animal origin, women who adhere to a strict vegan diet may be at risk for a B12 deficiency, said an NICHD author of the paper, James L. Mills, M.D., senior investigator in the Division of Epidemiology, Statistics, and Prevention Research. He added it is advisable for women with digestive disorders that interfere with the absorption of foods to consult a physician before getting pregnant, to make sure they are receiving adequate amounts of B12.

Dr. Mills explained that critical events in the formation of the brain and spinal column occur very early in pregnancy—in the first 28 days after conception—before many women even realize they are pregnant.

He added that the U.S. Public Health Service recommends that all women of childbearing age consume 400 micrograms of folic acid each day. This amount assures that a woman will have adequate stores of the vitamin, in the event of an unintended pregnancy.

"If women wait until they realize that they are pregnant before they start taking folic acid, it is usually too late," Dr. Mills said.

Similarly, he said, it would be wise for all women of childbearing age to consume the recommended amount of Vitamin B12, whether they are planning a pregnancy or not. "Half of the women who become pregnant each year in the U.S. were not planning to become pregnant."

"Our results offer evidence that women who have adequate B12 levels before they become pregnant may further reduce the occurrence of this class of birth defects," Dr. Mills said.

Vitamin B12 is available in milk, meats, poultry, eggs, as well as fortified cereals and some other fortified foods. Information on foods that contain Vitamin B12, as well as the Recommended Dietary Allowances for the vitamin, is available from the NIH Office of Dietary Supplements,

Folate is found in leafy green vegetables, fruits, and dried beans and peas. Information on sources of folate also is available from the NIH Office of Dietary Supplements,

Dr. Mills explains the study findings in the accompanying online video at

A transcript of the video is available on the NICHD Web site at

The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute’s Web site at

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit

Filmmakers to tackle Canadian Agent Orange scandal

Filmmakers to tackle Agent Orange scandal
Published Monday March 9th, 2009

A group of New York moviemakers will settle into the Fredericton region for the next few weeks to film what it calls "Canada's dirty secret" to a worldwide audience.

Filmmakers Danny Feighery and Gregg de Domenico and two colleagues arrive in Fredericton today to work on their documentary about the lingering effects of the spraying of Agent Orange and other toxic chemicals at Canadian Forces Base Gagetown.

They will remain until the April 1 deadline for the federal government's $20,000 ex-gratia compensation payments passes.

"It's such a bizarre story," said Feighery. "There's all these different qualifiers and rules and absurdities to it."

"The whole story seems to be pretty absurd. There's never been anything so massive in western civilization for a government to poison their own people on this scale."

He's personally invested in the story.

His grandfather was a member of the provost corps at CFB Gagetown - the precursor to the military police - so his mother Sharon grew up on the base, ate blueberries that had grown on the base and played there.

When his sister Theresa was born, she had spina bifida. It's a congenital defect of the spine, in which part of the spinal cord and the meninges are exposed through a gap in the backbone. The condition has been linked to exposure to Agent Orange and a whole host of other toxic chemicals that were sprayed on the base.

It wasn't until a family reunion last year in Nova Scotia where relatives talked about Agent Orange that Feighery's family began drawing possible links to his sister's spina bifida and exposure to toxic defoliants.

"No democracy has ever let half a million people be contaminated by a toxin and then never tell them about it and cover it up," he said.

De Domenico said the story deserves a wider audience.

"I'm curious about the story and I'd like to see somebody see this through to get some answers," he said. "I know, personally, I feel like - especially coming out of the Bush administration in the United States - we're all looking for some degree of accountability from our governments.

"I know I personally feel like I want to see transparency and I want to see fairness. I want to know we're not being taken advantage of by corporate interests."

They plan to delve into the involvement of chemical companies, the military and the government.

"We want to go further, looking into the factfinder's mission, the results of the factfinder's mission, how that affected Veterans Affairs and the compensation packages. Then straight into the compensation packages ending April 1 and where does everyone go from there," de Domenico said.

Veterans Affairs Minister Greg Thompson has said the April 1 deadline isn't absolute and if a late application is received, it will be considered.

Payments are also considered for primary caregivers of qualifying individuals who died on or after Feb. 6, 2006, the date the federal Conservative government took office.

Thankfully, he said, many people in the region have taken up the challenge of doing the research.

He just hopes to do them justice on the big screen.

"We're very much doing our best to tell their story."

