Women's heart attack symptoms are not all that different

May 4, 2020

Science Daily/European Society of Cardiology

The top three heart attack symptoms in both women and men are chest pain, sweating, and shortness of breath, reports a study presented today on EAPC Essentials 4 You, a scientific platform of the European Society of Cardiology (ESC), and published in the Journal of the American Heart Association.

"Heart attack symptoms are often labelled as 'typical' in men and 'atypical' in women," said study author Dr. Annemarijn de Boer of the University Medical Centre Utrecht, the Netherlands. "But our study shows that while symptoms can differ between the sexes, there are also many similarities."

Whatever your gender, if you experience heart attack symptoms, don't delay. Call the emergency services immediately.

Symptom recognition is crucial to enable fast, live saving treatment for people having a heart attack. Some previous studies report sex differences in symptoms while others report shared symptoms.

This study compiled the highest quality studies -- 27 in total -- from the past two decades detailing symptoms in patients with confirmed acute coronary syndrome (heart attack or unstable angina).

In addition to sharing the three most common symptoms, the majority of men and women experiencing an acute coronary syndrome had chest pain: 79% of men and 74% of women.

Significant differences in symptom presentation between women and men were also reported. Compared to men, women were more than twice as likely to have pain between the shoulder blades, 64% more likely to have nausea or vomiting, and 34% more likely to experience shortness of breath. Although chest pain and sweating were the most frequent symptoms in both women and men, they occurred less often in women, who had a 30% lower odds of chest pain and 26% lower odds of sweating compared to men.

The study did not investigate the reasons why there are some variations in symptom presentation between women and men, but Dr. de Boer said: "Previous research has shown sex differences in how heart attacks occur in the body, but it is uncertain how or whether this relates to symptom presentation. The cause of symptom differences between the sexes deserves further study."

https://www.sciencedaily.com/releases/2020/05/200504083055.htm

Women's lifestyle changes, even in middle age, may reduce future stroke risk

April 9, 2020

Science Daily/American Heart Association

Middle age may not be too late for women to substantially reduce their stroke risk by not smoking, exercising, maintaining a healthy weight and making healthy food choices, according to new research published today in Stroke, a journal of the American Stroke Association, a division of the American Heart Association.

In general, women are more likely than men to have a stroke, die from stroke and have poorer health and physical function after a stroke. The average age of first stroke in women is 75 years. Based on this information, researchers theorized that making mid-life lifestyle changes might help reduce stroke's burden among women.

"We found that changing to a healthy lifestyle, even in your 50s, still has the potential to prevent strokes," said Goodarz Danaei, Sc.D., lead study author and Bernard Lown Associate Professor of Cardiovascular Health at Harvard T.H. Chan School of Public Health in Boston. "Women who made lifestyle modifications in middle age reduced their long-term risk of total stroke by nearly a quarter and ischemic stroke, the most common type of stroke, by more than one-third."

Researchers analyzed the Nurses' Health Study, which includes health information on nearly 60,000 women who enrolled at average age of 52 and continued in the study for an average of 26 years. Researchers studied the impact on stroke risk from smoking cessation, exercising 30 minutes or more daily and gradual weight loss if women were overweight. The researchers also studied the impact of making recommended dietary modifications that emphasize eating more fish, nuts, whole grains, fruits and vegetables and less red meat, no processed meat and less alcohol.

During the 26-year follow-up, researchers found:

• 4.7% of women with no lifestyle interventions had a stroke of any type; 2.4% had ischemic stroke; and 0.7% had hemorrhagic stroke.

• Engaging in the three non-dietary interventions -- smoking cessation, daily exercise and weight loss -- was estimated to reduce the risk of total stroke by 25% and ischemic stroke by 36%.

• Sustained dietary modifications were estimated to reduce the risk of total stroke by 23%.

Researchers also found that increasing fish and nut consumption and reducing unprocessed red meat consumption appeared to have positive impacts on reducing stroke risk, although the degree of impact from these dietary changes was not as big as those achieved through increased physical activity, smoking cessation and maintaining a healthy weight.

While this was an observational study that included mostly white, middle-aged women, Danaei said, "there are other studies to support that the proportional changes in stroke risk from lifestyle and dietary modifications may be generalizable to men. We also estimate that exercising 30 minutes or more daily may reduce the risk of stroke by 20%."

https://www.sciencedaily.com/releases/2020/04/200409085637.htm

Babies retain even detailed events during a nap

During sleep, toddlers' brains consolidate details without generalizing them

April 7, 2020

Science Daily/Max Planck Institute for Human Cognitive and Brain Sciences

While sleeping the brain goes through previously experienced things, consolidates new memory contents and summarizes similar experiences into more general knowledge. This also applies to babies. However, they can more than just generalize what they have learned. A recent study shows: during sleep a baby's brain also consolidates the details of its individual experience and protects them from generalization and is therefore also important for what is known as episodic memory.

The brain is permanently exposed to new impressions. Even when sleeping, it does not rest and processes recent experiences. In very early childhood, it has been thought that sleep primarily promotes semantic memory. This includes general knowledge such as the meaning of words. However, scientists at the Max Planck Institute for Human Cognitive and Brain Sciences (MPI CBS) Leipzig and the Humboldt University (HU) Berlin, together with researchers from Lübeck and Tübingen, have now shown for the first time in their study published in Nature Communications that babies also build their episodic memory when they nap. This enables them to remember the details of their individual experiences after napping.

The scientists examined this relationship using a three-phase study. During the learning phase, the 14 to 17-month-old children were shown pictures of objects whose names they already knew, containing different cars, balls or dogs. They then heard the appropriate name for each picture. One group of the children spent the following one to two hours sleeping, while a second group stayed awake. In the subsequent test phase, the researchers showed the young participants different pictures again, including those that they had already seen in the learning phase as well as new cars, balls and dogs. Each object was once named correctly and once incorrectly. During all phases of the experiment, the researchers recorded the baby's brain activity using the electroencephalogram (EEG).

The analysis of the EEG activity made it clear: The brain of the children who had slept responded differently in the memory test than that of those who stayed awake -- but only in certain cases. If the researchers presented the babies with a ball that they had never seen before and called it a car, the brain responses initially did not differ. In both groups, the so-called N400 component appeared, which occurs when the brain processes inappropriate meanings. The children obviously knew that a ball is not a car.

It was different, however, when the babies viewed a ball from the learning phase and it was called a car. The group that had stayed awake again showed the N400 component, while the group that had slept did not. In the children who had napped, the researchers observed a brain response that was triggered when a ball from the learning phase was again correctly named as such. However, this response did not occur when a new ball was called a ball. The researchers concluded: After sleep, the babies no longer understood the object-word pairs they had previously experienced as naming a meaning. Rather, they recognized them as individual episodes. Object and word were thus merged into a unified event in the memory.

"The results show that sleep not only enables the infant brain to generalize individual experiences, but also to preserve individual experiences in detail and to differentiate them from existing general knowledge," explains first author Manuela Friedrich, researcher at the MPI CBS and HU Berlin. She further hypothesizes: "The fact that a recognized object-word episode is not understood as referring to general knowledge means that its details can be protected from mixing with existing memory."

