Growing impacts poor and stressed as an adult brain function

Newswise - Child poverty and chronic stress can lead to problems of regulation of emotions as an adult, according to research published online in the Proceedings of the National Academy of Sciences.

"Our findings suggest that the burden of stress of growing poverty can be an underlying mechanism that represents the relationship between poverty as a child and how the brain works as an adult," said Dr. K. Luan Phan, Professor of Psychiatry at the University of Illinois at Chicago College of Medicine and lead author of the study.

The study was conducted by researchers at the UIC, Cornell University, University of Michigan and the University of Denver.

The researchers found that test subjects who had family incomes less than 9 years old exhibited, as adults, increased activity in the amygdala, an area of the brain known for its role in fear and other negative emotions. These individuals showed less activity in areas of the prefrontal cortex, an area of the brain that regulates negative emotion.

Amygdala and the prefrontal cortex dysfunction has been associated with mood disorders such as depression, anxiety, impulsive aggression and substance abuse, according to the authors.

Phan said that it is well known that the negative effects of poverty can set "a cascade of increasing risk factors" for children to develop physical and psychological problems as an adult. But it is not known how child poverty might affect the functioning of the brain, particularly in emotional regulation. The ability to regulate negative emotions can provide protection against the consequences of physical and psychological health of acute and chronic stress, he said.

The study examined the associations between the poverty of children at age 9, exposure to chronic stress factors during childhood and neuronal activity in brain areas involved in emotional regulation at age 24.

49 Participants were part of a longitudinal study of child poverty. We collected data on household incomes, exhibitions stressor responses of physiological stress, social-emotional development and interactions, parents and children. Approximately half of the participants were from low-income families.

Using functional magnetic resonance imaging, the researchers evaluated the brain activity of the participants while they performed a task of emotional regulation. Subjects were asked to try to suppress negative emotions and viewing pictures, using a cognitive coping strategy.

"This serves as an index of brain-behavior of daily capacity of a person to cope with stress and negative emotions as those found" said Phan.

Perhaps the most important finding, Phan said, was that the amount of chronic stress from childhood to adolescence, such as substandard housing, overcrowding, noise and social stressors as familial disorder, violence or family separation - determines the relationship between childhood poverty and prefrontal brain function during the emotional regulation.

Co-authors include Pilyoung Kim of the University of Denver; Gary Evans of Cornell University; and Michael Angstadt, Shaun Ho, Chandra Sripada, James Swain and Israel Liberzon of the University of Michigan.

The study was supported by the national institutes of health (RC2MD004767), the Foundation of W.T. Grant, John D. and Catherine T. MacArthur Foundation Network on socioeconomic status and health, and the Robert Wood Johnson Foundation.

[This press release, together with accompanying photos, illustrations or multimedia files is online at http://news.uic.edu/?p=17630.

Low Vitamin D Levels Raise Anemia Risk in Children

AppId is over the quota
AppId is over the quota

Newswise — Low levels of the “sunshine” vitamin D appear to increase a child’s risk of anemia, according to new research led by investigators at the Johns Hopkins Children’s Center. The study, published online Oct. 10 in the Journal of Pediatrics, is believed to be the first one to extensively explore the link between the two conditions in children.

The researchers caution that their results are not proof of cause and effect, but rather evidence of a complex interplay between low vitamin D levels and hemoglobin, the oxygen-binding protein in red blood cells. The investigators say several mechanisms could account for the link between vitamin D and anemia, including vitamin D’s effects on red blood cell production in the bone marrow, as well as its ability to regulate immune inflammation, a known catalyst of anemia.

To capture the interaction between the two conditions, researchers studied blood samples from more than 10,400 children, tracking levels of vitamin D and hemoglobin. Vitamin D levels were consistently lower in children with low hemoglobin levels compared with their non-anemic counterparts, the researchers found. The sharpest spike in anemia risk occurred with mild vitamin D deficiency, defined as vitamin D levels below 30 nanograms per milliliter (ng/ml). Children with levels below 30 ng/ml had nearly twice the anemia risk of those with normal vitamin D levels. Severe vitamin D deficiency is defined as vitamin D levels at or below 20 ng/ml. Both mild and severe deficiency requires treatment with supplements.

When investigators looked at anemia and vitamin D by race, an interesting difference emerged. Black children had higher rates of anemia compared with white children (14 percent vs. 2 percent) and considerably lower vitamin D levels overall, but their anemia risk didn’t rise until their vitamin D levels dropped far lower than those of white children. The racial difference in vitamin D levels and anemia suggests that current therapeutic targets for preventing or treating these conditions may warrant a further look, the researchers say.