"There's only so many times you can sit with them and hold their hands while they're crying, saying they feel left in the cold. I want to feel like we can get the word out and maybe bring some more attention to this."

And for de Domenico and Feighery, who have long worked making commercials and feature films, it's a chance to put their craft to a higher use.

"We want to get back to a place where filmmaking is about helping society and making a difference."

"What we really need now is to talk to politicians who understand the story and are sympathetic.''

The film is tentatively titled Gagetown: Canada's Dirty Secret. They hope to have an 80- to 90-minute film ready by later this spring, the deadline for entering the Toronto Film Festival.

Feighery and de Domenico have been keeping in touch with people involved with the movie through their website:

Neuroscientists isolate gene essential to early brain development

Neuroscientists isolate gene essential to early brain development
November 27th, 2008

University of Queensland neuroscientists have discovered the crucial role a specific gene plays in forming the neural tube, the earliest identifiable structure in the developing brain and an essential precursor to the entire central nervous system.

While investigating neural tube closure in the clawed toad (Xenopus laevis) and in zebrafish, Associate Professor Helen Cooper at the Queensland Brain Institute (QBI) has, for the first time, described one of the processes that drive this crucial stage of brain development, which is common to all vertebrates.

“Globally, neural tube closure defects occur in about one-in-a-thousand human pregnancies, resulting in malformations of the central nervous system and conditions such as spina bifida or anencephaly,” Dr Cooper said.

In spina bifida, for example, incomplete closure of the embryonic neural tube leads to incorrect development of the spinal cord, often resulting in significant disability.

“Although it has been known for some time that regular intake of folic acid before conception greatly reduces the incidence of neural tube abnormalities, scientists are still trying to understand the complex interplay of genes during this crucial early stage of brain development.”

“Our laboratory has now established that a copy of one particular gene (Neogenin) is essential for proper formation of neural folds, the first stages in the development of neural tubes.

“If the neural folds do not develop then the neural tube cannot close, resulting in neural tube defects,” Dr Cooper said.

“And just as importantly, our lab has also discovered that Neogenin is vital for differentiation of neural stems cells throughout the development of the early central nervous system.”

Neuroscientists studying early brain development often investigate zebrafish because these small freshwater animals produce several hundred embryos, which develop rapidly and are almost totally transparent from fertilisation to hatching (about 48 hours), allowing scientists to view brain development as it happens.

Dr Cooper's research: “Neogenin and RGMa control neural tube closure and neuroepithelial morphology by regulating cell polarity” is published in this week's edition of the Journal of Neuroscience.

Babies & Robots: Infant power mobility on display

Babies & Robots: Infant power mobility on display
February 4th, 2009

Children with mobility issues, like cerebral palsy and spina bifida, can't explore the world like other babies, because they can't crawl or walk. Infant development emerges from the thousands of daily discoveries experienced by babies as they move and explore their worlds.

Mobility-deprived kids start exploring when they can operate a traditional power wheelchair, typically at age 3 or often older.

Research done by University of Delaware researchers is turning that on its head and could potentially change the way these children's brains develop.

Physical therapy professor Cole Galloway and mechanical engineering professor Sunil Agrawal have developed tiny power chairs babies as young as 6 months can operate using a joystick.

Now, they've paired with Permobil, a national producer of power chairs, and outfitted a chair for toddlers.

Galloway will be showcasing this research next week in Las Vegas at the American Physical Therapy Association's Combined Sections Meeting. (Tuesday, February 10, 10am-3pm)

A 17-month-old boy, Andrew, who's been driving the robots for more than a year, will be on hand to demonstrate the technology. On an average day, Andrew uses his chair to navigate his home and the outside world. He is ready to attend pre-K next year, impressive progress for a child with spina bifida.

Galloway believes providing mobility to children who wouldn't have it otherwise could impact their lives in countless ways, especially when you consider the rapid brain development during infancy.

"Babies literally build their own brains through their exploration and learning in the complex world," he says. "Their actions, feelings and thinking all shape their own brain's development.

"Mobility is linked to widespread advances in cognitive development and learning abilities in typically developing infants."

The University of Delaware has filed patents and is working to bring to market a robot-enhanced mini wheelchair for children aged 6 months-2 years.

For more information, check out: Us/People/galloway.html

Source: University of Delaware

Obesity during pregnancy linked to increased risk of babies born with abnormalities

Obesity during pregnancy linked to increased risk of babies born with abnormalities
February 11th, 2009

( -- A Newcastle University study has shown that obese women who become pregnant have an increased risk of their baby being born with certain abnormalities, including spina bifida.