The results are also interesting with respect to the so-called infantile amnesia, i.e. the phenomenon of not being able to remember one's own early childhood experiences. It has often been assumed that very young children are not yet capable of forming longer-term episodic knowledge. However, the current findings clearly show that even babies can remember events in detail -- and sleep contributes significantly to this.

https://www.sciencedaily.com/releases/2020/04/200407131435.htm

Consuming extra calories can help exercising women avoid menstrual disorders

March 31, 2020

Science Daily/The Endocrine Society

Exercising women who struggle to consume enough calories and have menstrual disorders can simply increase their food intake to recover their menstrual cycle, according to a study accepted for presentation at ENDO 2020, the Endocrine Society's annual meeting, and publication in the Journal of the Endocrine Society.

The study found that exercising women with menstrual disorders can start menstruating again by consuming an additional 300-400 calories a day.

"These findings can impact all exercising women, because many women strive to exercise for competitive and health-related reasons but may not be getting enough calories to support their exercise," said lead researcher Mary Jane De Souza, Ph.D., of Penn State University.

By consuming enough calories, exercising women with menstrual disorders can avoid complications associated with a condition known as the Female Athlete Triad, De Souza said. This is a medical condition that starts with inadequate food intake that fails to meet the body's needs. It leads to menstrual disorders and poor bone health. It is associated with a high incidence of stress fractures.

The study included 62 young, exercising women with infrequent menstrual periods. Thirty-two women increased their calorie intake an average of 300-400 calories a day, and 30 maintained their exercise and eating habits for the 12-month study. Women who consumed the extra calories were twice as likely to have their menstrual period during the study compared with the women who maintained their regular exercise and eating routine.

"This strategy is easy to implement with the help of a nutritionist. It does not require a prescription and avoids complications from drug therapy," De Souza said. "The findings will encourage healthcare providers to try to help exercising women with menstrual disorders who consume too few calories to eat more, and this may help them to be healthier athletes and avoid bone complications."

https://www.sciencedaily.com/releases/2020/03/200331093259.htm

Mother/infant skin-to-skin touch boosts baby's brain development and function

Both mother and baby physiology respond to kangaroo care method

March 25, 2020

Science Daily/Florida Atlantic University

As the world prioritizes social distancing to stop or slow down the spread of coronavirus (COVID-19), a new study by researchers at Florida Atlantic University demonstrates that mother-infant touch and contact are essential for optimal neurodevelopmental regulation in early infancy. Kangaroo Care, a skin-to-skin, chest-to-chest method of caring for a baby, especially one who is premature, has been associated with promoting neurophysiological development. This method of caring emphasizes the importance of holding the naked or partially dressed baby against the bare skin of a parent, typically the mother. New research is showing that extended use of Kangaroo Care can positively benefit full-term infants and their mothers during the post-partum period.

The longitudinal randomized, controlled trial investigated if Kangaroo Care influences markers of neuro-maturation in healthy, full-term infants. They focused on the potential association between Kangaroo Care and infant brain development, specifically measures of EEG (electroencephalogram) asymmetry/power and coherence.

In addition to EEG patterns in infants, the researchers looked at basal oxytocin -- the "cuddle" hormone -- and cortisol reactivity -- the "stress" hormone -- in infants and their mothers. Oxytocin is considered an affiliative hormone associated with caregiving and affectionate behavior whereas cortisol reactivity is implicated in the stress response system. Researchers compared six weeks of Kangaroo Care to standard caring (control group) during the first three months of life.

For the study, mothers assigned to the Kangaroo Care group were given a Kangaroo Care wrap (Nurtured by Design, The Kangaroo Zak) and were taught proper procedures by a certified trainer at the prenatal visit. Mothers were asked to use Kangaroo Care, skin-to-skin, chest-to-chest contact with her infant, for one hour a day for six weeks and were provided with journals to record the frequency of Kangaroo Care use. Mothers in the control group were given infant feeding pillows and journals and were asked to record infant feedings for six weeks. Babies were fitted with a stretch Lycra cap to measure EEG activity during a five-minute quiet-alert state at three-months. Oxytocin was measured by collecting maternal and infant urine, and infant cortisol reactivity was measured by collecting infant saliva samples before and after a mild stressor.

Results of the study, published in the journal Infant Behavior and Development, provide evidence that the physiology of mothers and their full-term infants is influenced by obtaining Kangaroo Care training and utilizing it during the post-partum period.

"We wanted to know if exposure to extended tactile stimulation using the Kangaroo Care method would increase peripheral basal oxytocin and suppress cortisol reactivity in the babies in our study," said Nancy Aaron Jones, Ph.D., senior author, an associate professor, and director of the FAU WAVES Emotion Laboratory in the Department of Psychology in FAU's Charles E. Schmidt College of Science, and a member of the FAU Brain Institute (I-BRAIN). "We also wanted to examine if Kangaroo Care increases oxytocin levels in mothers, which has important implications for post-partum depression."

Findings showed that the infants' left frontal area of the brain (implicated in higher-order cognitive and emotional regulatory skills) appears to be stimulated from the Kangaroo Care method. In addition, mother/infant dyads showed increased oxytocin along with decreases in stress reactivity, suggesting regulatory abilities are prompted by experiences with positive caregiving in infancy.

Results from the study indicate that Kangaroo Care training and level of use by caregivers during infancy can favorably influence both neurodevelopmental trajectories and infant neurobiological functioning.

"Our findings across several studies demonstrate a link between the supportive dimensions of maternal caregiving behavior and left hemisphere neurodevelopment, with maternal warmth and sensitivity predicting greater regulatory abilities and secure attachment," said Jones. "Full-term infants and their mothers likely benefit from the positive interactive experiences inherent in extended Kangaroo Care use."

https://www.sciencedaily.com/releases/2020/03/200325110913.htm

Preterm babies are more likely to be diagnosed with reactive attachment disorder

March 12, 2020

Science Daily/University of Turku

A new study by the Research Centre for Child Psychiatry of the University of Turku, Finland, suggests that premature babies have the risk of reactive attachment disorder that can impair child's ability to function in normal situations and their social interactions and it is connected with later child protection issues, psychiatric and substance use disorders, and social exclusion.

"The study showed that children's risk of being diagnosed with reactive attachment disorder increases by three times if their gestational age at birth is less than 32 weeks. The risk was twofold if the birth weight was less than 2.5 kilos, or if the newborn required monitoring in a Neonatal Intensive Care Unit, says lead author," researcher Subina Upadhyaya.

The results acknowledged parental age and psychiatric and substance abuse diagnoses, and mother's socio-economic status and smoking. Therefore, the association between attachment disorder and early preterm birth is not due to differences in these parental background or lifestyle differences between the diagnosed and the control group.

This is the first population study to report perinatal and obstetric risk factors for RAD. Previously, the research group discovered an association between parental mental health diagnosis, parental substance abuse and RAD.

Results support family-centered treatment

According to Professor in Child Psychiatry Andre Sourander from the University of Turku, the results benefit the planning of preventive and early mental health services.

"The fact that premature birth is so strongly associated with reactive attachment disorder is an important finding. It indicates that family-centered support of early parent-infant interactions and need for care should be taken into account when treating premature babies, says Sourander," who led the study.

Sourander says that most of the children in the study were born in the 1990s and early 2000s. Treatment practices have changed since then in many countries.

