Can dietary intervention reduce heavy metals load and improve neurobehavioral problems in children?

ABSTRACT

Heavy metal exposure is a threatening health hazard especially among children. It is reported to affect physical and neurobehavioral health status. Cairo is reported to have high levels of heavy metal pollution specially lead and cadmium. Foods, mainly proteins, milk, vegetables and fruits with its high content of calcium, iron, zinc, vitamins C, A and B complex are reported to have a protective role against heavy metal absorption and intoxication. Children with inadequate intake of these food items are at higher risk for heavy metals load with its associated health hazards. Egyptian children specially those from lower social and economical levels were reported to receive unbalanced inadequate diet resulting in several nutritional deficiencies including iron, zinc, vitamin A, C, B complex and calcium deficiencies. Is to test the hypothesis that dietary intervention supplying diet rich in protein, milk, vegetables and fruits to children with unhealthy nutritional habits can reduce the heavy metal load in their body and hence improve the associated neurobehavioral problems. 30 children [18 boys and 12 girls] were selected from the obesity clinic, NRC, age range was 11-14 years. They all reported to receive unbalanced diet that consists mainly of fats, sugars and carbohydrates. Full clinical examination, 24-hour dietary recall, BMI, neurobehavioral assessment and urine analysis for determination of lead, cadmium and aluminum levels using the atomic absorption spectrophotometer, were performed for all children, at the beginning and 2 months after following a healthy diet rich in protein, milk, fresh vegetables and fruits. Mean urine levels for lead, cadmium and aluminum levels were, 47.2 +/- 6.5, 12.8 +/- 1.4, 9.8 +/- 1.5 microgram/liter respectively at the beginning of the study. After 2 months of changing the diet the levels were 38 +/- 6.9, 9.4 +/- 1.2 and 9.6 +/- 1.6 microgram/Liter. p value was significant at [0.001] level for lead and cadmium, but non significant for aluminum. Our recorded levels are considered higher than recorded reference values. As for the neurobehavioral variables mean scores for aggression, mood, lethargy and concentration were 12.8 +/- 2.1, 8,3 +/- 1.2, 13.5 +/- 1.6 and 7.7 +/- 1.2 before the diet change. While after 2 months of diet change the scores were 10.1 +/- 1.19, 11.6 +/- 1.3, 9.4 +/- 1.7 and 12.6 +/- 1.4. Significant changes were recorded [p<0.001] for all neurobehavioral variables. Significant correlation was found between lead level, and aggression, mood and concentration scores, between cadmium level, and lethargy and concentration, and between aluminum levels, and concentration scores. Changing the dietary pattern to be rich in milk, protein, fresh vegetables and fruits helps to reduce heavy metals burden and improve neurobehavioral symptoms