They found that women who were obese were more than twice as likely to have a baby with spina bifida, a condition which affects a very small number of pregnancies but which may result in disability.

Dr Judith Rankin from the team who carried out the study says, “Women who are thinking about trying for a baby need to check their own weight first and then think about seeking help if they are overweight. While you are pregnant it’s not the time to start a weight loss diet but it is more important to eat sensibly and healthily.”

Recent studies suggest up to a fifth of pregnant mothers are classed as obese in the UK - a figure that has doubled in the last 10 years.*

In the United States, a third of women age 15 years and older were obese in 2004.

Obese is considered as a Body Mass Index (BMI) over 30, while overweight is classed as a BMI over 25, as categorized by the World Health Organisation.

The study, out today in the academic journal JAMA, analysed and combined data from 39 previous studies to look at the risks of abnormalities in the baby for mothers who were obese or overweight.

It showed that obese women were nearly twice as likely to have a baby with neural tube defects which are caused by the incomplete development of the brain, spinal cord and/or their protective coverings. For one of those conditions, spina bifida, the risk was more than doubled.

Researchers also detected an increased risk in heart defects (cardiovascular anomaly), cleft lip and palate, a malformation of the lower bowel (anorectal atresia), increased risk of water on the brain (hydrocephaly) and problems in the growth of arms and legs (limb reduction anomaly).

For the first time, researchers found a possible link between mothers who are overweight and babies with neural tube defects, although they say more research needs to be done in this area.

“This is the first time that so many studies have been combined to build a more accurate picture and it shows a link between a mother’s weight and many of these serious conditions in the newborn baby. Given that we are seeing an increase in the number of people who are overweight or obese, then we may see an increase in the number of babies born with abnormalities”, says Dr Rankin.

Despite their findings, the researchers were keen to stress that these abnormalities are uncommon. “Spina bifida only occurs in approximately one in every two thousand births, so the risk, even among obese women, remains very low.”

The Newcastle University team will now continue the work to examine why there is a link between a mother’s weight and abnormalities in the baby.

Academic paper: Maternal Overweight and Obesity and the Risk of Congenital Anomalies. A systematic review and Meta-analysis. Katherine J. Stothard, PhD, Peter W.G Tennant, MSc, Ruth Bell, MD, Judith Rankin, PhD.

More information: JAMA. 2009;3016:636-650.


*There are no national published figures relating to pregnancy so this figure is based on a study published in 2006 in BJOG which showed 16% of women are obese at booking in Middlesbrough.

Birth brain defect could be treated with vitamin supplement

Birth brain defect could be treated with vitamin supplement
March 17th, 2009

( -- Pioneering research published today suggests that a vitamin supplement taken during pregnancy could prevent hydrocephalus - one of the common forms of birth brain defect.

Scientists at The University of Manchester and Lancaster University say laboratory tests have shown that administering a combination of vitamins (tetrahydrofolate and folinic acid), dramatically reduces the risk of hydrocephalus.

Dr Jaleel Miyan, who led the research in Manchester’s Faculty of Life Sciences, said: “Hydrocephalus is a condition arising from an abnormal build-up of fluid within the chambers of the brain.

“This fluid build-up - usually caused by a blockage in the fluid’s pathway due to trauma, infection or abnormal development - is associated with an increase in the pressure on the brain resulting in brain damage. When this happens, doctors can relieve this pressure only by performing surgery.

“Our studies have revealed that hydrocephalus is associated with a change in the composition of the cerebrospinal fluid and it is this chemical change that prevents normal growth of the brain cells resulting in arrested brain development. This occurs prior to any brain damage due to raised pressure.”

The findings of the study, funded by Association for Spina Bifida & Hydrocephalus (ASBAH) and published in the Journal of Neuropathology and Experimental Neurology, led the team to examine ways of stimulating cell division to encourage normal brain development.

Dr Miyan explained: “A combination of tetrahydrofolate and folinic acid - both naturally occurring substances - stimulated brain cell growth and had a significant positive effect on brain development in laboratory experiments on rats and reduced the incidence of hydrocephalus.

“In laboratory experiments, the combined folate supplement works at any stage during pregnancy which means that it may be effective even if it is commenced after the diagnosis of hydrocephalus is made at an 18 to 20 week pregnancy scan.