"The management of premature infants should be multidisciplinary and personalised. Parent-infant interaction and family-centered care have recently received attention, and the care of premature infants has become increasingly comprehensive. The practice of skin-to-skin care is increasingly becoming popular worldwide. Early parental-infant closeness should be encouraged in centers that care for preterm infants.

"In the future, it is important to determine whether the independent relationship of prematurity to RAD has decreased as treatment practices have changed," Professor Sourander concludes.

All the children who were born in Finland between 1991-2012 and diagnosed with RAD were included in the study. There were a total of 614 cases and 2423 controls. The study was part of Inequalities, Interventions, and New Welfare State research flagship funded by Academy of Finland.

https://www.sciencedaily.com/releases/2020/03/200312101031.htm

Poor sleep in infancy linked to behavioral and emotional problems in toddlers

March 11, 2020

Science Daily/University of Birmingham

Disrupted and poor quality sleep in the earliest months of a child's life can be an indicator of depression, anxiety and behavioural problems among toddlers, according to a new study.

Researchers at the Institute for Mental Health, at the University of Birmingham in collaboration with the Finnish Institute for Health and Welfare, in Helsinki, found a clear relationship between sleep problems in infancy such as frequent night wakings, short sleep duration or difficulty in falling asleep and particular emotional and behavioural problems at 24 months of age.

Although childhood sleep problems are extremely common and their association with daytime behavioural difficulties is well recognised, this study shows for the first time how sleep problems in infancy and very early childhood are associated with emotional and behavioural problems later in childhood.

The team believes these findings, published in BMJ Paediatrics Open, highlight the need to address infant sleep problems at an early stage, to prevent the development or worsening of future emotional and behavioural problems in later stages of childhood.

The team studied the results of two sleep questionnaires completed by parents within the CHILD-SLEEP birth-cohort, a large study cohort based in southern Finland. For this specific study, the researchers obtained information from nearly 1700 parents who completed a baseline questionnaire, and reported on sleep habits of their children at 3,8, 18 and 24 months. These results were compared with a separate questionnaire on emotional and behavioural symptoms, which was completed by 950 parents at the child´s age of 24 months..

The researchers found that high frequency of night wakings at 3 months was strongly linked to emotional, behavioural and self-regulation (the ability to control emotions and behaviours) problems in toddlers.Further, infants who experienced shorter sleep duration, who took longer to fall asleep and who experienced frequent night wakings at different stages of early childhood were likely to find problems in regulating their behaviour and emotions at the age of 24 months, leading to disrupting emotions and behaviours, such as temper tantrums.

The study contributes to recent research on the role of early sleep problems in socio-emotional development.

Lead researcher Dr Isabel Morales-Muñoz explained: "Our results show that infants who sleep for shorter periods of time, take longer to fall asleep and wake up more frequently during the night are more likely to show emotional and behavioural problems in later stages of childhood. It's likely that sleep quality in these early months and the development of self-regulation -- the ability to control our behaviour -- are closely intertwined."

The study suggests that infant sleep problems may be due to a variety of mechanisms, including genetic and environmental factors.

"Scientists think there are links in the central nervous system between sleep-wake behaviour and our emotions, and so it's possible these links have a biological basis," says Dr Morales-Muñoz. "Environmental factors, such as sleeping practices in the family, parental reactions to crying and parental stress also play an important part in a child's sleep and socioemotional development."

Dr Morales-Muñoz added: "Although more research needs to be done in this area, we think early interventions in infants experiencing these sleep problems could be really beneficial and help very young children develop their behavioural and emotional self-control."

https://www.sciencedaily.com/releases/2020/03/200311082937.htm

Leaving your baby to 'cry it out' has no adverse effects on child development

 March 10, 2020

Science Daily/University of Warwick

Leaving an infant to 'cry it out' from birth up to 18 months does not adversely affect their behaviour development or attachment, researchers from the University of Warwick have found, they also discovered that those left to cry cried less and for a shorter duration at 18 months of age.

An infant's development and attachment to their parents is not affected by being left to 'cry it out' and can actually decrease the amount of crying and duration.

Researchers from the University of Warwick have today, the 11th of March had the paper 'Parental use of 'cry it out' in infants: No adverse effects on attachment and behavioural development at 18 months' published in the Journal of Child Psychology and Psychiatry.

In the paper they deal with an issue that is discussed for decades by parent websites and parents without much scientific evidence: Should you always immediately intervene when your baby cries?

Researchers followed 178 infants and their mums over 18 months and repeatedly assessed whether parents intervened immediately when baby cried or let the baby let it cry out a few times or often. They found that it made little difference to the baby's development by 18 months.

In fact, they found leaving babies to cry it out a few times at term and often at 3 months was associated with shorter crying duration at 18 months.

The use of parent's leaving their baby to 'cry it out' was assessed via maternal report at term, 3, 6 and 18 months and cry duration at term, 3 and 18 months. Duration and frequency of fussing and crying was assessed at the same ages with the Crying Pattern Questionnaire.

How sensitive the mother is in interaction with their baby was video-recorded and rated at 3 and 18 months of age.

Attachment was assessed at 18 months using a gold standard experimental procedure, the strange situation test, which assesses how securely an infant is attached to the major caregiver during separation and reunion episodes.

Behavioural development was assessed by direct observation in play with the mother and during assessment by a psychologist and a parent-report questionnaire at 18 months.

Researchers found that whether contemporary parents respond immediately or leave their infant to cry it out a few times to often makes no difference on the short -- or longer term relationship with the mother or the infants behaviour.

This study shows that 2/3 of mum's parent intuitively and learn from their infant, meaning they intervene when they were just born immediately, but as they get older the mother waits a bit to see whether the baby can calm themselves, so babies learn self-regulation.

This "differential responding" allows a baby to learn over time to self-regulate during the day and also during the night.

Dr Ayten Bilgin from the Department of Psychology at the University of Warwick comments:

"Only two previous studies nearly 50 or 20 years ago had investigated whether letting babies 'cry it out' affects babies' development. Our study documents contemporary parenting in the UK and the different approaches to crying used."

Professor Dieter Wolke, who led the study, comments:

"We have to give more credit to parents and babies. Most parents intuitively adapt over time and are attuned to their baby's needs, wait a bit before intervening when crying and allow their babies the opportunity to learn to self-regulate. Most babies develop well despite their parents intervening immediately or not to crying."

https://www.sciencedaily.com/releases/2020/03/200310193305.htm

Persistent sleep difficulties in infancy linked to heightened risk of childhood anxieties

Poor infant sleepers should be monitored for mental health issues later on, say researchers

March 9, 2020

Science Daily/BMJ

Persistent sleep difficulties during the first 12 months of life are linked to a heightened risk of developing childhood anxieties and emotional disorders, indicates research published online in the Archives of Disease in Childhood.

Based on their findings, poor infant sleepers should be monitored for mental health issues in later childhood, advise the researchers.

Around 19% of infants (0-12 months of age) have sleep difficulties, including frequent waking at night and/or trouble falling asleep without help from a parent.

These difficulties have been associated with poorer mental health in early childhood, but it's not clear if this risk persists into older childhood, and if so, whether specific psychiatric symptoms are likely to emerge as a result.

To explore this further, the researchers drew on data from a long term study tracking the health of 1507 first time mothers and their children in Australia.

