Emerging research suggests additional strategies for prevention

“Exposure to alcohol in the womb doesn’t affect all fetuses equally. Why does one woman who drinks alcohol during pregnancy give birth to a child with physical, behavioral or learning problems — known as fetal alcohol spectrum disorder — while another woman who also drinks has a child without these problems?”

This is really the question, isn’t it? And researchers are hard at work trying to find an answer. Over the past week, a number of media sources have been reporting on a study just published by a team of researchers at Northwestern University (see the new release “Why Some Kids Are Harmed by Mother’s Alcohol, But Others Aren’t”  here). In their research with rats, they were able to demonstrate that a genetic variation in moms can increase the vulnerability of male fetuses to FASD by disrupting the balance of thyroid hormones in the brain.

This study is part of a growing body of research from the field of epigenetics which examines the interaction between the environment (in this case, exposure to alcohol during pregnancy) and the expression of various genes (in this case, the Dio3 gene in male fetuses).

This study is also contributing to very preliminary discussions of about the use of dietary supplements during pregnancy as a strategy for preventing FASD. Prenatal supplements are not a foreign idea – we already encourage women to incorporate folic acid (a B vitamin) into their diet as a strategy for the prevention of neural tube defects and I’m sure we’ll continue to hear more about the importance of the amino acid, choline, in both the pre- and post-natal period.

Research is continuing to support the idea that nutrition is one factor that determines the specific effects that exposure to alcohol during pregnancy can have. Because we know that nutrient deficiencies can exacerbate FASD, this suggests that nutrient supplements might reduce the risks or effects of alcohol. Zinc, vitamin A, vitamin C, and vitamin E are just some of the nutrients that are being looked at as possibly being a protective factor against in utero exposure to alcohol.

Unfortunately, nutrient supplementation might not be as straightforward a solution as we’d like – different women have different metabolisms, important nutrients interact with each other which affects absorption, nutrient absorption is itself affected by alcohol, ideal amounts of nutrients are hard to figure out… You get the idea. At present, the majority of this research is being done in animals and just beginning to be applied to human beings. For the moment, preventing FASD will require us to continue to look at the broad range of factors that influence alcohol use during pregnancy. Fortunately, this suggests many possible solutions.

Tanya Nguyen and Jennifer D. Thomas have just published an accessible overview on FASD and nutrition for the Encyclopedia on Early Childhood Development (see reference below).

References:

Caudill, M.A. (2010). Pre- and Postnatal Health: Evidence of Increased Choline Needs. Journal of the American Dietetic Association, 110 (8):1198-1206.

Nguyen T, Thomas JD. (2011). Fetal alcohol spectrum disorders and nutrition. O’Connor MJ, topic ed. In: Tremblay RE, Boivin M, Peters RDeV, Barr RG, eds. Encyclopedia on Early Childhood Development [online]. Montreal, Quebec: Centre of Excellence for Early Childhood Development; 2011:1-8. Available at: http://www.child-encyclopedia.com/documents/Nguyen-ThomasANGxp1.pdf.

Sittig, L.J., Shukla, P.K., Herzig, L.B.K., Redei, E.E. (2011). Strain-specific vulnerability to alcohol exposure in utero via hippocampal parent-of-origin expression of deiodinase-III The FASEB Journal. Published ahead of print March 23, 2011, doi:10.1096/fj.10-179234