Basic Study
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World J Psychiatry. Jan 19, 2024; 14(1): 159-178
Published online Jan 19, 2024. doi: 10.5498/wjp.v14.i1.159
Nutritional epigenetics education improves diet and attitude of parents of children with autism or attention deficit/hyperactivity disorder
Renee J Dufault, Katherine M Adler, David O Carpenter, Steven G Gilbert, Raquel A Crider
Renee J Dufault, College of Graduate Health Studies, A.T. Still University, Kirksville, MO 63501, United States
Renee J Dufault, Steven G Gilbert, Department of Research, Food Ingredient and Health Research Institute, Naalehu, HI 96772, United States
Katherine M Adler, Department of Health Sciences, University of New Haven, West Haven, CT 06516, United States
David O Carpenter, Institute for Health and the Environment, School of Public Health, State University of New York, Albany, NY 12222, United States
Steven G Gilbert, Department of Research, Institute of Neurotoxicology and Neurological Disorders, Seattle, WA 98105, United States
Raquel A Crider, Department of Statistics, Food Ingredient and Health Research Institute, Naalehu, HI 96772, United States
Author contributions: Dufault RJ developed the nutritional epigenetics model for autism and attention deficit/hyperactivity disorder, developed the curriculum for the intervention, designed and conducted the intervention study, acquired, analyzed, and interpreted the pre- and post-intervention data, wrote the draft manuscript; Crider RA provided guidance on statistical analysis, presented the summary of results in table 7, and reviewed and approved the analytical results; Adler KM served as primary advisor for experimental design; Carpenter DO and Gilbert SG provided feedback on data interpretation; and all authors approved the final version of the article.
Institutional review board statement: The study was reviewed, approved, and found to be exempt from further review by the Institutional Review Board at A.T. Still University.
Informed consent statement: Participants were alternately assigned to the test or control group when eligibility was confirmed and after receipt of the signed informed consent form.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data is available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Renee J Dufault, PhD, Research Scientist, College of Graduate Health Studies, A.T. Still University, 800 W Jefferson Street, Kirksville, MO 63501, United States. rdufault@atsu.edu
Received: September 27, 2023
Peer-review started: September 27, 2023
First decision: October 24, 2023
Revised: November 14, 2023
Accepted: December 11, 2023
Article in press: December 11, 2023
Published online: January 19, 2024
Processing time: 112 Days and 7.4 Hours
Abstract
BACKGROUND

Unhealthy maternal diet leads to heavy metal exposures from the consumption of ultra-processed foods that may impact gene behavior across generations, creating conditions for the neurodevelopmental disorders known as autism and attention deficit/hyperactivity disorder (ADHD). Children with these disorders have difficulty metabolizing and excreting heavy metals from their bloodstream, and the severity of their symptoms correlates with the heavy metal levels measured in their blood. Psychiatrists may play a key role in helping parents reduce their ultra-processed food and dietary heavy metal intake by providing access to effective nutritional epigenetics education.

AIM

To test the efficacy of nutritional epigenetics instruction in reducing parental ultra-processed food intake.

METHODS

The study utilized a semi-randomized test and control group pretest-posttest pilot study design with participants recruited from parents having a learning-disabled child with autism or ADHD. Twenty-two parents who met the inclusion criteria were randomly selected to serve in the test (n = 11) or control (n = 11) group. The test group participated in the six-week online nutritional epigenetics tutorial, while the control group did not. The efficacy of the nutritional epigenetics instruction was determined by measuring changes in parent diet and attitude using data derived from an online diet survey administered to the participants during the pre and post intervention periods. Diet intake scores were derived for both ultra-processed and whole/organic foods. Paired sample t-tests were conducted to determine any differences in mean diet scores within each group.

RESULTS

There was a significant difference in the diet scores of the test group between the pre- and post-intervention periods. The parents in the test group significantly reduced their intake of ultra-processed foods with a pre-intervention diet score of 70 (mean = 5.385, SD = 2.534) and a post-intervention diet score of 113 (mean = 8.692, SD = 1.750) and the paired t-test analysis showing a significance of P < 0.001. The test group also significantly increased their consumption of whole and/or organic foods with a pre-intervention diet score of 100 (mean = 5.882, SD = 2.472) and post-intervention diet score of 121 (mean = 7.118, SD = 2.390) and the paired t-test analysis showing a significance of P < 0.05.

CONCLUSION

Here we show nutritional epigenetics education can be used to reduce ultra-processed food intake and improve attitude among parents having learning-disabled children with autism or ADHD.

Keywords: Epigenomics; Parenteral nutrition; Autism; Attention deficit/hyperactivity disorder; Ultra-processed foods; Heavy metals

Core Tip: Ultra-processed foods remain a source of heavy metal exposure in American families. The bioaccumulation of inorganic mercury and lead in the blood increases the severity of symptoms in children with autism and attention deficit/hyperactivity disorder via paraoxonase-1 gene modulation. Providing parents with nutritional epigenetics instruction may reduce their intake of ultra-processed foods and empower them to influence their child’s behavior through dietary changes.