The mothers described their infant's sleep patterns when s/he was 3 (online), 6 (online), 9 (interview), and 12 months old (online), and their mental health when s/he was 4 and 10 years of age, using validated questionnaires: DAWBA and SDQ.

They also completed the Spence Children's Anxiety Scale for Parents when their child was 10 years old.The final analysis was based on 1460 mother-infant pairs.

In all, the sleep patterns of nearly 1 in 4 (25%; 360) infants were 'settled,' while over half (56%; 817) had moderate, fluctuating sleep problems, and around 1 in 5 (19.5%; 283) had persistent severe sleep problems.

Disturbed sleep patterns were associated with heightened risks of childhood anxiety and emotional issues, the analysis showed.

Compared with infants whose sleep patterns were settled, those with persistent and severe sleep difficulties were nearly 3 times as likely to have emotional problem symptoms when they were 4 years old.

And they were more than twice as likely to meet the diagnostic criteria for an emotional disorder by the time they were 10.

Emotional disorder includes any of the following: separation anxiety; social phobia; agoraphobia; obsessive compulsive disorder; specific phobias; panic disorder; post traumatic stress; generalised anxiety; depression; or bipolar disorder.

Infants whose sleep problems were persistent and severe were also more than twice as likely to have separation anxiety, to fear getting hurt (physically), and to be more anxious generally by the age of 10.

This is an observational study, and as such, can't establish cause, nor were neurological problems, which may affect both sleep and mental health, measured. And, caution the researchers, the study only included singleton children and Australian mothers, so its findings may not be applicable more widely.

Nevertheless, their findings echo those of previous research, they point out. They conclude: "Persistent disturbed sleep during infancy may be an early indicator of a child's heightened susceptibility to later mental health difficulties -- in particular, anxiety problems."

And they advise: "Infants with persistent severe sleep problems should be monitored for emerging mental health difficulties during childhood."

https://www.sciencedaily.com/releases/2020/03/200309221328.htm

The harmful effects of stress during pregnancy can last a lifetime

March 5, 2020

Science Daily/Yale University

Mice exposed to stress in the womb and soon after birth can expect a lifetime of immune system deficiencies that hinder the ability to ward off infections and cancer, Yale University researchers report March 5 in the journal Cell.

In a new study, they tracked a lifetime of physiological changes experienced by mice given a liquid solution containing the stress hormone glucocorticoid while in the womb or soon after birth. Glucocorticoids are naturally occurring hormones that reduce inflammation and are instrumental in helping infants and adults alike adapt quickly to environmental dangers, such as famine or violence. Physicians use them to treat asthma and autoimmune diseases caused by overactive immune systems, for example.

But, the researchers found, early-life exposure to the stress hormone can permanently alter many immune system responses, decreasing the body's ability to ward off bacterial infections and fight tumors.

"Mice for rest of their lives are rewired and reprogrammed in ways fundamentally different from those not exposed to glucocorticoids," said Yale immunobiologist Ruslan Medzhitov, senior author of the study and Howard Hughes Medical Institute investigator.

Medzhitov and first author Jun Young Hun, also of Yale, catalogued a host of physiological changes that occurred in mice given glucocorticoids and that had serious consequences for the rest of their lives. As adults, for instance, the exposed mice were more susceptible to bacterial infections and tumors than mice without exposure. One specific physiological change was decreased activity in a key T cell that responds to pathogens and other threats to the host.

The study helps explain why individuals vary so widely in their ability to ward off infections, the authors said. It also provides an explanation for a social phenomenon found throughout human history: an emphasis on shielding women from stress during pregnancy.

"In all cultures, there are efforts to shelter women from stress during pregnancy," he said. "The effects of early life stress don't just go away."

As more is learned about molecular changes caused by early exposure to stress, the more likely it is that medical science will find a way to minimize its damage, said the authors.

"We aren't there yet," Medzhitov said.

https://www.sciencedaily.com/releases/2020/03/200305132154.htm

###

Infant sleep problems can signal mental disorders in adolescents

July 1, 2020

Science Daily/University of Birmingham

Specific sleep problems among babies and very young children can be linked to mental disorders in adolescents, a new study has found.

A team at the University of Birmingham's School of Psychology studied questionnaire data from the Children of the 90s, a UK-based longitudinal study which recruited pregnant mothers of 14,000 babies when it was set up almost three decades ago.

They found that young children who routinely woke up frequently during the night and experienced irregular sleep routines were associated with psychotic experiences as adolescents. They also found that children who slept for shorter periods at night and went to bed later, were more likely to be associated with borderline personality disorder (BPD) during their teenage years.

Lead researcher, Dr Isabel Morales-Muñoz, explained: "We know from previous research that persistent nightmares in children have been associated with both psychosis and borderline personality disorder. But nightmares do not tell the whole story -- we've found that, in fact, a number of behavioural sleep problems in childhood can point towards these problems in adolescence."

The researchers examined questionnaire data from more than 7,000 participants reporting on psychotic symptoms in adolescence, and more than 6,000 reporting on BPD symptoms in adolescence. The data analysed is from the Children of the 90s study (also known as the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort) which was set up by the University of Bristol.

Sleep behaviour among participants was reported by parents when the children were 6, 18 and 30 months, and assessed again at 3.5, 4.8 and 5.8 years old.

The results, published in JAMA Psychiatry, show particular associations between infants at 18 months old who tended to wake more frequently at night and who had less regular sleep routines from 6 months old, with psychotic experiences in adolescence. This supports existing evidence that insomnia contributes to psychosis, but suggests that these difficulties may be already present years before psychotic experiences occur.

The team also found that children who had less sleep during the night and went to bed later at the age of three-and-a-half years were related to BPD symptoms. These results suggest a specific pathway from toddlers through to adolescents with BPD, which is separate from the pathway linked with psychosis.

Finally, the researchers investigated whether the links between infant sleep and mental disorders in teenagers could be mediated by symptoms of depression in children aged 10 years old. They found that depression mediated the links between childhood sleep problems and the onset of psychosis in adolescents, but this mediation was not observed in BPD, suggesting the existence of a direct association between sleep problems and BPD symptoms.

Professor Steven Marwaha, senior author on the study, added: "We know that adolescence is a key developmental period to study the onset of many mental disorders, including psychosis or BPD. This is because of particular brain and hormonal changes which occur at this stage. It's crucial to identify risk factors that might increase the vulnerability of adolescents to the development of these disorders, identify those at high risk, and deliver effective interventions. This study helps us understand this process, and what the targets might be.

"Sleep may be one of the most important underlying factors -- and it's one that we can influence with effective, early interventions, so it's important that we understand these links."

About Children of the 90s

Based at the University of Bristol, Children of the 90s, also known as the Avon Longitudinal Study of Parents and Children (ALSPAC), is a long-term health research project that enrolled more than 14,000 pregnant women in 1991 and 1992. It has been following the health and development of the parents, their children and now their grandchildren in detail ever since. It receives core funding from the Medical Research Council, the Wellcome Trust and the University of Bristol.

https://www.sciencedaily.com/releases/2020/07/200701125431.htm

Playtime with dad may improve children's self-control

June 29, 2020

Science Daily/University of Cambridge

Children whose fathers make time to play with them from a very young age may find it easier to control their behaviour and emotions as they grow up, research suggests.

