Introduction:
There is a growing amount of medical research indicating that alterations in the type of bacteria that live in our gastrointestinal (GI) tract can influence brain function, mood and overall mental health. A new study from Finland is the first to show that probiotic supplementation early in life may be an effective way to reduce the rising tide of brain disorders in children, such as attention deficit hyperactivity disorder and autism spectrum disorders.
Background Data:
Gastrointestinal (GI) disturbances are very common in children with brain disorders such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) including Asperger’s syndrome (AS). A number of mechanisms have been suggested linking these brain disorders as well as some of the common digestive disturbances these kids experience to alterations in the gut bacteria.
One novel theory is that lower levels of beneficial gut bacteria such as Lactobacillus and Bifidobacteria in children with ASD and ADD leads to an increase in toxin-producing bacteria such as Clostridium species. One study that supports this link that a gut microbial imbalance, such as the presence of toxin-producing Clostridium species, could contribute to ASD behavioral symptoms involved 11 children with ASD who were treated for 8 weeks with vancomycin. This antibiotic is often used in the treatment of chronic diarrhea due to Clostridium difficile. In this small study, scores for behavior and communication improved significantly during the treatment period; however, these gains only lasted while the children were given the antibiotic. This study raises the possibility that using probiotics, rather than antibiotics, may be helpful in at least some cases of ASD and, perhaps, ADHD as well.
In addition to the possibility that children with ASD and/or ADHD may be influenced by the absorption of gut-derived bacterial toxins, an altered gut flora also leads to increased gut permeability. Several studies have shown that the integrity of the intestinal lining is compromised in both ADHD and ASD. Increased gut permeability could lead to the absorption of microbial byproducts as well as partially digested food-derived compounds that may affect brain cell function directly or lead to immune responses that could also affect brain cells. Since probiotics can also improve the gut barrier, they may provide additional benefits in ADHD and ASD through this mechanism as well. Furthermore, since approximately 80% of the immune system resides in and around the intestinal lining, probiotics may also favorably affect the immune system to reduce the GI inflammation often observed in children with ADHD and ASD.
Lastly, a recent study in healthy women showed that supplementation with a mixture of probiotic bacteria had significant effects on brain regions that control central processing of emotion and sensation indicating that the probiotic bacteria themselves may be capable of exerting beneficial effects directly on brain function and mood.
New Data:
To test the hypothesis that probiotic supplementation may protect against the development of ADHD and AS, researchers in Finland looked closer at a study that was originally designed to test the effect of early supplementation with a probiotic in infancy on the later development of eczema. The mothers of 159 children were recruited in the and randomized in double-blind, placebo-controlled manner to receive 10 billion colony-forming units of Lactobacillus rhamnosus or placebo daily for 4 weeks before expected delivery. After delivery, the capsule contents were given either to the children, or continuously to the mothers, if breast-feeding, for 6 months.
To evaluate for a possible link between probiotic supplementation and ADHD or AS, 75 of these children were evaluated by an experienced child psychiatrist or neurologist not involved in the study or follow-up and the children were randomized and blinded so as not to produce any study bias. Results showed that ADHD or AS was diagnosed in 6/35 (17.1%) children in the placebo and none in the probiotic group (0/40). The probability value of this occurring was 0.008 indicating that it was not due to chance, but rather to a clear effect.
Because fecal samples were stored, the researchers were able to analyze the children for gut bacteria during their first six months of life. What the researchers found was that the numbers of Bifidobacterium species bacteria in feces during the first 6 months of life was lower in children with ADHD and AS compared to the healthy children.
The researchers concluded “Probiotic supplementation early in life may reduce the risk of neuropsychiatric disorder development later in childhood possible by mechanisms not limited to gut microbiota composition.”
Commentary:
When I read this study, my immediate response was WOW. Not because the results were unexpected, but rather my surprise that someone actually studied the possibility that probiotic supplementation may offer significant protection against the development of AS and ADHD.
What are the takeaways from this study? Alterations in gut bacteria and/or GI function/integrity may be a major factor in the development of childhood behavioral disorders. I strongly encourage all expecting mothers to supplement their diets with a high quality probiotic supplement, continue with that supplement while breastfeeding, and give their infants a probiotic supplement when they are no longer being breastfed.
My specific product recommendations are for women to use the Ultimate Probiotic Women’s Formula from Natural Factors at a dosage of one capsule per day for general support that will provide 12 billion live bacteria. For infants and children, I recommend the Ultimate Probiotic Children Formula from Natural Factors. For children 0-5 years old: 1/2 teaspoon, 1 to 3 times per day. For children 6-12 years old: 1 teaspoon, 1 to 3 times a day. Both of these formulas contain a good dosage of Lactobacillus rhamnosus along with compatible other probiotic bacteria.
Reference:
Pärtty A, Kalliomäki M, Wacklin P, Salminen S, Isolauri E. A possible link between early probiotic intervention and the risk of neuropsychiatric disorders later in childhood: a randomized trial. Pediatr Res. 2015 Mar 11. doi: 10.1038/pr.2015.51.
Dr. Michael Murray
4/14/15
