Basic Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
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
ARTICLE HIGHLIGHTS
Research background

Ultra-processed foods contain heavy metal and pesticide residues. Specific food ingredients and heavy metal contaminants found in ultra-processed foods may result in mineral imbalances that impact or disrupt gene expression. Evidence suggests prenatal nutritional deficits and heavy metal exposures associated with poor diet are the primary epigenetic factors responsible for the development of autism and attention deficit/hyperactivity disorder (ADHD) via metallothionein gene dysfunction and paraoxonase-1 gene suppression. The excess consumption of ultra-processed foods by parents is associated with the development of these neurodevelopmental disorders.

Research motivation

The prevalence of autism and ADHD is increasing in the United States. The key problem to be solved is the excess consumption of ultra-processed foods by parents. Parents must be encouraged to reduce their consumption of ultra-processed foods. In educating parents on the role ultra-processed foods play in the development of autism and ADHD, they may become empowered to change their diets.

Research objectives

The aim of this basic study was to test the efficacy of a six-week nutritional epigenetics tutorial in reducing parental ultra-processed food intake.

Research methods

The parent education intervention we created was novel as it is the first ever to provide instruction focused on the constructs of the nutritional epigenetics model for autism and ADHD. In learning how what they eat determines how their genes behave, parents in the test group chose to change their diets. We measured their dietary changes pre- and post-intervention using a novel, pre-tested and validated, diet survey with questions designed to measure ultra-processed or whole/organic food intake. Ultra-processed foods are characterized as having more than one ingredient along with at least one ingredient known, or likely, to contain heavy metal residues.

Research results

The literature review conducted for this basic study revealed maternal ultra-processed food consumption is associated with adverse child neurodevelopment. This new finding further strengthens the nutritional epigenetics model for autism and ADHD that was initially published in 2009 as the Mercury Toxicity Model. The literature review also revealed the role of dietary heavy metals in creating the co-morbid condition of gut dysbiosis that is found in children with autism and ADHD. Dietary heavy metal exposures continue to be a problem in the United States ultra-processed food supply.

Research conclusions

The nutritional epigenetics model for autism and ADHD that this study uses as the basis for the nutritional epigenetics instruction is not new but is further refined by the results of this study. The success of the nutritional epigenetics tutorial in helping parents reduce their intake of ultra-processed foods may be attributed to the parents’ acceptance of the model constructs. They know the ultra-processed food supply is contaminated with heavy metal and pesticide residues. Two reports issued by the United States Congress in 2021 confirm there is a heavy metal problem in the ultra-processed food supply.

Research perspectives

In conducting future research, it may be useful to collect blood samples from the children and parents for heavy metal analyses pre- and post-six-week intervention that includes nutritional epigenetics instruction. If the children present with symptoms associated with autism and/or ADHD, then blood mercury and lead levels are important to measure. Pre- and post-intervention stool samples could also be collected to measure any changes in the gut biome, especially if a child presents with symptoms of gut dysbiosis.