The study, by academics at the Faculty of Education, University of Cambridge and the LEGO Foundation, pulled together fragmentary evidence from the past 40 years to understand more about how fathers play with their children when they are very young (ages 0 to 3). The researchers wanted to find out whether father-child play differs from the way children play with their mothers, and its impact on children's development.

Although there are many similarities between fathers and mothers overall, the findings suggest that fathers engage in more physical play even with the youngest children, opting for activities such as tickling, chasing, and piggy-back rides.

This seems to help children learn to control their feelings. It may also make them better at regulating their own behaviour later on, as they enter settings where those skills are important -- especially school.

Paul Ramchandani, Professor of Play in Education, Development and Learning at the University of Cambridge, said: "It's important not to overstate the impact of father-child play as there are limits to what the research can tell us, but it does seem that children who get a reasonable amount of playtime with their father benefit as a group."

Dr Ciara Laverty, from the LEGO Foundation, said: "At a policy level, this suggests we need structures that give fathers, as well as mothers, time and space to play with their children during those critical early years. Even today, it's not unusual for fathers who take their child to a parent-toddler group, for example, to find that they are the only father there. A culture shift is beginning to happen, but it needs to happen more."

Parent-child play in the first years of life is known to support essential social, cognitive and communication skills, but most research focuses on mothers and infants. Studies which investigate father-child play are often small, or do so incidentally. "Our research pulled together everything we could find on the subject, to see if we could draw any lessons," Ramchandani said.

The Cambridge review used data from 78 studies, undertaken between 1977 and 2017 -- most of them in Europe or North America. The researchers analysed the combined information for patterns about how often fathers and children play together, the nature of that play, and any possible links with children's development.

On average, they found that most fathers play with their child every day. Even with the smallest children, however, father-child play tends to be more physical. With babies, that may simply mean picking them up or helping them to gently raise their limbs and exert their strength; with toddlers, fathers typically opt for boisterous, rough-and-tumble play, like chasing games.

In almost all the studies surveyed, there was a consistent correlation between father-child play and children's subsequent ability to control their feelings. Children who enjoyed high-quality playtime with their fathers were less likely to exhibit hyperactivity, or emotional and behavioural problems. They also appeared to be better at controlling their aggression, and less prone to lash out at other children during disagreements at school.

The reason for this may be that the physical play fathers prefer is particularly well-suited for developing these skills.

"Physical play creates fun, exciting situations in which children have to apply self-regulation," Ramchandani said. "You might have to control your strength, learn when things have gone too far -- or maybe your father steps on your toe by accident and you feel cross!"

"It's a safe environment in which children can practise how to respond. If they react the wrong way, they might get told off, but it's not the end of the world -- and next time they might remember to behave differently."

The study also found some evidence that father-child play gradually increases through early childhood, then decreases during 'middle childhood' (ages 6 to 12). This, again, may be because physical play is particularly important for helping younger children to negotiate the challenges they encounter when they start to explore the world beyond their own home, in particular at school.

Despite the benefits of father-child play, the authors stress that children who only live with their mother need not be at a disadvantage.

"One of the things that our research points to time and again is the need to vary the types of play children have access to, and mothers can, of course, support physical play with young children as well," Ramchandani added. "Different parents may have slightly different inclinations when it comes to playing with children, but part of being a parent is stepping outside your comfort zone. Children are likely to benefit most if they are given different ways to play and interact."

https://www.sciencedaily.com/releases/2020/06/200629120137.htm

Blood pressure connected to eye health in young children

June 29, 2020

Science Daily/American Heart Association

Young children with narrow retinal artery diameters were more likely to develop higher blood pressure, and children with higher blood pressure levels were more likely to develop retinal microvascular impairment during early childhood, according to a new study published today in Hypertension, an American Heart Association journal. This is the first study to show this connection in children.

High blood pressure, the main risk factor for the development of cardiovascular disease (CVD), can manifest as early as childhood, and the prevalence of high blood pressure among children continues to rise. In previous studies, analysis of blood vessels in the retina has shown promise as a predictor of CVD risk among adults. In the study titled, "Retinal Vessel Diameters and Blood Pressure Progression in Children," researchers sought to predict the development of high blood pressure in children over four years based on retinal blood vessel measurements.

"Hypertension continues as the main risk factor for the development of cardiovascular diseases and mortality," says Henner Hanssen, M.D., the study's lead author and a professor in the department of sport, exercise and health at the University of Basel in Switzerland. "Primary prevention strategies are needed to focus on screening retinal microvascular health and blood pressure in young children in order to identify those at increased risk of developing hypertension. The earlier we can provide treatment and implement lifestyle changes to reduce hypertension, the greater the benefit for these children."

Researchers screened 262 children ages six to eight from 26 schools in Basel, Switzerland, in 2014, for baseline blood pressure and retinal arterial measurements. Both measures were taken again in 2018. Blood pressure measurements at both baseline and follow-up were performed in a sitting position after a minimum of five minutes of rest and were categorized based on the American Academy of Pediatrics' blood pressure guidelines. These guidelines utilize the same measurements as the American Heart Association/American College of Cardiology 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults.

Results from the analysis indicate:

children with narrower retinal vessel diameters at baseline developed higher systolic blood pressure at follow-up; 

retinal vessel diameters could explain 29 -31% of the changes in systolic blood pressure progression between 2014 and 2018;

children with higher blood pressure levels at baseline developed significantly narrower arteriolar diameters at follow-up, depending on weight and cardiorespiratory fitness; and

initial blood pressure measures explained 66-69% of the change in retinal arteriolar diameter from baseline to follow-up.

"Early childhood assessments of retinal microvascular health and blood pressure monitoring can improve cardiovascular risk classification. Timely primary prevention strategies for children at risk of developing hypertension could potentially counteract its growing burden among both children and adults," said Hanssen.

Researchers noted limitations of their study include that they could not confirm blood pressure measurements over a single 24-hour period, so they would not account for "white coat" hypertension, a condition where patients have high blood pressure readings when measured in a medical setting. Developmental stage

Children of academics exhibit more stress

June 25, 2020

Science Daily/Ruhr-University Bochum

Starting university is an exciting phase for everyone. However, children from academic households exhibit significantly more stress during this period than those from non-academic families. A Swiss-German research team has found this out by analysing the hair of female first-year students. Study authors Professor Alex Bertrams from the University of Bern and Dr. Nina Minkley from Ruhr-Universität Bochum (RUB) have concluded that students may be stressed by the fear of jeopardising the social status of their families if they fail their degrees. They published their report in Frontiers of Psychiatry on 5 June 2020.

Stress hormone accumulates in the hair

In stressful situations, the body releases an increased amount of the hormone cortisol, which also reaches growing hair and is stored there if the levels remain high over a lengthy period of time. By analysing the hair, researchers can identify the phases when a person had more stress.

In order to find out whether the stress levels of young people from different family backgrounds differ when they're starting university, the research team recruited a total of 71 test persons. "The only inclusion criteria were that they started their first semester and that they had sufficiently long hair," explains Nina Minkley from the Behavioural Biology and Didactics of Biology research group at RUB. "In the end, this meant that we recruited almost only women, and we decided not to include the few eligible men to avoid falsifying the results."