“The clear racial variance we saw in our study should serve as a reminder that what we may consider a pathologically low level in some may be perfectly adequate in others, which raises some interesting questions about our current one-size-fits-all approach to treatment and supplementation,” says lead investigator Meredith Atkinson, M.D., M.H.S., a pediatric kidney specialist at the Johns Hopkins Children’s Center.

Untreated, chronic anemia and vitamin D deficiency can have wide-ranging health consequences, including organ damage, skeletal deformities and frequent fractures, and lead to premature osteoporosis in later life.

Long known for its role in bone development, vitamin D has recently been implicated in a wide range of disorders. Emerging evidence suggests that low vitamin D levels may play a role in the development of certain cancers and heart disease and lead to suppressed immunity, the researchers note.

Anemia, which occurs when the body doesn’t have enough oxygen-carrying red blood cells, is believed to affect one in five children at some point in their lives, experts say. Several large-scale studies have found severe vitamin D deficiency in about a tenth of U.S. children, while nearly 70 percent have suboptimal levels.

“If our findings are confirmed through further research, low vitamin D levels may turn out to be a readily modifiable risk factor for anemia that we can easily tackle with supplements,” says senior study investigator Jeffrey Fadrowski, M.D., M.H.S., also a pediatric kidney specialist at Johns Hopkins.

The research was funded by the National Institute of Diabetes, Digestive and Kidney Diseases under grant number K23 DK084116.

Other investigators involved in the research included Michal Melamed, M.D., M.H.S., of the Albert Einstein College of Medicine in Bronx, New York; Juhi Kumar, M.D., M.P.H., of Weill Cornell Medical College; Cindy Roy, Ph.D., and Edgar Miller III, M.D., Ph.D., of Johns Hopkins; and Susan Firth, M.D., Ph.D., of The Children’s Hospital of Philadelphia.

Related article on the Web:
Memo to Pediatricians: Screen All Kids for Vitamin D Deficiency, Test Those at High Risk

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Founded in 1912 as the children's hospital of the Johns Hopkins Medical Institutions, the Johns Hopkins Children's Center offers one of the most comprehensive pediatric medical programs in the country, with more than 92,000 patient visits and nearly 9,000 admissions each year. Hopkins Children’s is consistently ranked among the top children's hospitals in the nation. Hopkins Children’s is Maryland's largest children’s hospital and the only state-designated Trauma Service and Burn Unit for pediatric patients. It has recognized Centers of Excellence in dozens of pediatric subspecialties, including allergy, cardiology, cystic fibrosis, gastroenterology, nephrology, neurology, neurosurgery, oncology, pulmonary, and transplant. For more information, visit www.hopkinschildrens.org.

Johns Hopkins Medicine (JHM), headquartered in Baltimore, Maryland, is a $6.7 billion integrated global health enterprise and one of the leading health care systems in the United States. JHM unites physicians and scientists of the Johns Hopkins University School of Medicine with the organizations, health professionals and facilities of The Johns Hopkins Hospital and Health System. JHM's vision, “Together, we will deliver the promise of medicine,” is supported by its mission to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care. Diverse and inclusive, JHM educates medical students, scientists, health care professionals and the public; conducts biomedical research; and provides patient-centered medicine to prevent, diagnose and treat human illness. JHM operates six academic and community hospitals, four suburban health care and surgery centers, and more than 30 primary health care outpatient sites. The Johns Hopkins Hospital, opened in 1889, was ranked number one in the nation for 21 years in a row by U.S. News & World Report.

Legal expert: breast milk must come from known, trusted sources

News that human breast milk for sale online for babies can contain dangerous bacteria should not come as a surprise, says Sarah Jane Hughes, a legal expert and member of the Faculty in the University Maurer School of law in Bloomington Indiana.

"Breast milk should be from sources known, or acquired through sources known as hospitals, to reduce the risk of contamination," said Hughes, the University and Fellow Student in commercial law at the school of Maurer.

"Breast milk for donation often is frozen quickly after an expression to be preserved," added Hughes. "If they are not managed correctly, it can deteriorate quickly. Donor breast milk to hospitals should be pre-selected for diseases, such as AIDS or hepatitis".

In a study published online in the journal Pediatrics, the researchers bought and analyzed 101 samples of breast milk sold by women on a popular website, which did not identify. Three-fourths of the samples contained bacteria at levels high enough as to sick babies, the researchers found.

A member of the faculty since long ago at Maurer school, Hughes also has experience as a breast milk donor in the metropolitan area of Washington, D.C.. You can contact her at 812-855-6318 or sjhughes@indiana.edu.

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