Strands of hair and questionnaires

The participants supplied the research team with three thin strands of hair each, which were cut off near the scalp. Since a hair grows about one centimetre per month, the researchers examined the latest one and a half centimetres that had grown in the six weeks since the beginning of the semester. In addition, the participants filled out questionnaires in which they provided information about their parents' educational background. They were also asked about the stress they subjectively perceived.

It emerged that first-year students from academic households where at least one parent had a university degree exhibit higher stress levels than those from non-academic households, even though they didn't differ in other respects. The subjectively perceived stress levels, for example, were the same.

Stress due to impending loss of status

The research team interprets this result as an indication of female students from academic households being under greater pressure, because failing their study would result in a loss of status for them and their families. This is in line with findings in sociological studies, which have shown that children of academics tend to go to university even if their academic performance isn't expected to be successful, based on their school grades. "Children of non-academics, on the other hand, can only win and are therefore probably less stressed," concludes Minkley.

https://www.sciencedaily.com/releases/2020/06/200625144820.htm

Cyberbullying linked to post traumatic stress for victims and perpetrators

Children should be screened for symptoms, suggest researchers

June 23, 2020

Science Daily/BMJ

Cyberbullying -- bullying online rather than face to face -- is linked to various types of post traumatic stress disorder (PTSD) symptoms, both for victims and perpetrators, suggests the first study of its kind, published online in the Archives of Disease in Childhood.

Their findings prompt the researchers to suggest that asking about cyberbullying should become a routine part of any children's mental health or psychological assessment.

The prevalence of cyberbullying among teens is thought to be between 10% and 40% and to pose specific risks because it can be done day and night, in various contexts, is rapid, anonymous, and reaches a wide audience, say the researchers.

It has been suggested that there may be some overlap between traditional bullying and cyberbullying.

To explore this further, and find out what the mental health impact of cyberbullying might be, the researchers questioned 2218 pupils aged between 11 and 19 from four secondary schools in London about their experiences of bullying.

They used The Olweus Bully/Victim Questionnaire to find out what type of bullying the teens had been involved with, how often this had happened, and for how long it had lasted.

And they screened for PTSD symptoms using the Children Revised Impact of Events Scale (CRIES), which has two dimensions: intrusive thoughts and avoidance behaviours.

Just over half the teens were girls (55%). Around a third (34%) were of white ethnicity; two thirds were of black, Asian and other minority ethnic backgrounds. Most of the children (80%) had been born in the UK.

The survey responses showed that nearly half (46%) of all the pupils reported a history of any type of bullying: 17% as victims; 12% as perpetrators; and 4% as both.

But involvement in traditional bullying (1 in 3 of the teens) was more common than involvement in cyberbullying (1 in 4).

Some 13% of the teens had been cyberbullied; 8.5% had bullied others online; and 4% had been both victim and perpetrator. Some 16% of the teens had been bullied in person; 12% had bullied others in person; and 6.5% had been both victim and perpetrator.

There was some overlap between both types of bullying, although pure cyberbullies were less likely to also be traditional bullies.

Half of those involved in a specific role in cyberbullying were also involved in the same role in traditional bullying: 52% of cyber victims were also traditional victims; 45.5% of cyber victims were also traditional bully victims; and 48% of the cyberbullies were also traditional bullies.

Around 72% (1516) of the teens completed the CRIES assessment. More than a third of cyber victims (35%), more than one in four (29%) of the cyberbullies, and a similar proportion (28%) of those who were both, scored above the threshold for clinically significant PTSD symptoms.

Further analysis indicated that cyber victims displayed significantly more PTSD symptoms than did cyberbullies, and they experienced more intrusive thoughts and avoidance behaviours.

Cyberbullies also had significantly more PTSD symptoms than teens who weren't involved in any form of bullying.

This is an observational study, so can't establish cause and effect. It also relied on subjective reports, and it didn't include a full clinical assessment of suspected PTSD symptoms.

And while the sample was representative of UK urban teens, the findings may not be applicable to other regions or countries, caution the researchers.

Nevertheless, they suggest their findings have important implications. "Parents, teachers and health professionals need to be aware of possible PTSD symptoms in young people involved in cyberbullying," they write.

And they note: "Despite cyberbullying being less frequent than traditional bullying, it is noteworthy that more than a third of the cyberbullies were not involved in traditional bullying, whereas a huge majority of the cyberbully victims were involved in traditional bullying, mainly as traditional victims or [as both victim and perpetrator].

"This suggests that the anonymity provided to perpetrators online may constitute a new platform for bullying to occur, though this finding requires further study."

https://www.sciencedaily.com/releases/2020/06/200623185242.htm

Poor sleep significantly linked with teenage depression

Depression group slept 30 minutes less per night than other groups in study

June 17, 2020

Science Daily/University of Reading

Teenagers who experience very poor sleep may be more likely to experience poor mental health in later life, according to a new study.

In a paper published in the Journal of Child Psychology and Psychiatry, researchers analysed self-reported sleep quality and quantity from teenagers and found that there was a significant relationship between poor sleep and mental health issues.

The team, based at the University of Reading, and Goldsmiths and Flinders Universities found that among the 4790 participants, those who experienced depression reported both poor quality and quantity of sleep, while those with anxiety had poor quality of sleep only, compared to those teenagers who took part who didn't report anxiety or depression.

Dr Faith Orchard, a Lecturer in Clinical Psychology at the University of Reading said:

"This latest research is another piece of evidence to show that there is a significant link between sleep and mental health for teenagers. This study highlights that those young people who have experienced depression and anxiety had overwhelmingly experienced poor sleep during their teens.

"What's noticeable is that the difference in average amount of sleep between those who experienced depression, which amounts to going to sleep 30 minutes later each night compared to other participants. Within the data, there were some participants who reported hugely worse quality and quantity of sleep, and the overall picture highlights that we need to take sleep much more into account when considering support for teenager wellbeing."

Teens were asked to self-report on sleep quality and quantity over a series of issues, and the researchers found that the control group of teenagers were on average getting around eight hours of sleep a night on school nights and a little over nine and half hours sleep on weekends.

Meanwhile, the group who had a depressive diagnosis were getting less than seven and a half hours sleep on week nights and just over nine hours sleep at weekends.

A co-author, Professor Alice Gregory from Goldsmiths University, said:

"The National Sleep Foundation recommends that adolescents aged between 14-17 years typically need around 8-10 hours of sleep each night. What is notable here is that the group with a diagnosis of depression most clearly fell outside of these recommendations during the week -- getting on average 7.25 hours of sleep on each school night."

The depression group were therefore reporting an average total of 3325 minutes of sleep a week compared to the control group who reported 3597, meaning that the depression group were on average getting 272 minutes or three and a half hours less sleep a week.

While the team noted that although the data was based on self-reporting of sleep and therefore less accurate, the fact of self-reported worse quality and quantity of sleep was still significant.

Dr Orchard said:

"What we are now seeing is that the relationship between sleep and mental health for teenagers is a two way street. While poorer sleep habits are associated with worse mental health, we are also seeing how addressing sleep for young people with depression and anxiety can have a big impact on their wellbeing.

"It's also important to note that the numbers of young people who report anxiety and depression are still low overall. Good sleep hygiene is important, and if you are concerned about yours or your child's wellbeing we strongly encourage you to seek support from your doctor, but any short term negative impact on sleep is not a cause for alarm."

Professor Gregory said:

"The Department for Education is aware of the importance of sleep in children and adolescence -- and it is really good news that from September 2020 Statutory Guidance will mean that they will be taught about the value of good quality sleep for many aspects of their lives including their mood."

Co-author Professor Michael Gradisar from Flinders University, Australia said:

"This longitudinal study confirms what we see clinically -- that poor sleep during adolescence can be a 'fork in the road', where a teen's mental health can deteriorate if not treated. Fortunately there are sleep interventions available for schools and individual families -- and these can place teens back on the road to healthy sleep.."

https://www.sciencedaily.com/releases/2020/06/200617194508.htm

Air quality impacts early brain development

Study explores how living close to roadways may impact the brain

June 17, 2020

Science Daily/University of California - Davis

Researchers at the University of California, Davis, have found a link between traffic-related air pollution and an increased risk for changes in brain development relevant to neurodevelopmental disorders. Their study, based on rodent models, corroborates previous epidemiological evidence showing this association.

While air pollution has long been a concern for pulmonary and cardiovascular health, it has only been within the past decade that scientists have turned their attention to its effects on the brain, said UC Davis toxicologist Pamela Lein, senior author of the study, recently published in Translational Psychiatry.

Researchers had previously documented links between proximity to busy roadways and neurodevelopmental disorders such as autism, but preclinical data based on real-time exposures to traffic-related air pollution was scarce to nonexistent.

Lein worked with UC Davis atmospheric scientist Anthony Wexler and first author Kelley Patten, a doctoral student in the UC Davis graduate group for pharmacology and toxicology, to develop a novel approach to study the impacts of traffic-related air pollution in real time. They set up a vivarium near a traffic tunnel in Northern California so they could mimic, as closely as possible, the experience of humans in a rodent model.

"This approach was a creative way to get at the question of what impacts air pollution has on the brain in the absence of confounding factors such as socioeconomic influences, diet, etc.," Lein said. "It's important to know if living close to these roadways poses a significant risk to the developing human brain.

"If it does," Lein continues, "scientists can warn susceptible individuals, such as pregnant women -- particularly those who have already had a child diagnosed with a neurodevelopmental disorder -- to take appropriate precautions to minimize risks to the health of their child's brain."

EARLY EXPOSURE OUTCOMES 

The researchers compared the brains of rat pups exposed to traffic-related air pollution with those exposed to filtered air. Both air sources were drawn from the tunnel in real time.

They found abnormal growth and increased neuroinflammation in the brains of animals exposed to air pollution. This suggests that air pollution exposure during critical developmental periods may increase the risk for changes in the developing brain that are associated with neurodevelopmental disorders.

"What we witnessed are subtle changes," Patten said. "But we are seeing these effects using air pollution exposures that fall within regulatory limits. With the backdrop of other environmental and genetic risk factors in humans, this may have a more pronounced effect. This exposure also contains very fine particulate matter that isn't currently regulated."

In a separate study, Patten extended this exposure for 14 months to look at longer-term impacts of traffic-related air pollution and is in the process of writing up those results.

The team is also interested in what component of traffic-related air pollution is driving the neurodevelopmental outcomes.

If they can identify the culprits, Lein said, then scientists can approach legislators to develop scientifically based regulations to protect the developing human brain.

TEAM EFFORTS

UC Davis atmospheric scientist and co-author Keith Bein said that the single most challenging aspect of studying the health effects of air pollution may be replicating how, when and what people are exposed to throughout their lifetimes.

Tackling this requires creative thinking and a multidisciplinary team of researchers, including exposure engineers, atmospheric scientists, toxicologists, biologists, behaviorists and animal care specialists.

"We have managed to build a unique and talented team and taken advantage of our built environment to bring us closer than we've been before to achieving these objectives," Bein said. "Increasingly, these types of efforts are required to continue advancing the field, thereby informing policymakers and stakeholders about how best to protect human health."

Other study co-authors include: Eduardo González and Anthony Valenzuela, UC Davis School of Veterinary Medicine; Elizabeth Berg, UC Davis School of Medicine; Christopher Wallis, UC Davis Air Quality Research Center; Joel Garbrow, Washington University; and Jill Silverman at the UC Davis MIND Institute and School of Medicine. The study was supported by the National Institutes of Health.

https://www.sciencedaily.com/releases/2020/06/200617145934.htm

Impact of children's loneliness today could manifest in depression for years to come

May 31, 2020

Science Daily/University of Bath

Children and adolescents are likely to experience high rates of depression and anxiety long after current lockdown and social isolation ends and clinical services need to be prepared for a future spike in demand, according to the authors of a new rapid review into the long-term mental health effects of lockdown.

The research, which draws on over 60 pre-existing, peer-reviewed studies into topics spanning isolation, loneliness and mental health for young people aged 4 -- 21, is published today (Monday 1 June 2020) in the Journal of the American Academy of Child and Adolescent Psychiatry.

According to the review, young people who are lonely might be as much as three times more likely to develop depression in the future, and that the impact of loneliness on mental health could last for at least 9 years.

The studies highlight an association between loneliness and an increased risk of mental health problems for young people. There is also evidence that duration of loneliness may be more important than the intensity of loneliness in increasing the risk of future depression among young people.

This, say the authors, should act as a warning to policymakers of the expected rise in demand for mental health services from young people and young adults in the years to come -- both here in the UK and around the world.

Dr Maria Loades, clinical psychologist from the Department of Psychology at the University of Bath who led the work, explained: "From our analysis, it is clear there are strong associations between loneliness and depression in young people, both in the immediate and the longer-term. We know this effect can sometimes be lagged, meaning it can take up to 10 years to really understand the scale of the mental health impact the covid-19 crisis has created."

For teachers and policymakers currently preparing for a phased re-start of schools in the UK, scheduled from today, Monday 1 June, Dr Loades suggests the research could have important implications for how this process is managed too.

She adds: "There is evidence that it's the duration of loneliness as opposed to the intensity which seems to have the biggest impact on depression rates in young people. This means that returning to some degree of normality as soon as possible is of course important. However, how this process is managed matters when it comes to shaping young people's feelings and experiences about this period.

"For our youngest and their return to school from this week, we need to prioritise the importance of play in helping them to reconnect with friends and adjust following this intense period of isolation."

Members of the review team were also involved in a recent open letter to UK Education Secretary, Gavin Williamson MP, focusing on support for children's social and emotional wellbeing during and after lockdown. In their letter they suggested that:

- The easing of lockdown restrictions should be done in a way that provides all children with the time and opportunity to play with peers, in and outside of school, and even while social distancing measures remain in place;

- Schools should be appropriately resourced and given clear guidance on how to support children's emotional wellbeing during the transition period as schools reopen and that play -- rather than academic progress -- should be the priority during this time;

- The social and emotional benefits of play and interaction with peers must be clearly communicated, alongside guidance on the objective risks to children.

Acknowledging the trade-offs that need to be struck in terms of restarting the economy and reducing educational disparities, their letter to the Education Secretary concludes: 'Poor emotional health in children leads to long term mental health problems, poorer educational attainment and has a considerable economic burden.'

https://www.sciencedaily.com/releases/2020/05/200531200333.htm

Family environment affects adolescent brain development

May 20, 2020

Science Daily/Karolinska Institutet

Childhood environment and socioeconomic status affect cognitive ability and brain development during adolescence independently of genetic factors, researchers at Karolinska Institutet report in a new study published in the journal PNAS. The study demonstrates how important the family environment is, not just during early infancy but also throughout adolescence.

While the way in which genes and environment affect the brain and cognitive faculties is a hotly debated topic, previous studies have not taken genes into account when describing environmental effects. Researchers at Karolinska Institutet in Sweden have therefore studied both environmental factors and a new genetic measure -- an index value based on an aggregation of the 5,000 or so DNA locations that are most strongly associated with educational attainment.

The study involved 551 adolescents from different socioeconomic environments around Europe. At the age of 14, the participants gave DNA samples, performed cognitive tests and had their brain imaged in a MR scanner, a process that was repeated five years later.

At the age of 14, genes and environment were independently associated with cognitive ability (measured using working memory tests) and brain structure. The environmental effects were, however, 50 to 100 per cent stronger than the genetic. Differences in socioeconomic status were related to differences in the total surface area of the neocortex.

"The previous debate was whether there is a special area that is affected by the environment, such as long-term memory or language," says Nicholas Judd, doctoral student at the Department of Neuroscience, Karolinska Institutet and co-first author of the study along with his departmental colleague Bruno Sauce. "However, we've been able to show that the effect occurs across the neocortex and so probably affects a whole host of functions."

Genetic differences were also linked to brain structure, affecting not only the brain's total area but also specifically an area of the right parietal lobe known to be important for mathematical skills, reasoning and working memory. This is the first time a brain area has been identified that is linked to this genetic index.

When the researchers followed up on the teenagers five years later, they were able to examine how genes and environment had affected the brain's development during adolescence. What they discovered was that while the genes did not explain any of the cerebral changes, the environment did. However, it is unknown which aspect of the environment is responsible for this.

"There are a number of possible explanations, such as chronic stress, diet or intellectual stimulation, but the study shows just how important the environment is, not only during early childhood," says principal investigator Torkel Klingberg, professor of Cognitive Neuroscience at the Department of Neuroscience, Karolinska Institutet. "Finding the most important environmental factors for optimising childhood and adolescent development is a matter for future research."

https://www.sciencedaily.com/releases/2020/05/200520131330.htm

Healthy eating behaviors in childhood may reduce the risk of adult obesity and heart disease

May 11, 2020

Science Daily/American Heart Association

Encouraging children to make their own decisions about food, within a structured environment focused on healthy food choices, has been linked to better childhood nutrition and healthier lifelong eating behaviors. Parents and caregivers can play a significant role in creating an environment that helps children develop healthier eating behaviors early in life, which can reduce the risk for overweight, obesity and cardiovascular disease as adults.

How children are fed may be just as important as what they are fed, according to a new scientific statement from the American Heart Association, "Caregiver Influences on Eating Behaviors in Young Children," published today in the Journal of the American Heart Association.

The statement is the first from the Association focused on providing evidence-based strategies for parents and caregivers to create a healthy food environment for young children that supports the development of positive eating behaviors and the maintenance of a healthy weight in childhood, thereby reducing the risks of overweight, obesity and cardiovascular disease later in life.

Although many children are born with an innate ability to stop eating when they are full, they are also influenced by the overall emotional atmosphere, including caregiver wishes and demands during mealtimes. If children feel under pressure to eat in response to caregiver wants, it may be harder for them to listen to their individual internal cues that tell them when they are full.

Allowing children to choose what and especially how much to eat within an environment composed of healthy options encourages children to develop and eventually take ownership of their decisions about food and may help them develop eating patterns linked to a healthy weight for a lifetime, according to the statement authors.

"Parents and caregivers should consider building a positive food environment centered on healthy eating habits, rather than focusing on rigid rules about what and how a child should eat," said Alexis C. Wood, Ph.D., the writing group chair for the scientific statement and assistant professor at the U.S. Department of Agriculture/Agriculture Research Services Children's Nutrition Research Center and the department of pediatrics (nutrition section) at Baylor College of Medicine in Houston.

The statement suggests that parents and caregivers should be positive role models by creating an environment that demonstrates and supports healthy food choices, rather than an environment focused on controlling children's choices or highlighting body weight. Parents and caregivers should encourage children to eat healthy foods by:

• providing consistent timing for meals;

• allowing children to select what foods they want to eat from a selection of healthy choices;

• serving healthy or new foods alongside foods children already enjoy;

• regularly eating new, healthy foods while eating with the child and demonstrating enjoyment of the food;

• paying attention to a child's verbal or non-verbal hunger and fullness cues; and

• avoiding pressuring children to eat more than they wish to eat.

Wood noted that some parents and caregivers may find it challenging to allow children to make their own food decisions, especially if the children become reluctant to try new foods and/or become picky eaters. These behaviors are common and considered normal in early childhood, ages 1 to 5 years, as children are learning about the tastes and textures of solid foods. Imposing rigid, authoritarian rules around eating and using tactics such as rewards or punishments may feel like successful tactics in the short term. However, research does not support this approach; rather, it may have long-term, negative consequences. An authoritarian eating environment does not allow a child to develop positive decision-making skills and can reduce their sense of control, which are important developmental processes for children.

In addition, the authoritarian approach has been linked to children being more likely to eat when they are not hungry and eating less healthy foods that are likely higher in calories, which increase the risk of overweight and obesity and/or conditions of disordered eating.

On the other hand, an indulgent approach, where a child is allowed to eat whatever they want whenever they want, does not provide enough boundaries for children to develop healthy eating habits. Research has also linked this "laissez-faire" approach to a greater risk of children becoming overweight or having obesity.

Research does suggest that some strategies can increase children's dietary variety during the early years if they are "picky" or "fussy" about foods. Repeatedly offering children a wide variety of healthy foods increases the likelihood they will accept them, particularly when served with foods they prefer. In addition, caregivers or parents who enthusiastically eat a food may also help a child accept this food. Modeling eating healthy foods -- by caregivers, siblings and peers -- is a good strategy for helping children to be open to a wider variety of food options.

"Children's eating behaviors are influenced by a lot of people in their lives, so ideally, we want the whole family to demonstrate healthy eating habits," said Wood.

It is important to note that not all strategies work for all children, and parents and caregivers should not feel undue stress or blame for children's eating behaviors. "It is very clear that each child is an individual and differs in their tendency to make healthy decisions about food as they grow. This is why it is important to focus on creating an environment that encourages decision-making skills and provides exposure to a variety of healthy, nutritious foods throughout childhood, and not place undue attention on the child's individual decisions," concluded Wood.

Caregivers can be a powerful force in helping children develop healthy eating habits, and yet their role is limited by other factors. The statement authors encourage policies that address barriers to implementing the statement's recommendations within the wider socioeconomic context, including social determinants of health such as socio-economic status, food insecurity and others. While efforts that encourage caregivers to provide a responsive, structured feeding environment could be an important component of reducing obesity and cardiometabolic risk across the lifespan, they note that they will be most effective as part of a multi-level, multi-component prevention strategy.

https://www.sciencedaily.com/releases/2020/05/200511092923.htm