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Improved nutrition, sanitation linked to beneficial changes in childhood stress and epigenetic programming

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Improved nutrition, sanitation linked to beneficial changes in childhood stress and epigenetic programming

Tubewells are a typical drinking water source in rural Bangladesh and can sometimes contain high levels of contaminants. Credit: WASH benefits

We are increasingly aware of how environmental factors influence a child’s early development and health trajectory. We learned this mainly through research involving direct observations of how environmental conditions such as air pollution or a lack of nutritious food affect the functioning of our genes, and over time what diseases we may develop.

However, a new study led by a global health researcher at UC Santa Cruz provides some of the clearest and most comprehensive evidence yet on what is known about stress physiology and “epigenetic programming.”

In a large-scale randomized controlled trial conducted in rural Bangladesh, the research team found that an integrated intervention that included drinking water, sanitation, hand washing and nutrition influenced the set point, reactivity and regulation of the physiological stress system in early childhood .

The findings, published in Nature communicationdetail how the health interventions had measurable effects about the children in the study at a genetic level – including improved functioning of their stress response system, reduced oxidative stress in the body and reduced methylation levels of their DNA.

Oxidative stress can damage cells, proteins and DNA, which can contribute to aging and lead to diseases such as diabetes, cancer and Alzheimer’s disease. Methylation is a chemical modification of DNA or other molecules that is often caused by environmental conditions that can persist as cells divide.

Rigorous research design

This research is the latest in a series of findings based on a large-scale groundbreaking study in Bangladesh that began with more than 5,500 pregnant women and the children they delivered. The women were placed in 720 study clusters and assigned to one of seven groups.

Participants in four of the groups received clean drinking water, sanitation facilities, handwashing stations or nutritional advice plus nutritional supplements. The remaining three groups received either combined interventions of water/sanitation/handwashing or water/sanitation/handwashing/nutrition, or no interventions at all (the control group).

The researchers say the design and scope of that study, known as the ‘WASH Benefits Bangladesh’ study, resulted in more scientifically rigorous findings than the majority of stress physiological and epigenetic research done to date, which has relied on one-dimensional studies without experimental research. interventions and control groups for comparison.

“Here we see differences in outcomes between an intervention group and a control group, both of significant magnitude,” said Audrie Lin, who joined the UC Santa Cruz faculty in July 2023 as an assistant professor of microbiology and environmental toxicology.

“When we started creating the WASH Benefits study in 2009, its scale was unprecedented in the field of health and nutrition research.”

Global relevance

This study is also more relevant on a global scale due to the trial’s location in a resource-poor region. Many previous studies have been conducted in high-income countries such as the United States or the United Kingdom, where access to safe drinking water, sanitation and hygiene is relatively high compared to the rest of the world.

“This is truly representative of the conditions faced by a majority of the world’s population,” said Lin, who spent six years living in Bangladesh and Kenya setting up the WASH trial and training teams on the ground.

“When this kind of research is done in high-income countries, you’re not really identifying all these important stressors that can affect a child.”

What also sets this study apart from others in the literature is the use of physical interventions to improve stress physiology in young children in a low-resource context, rather than psychosocial measures such as behavioral therapy or parental coaching.

By introducing safe drinking water, food, sanitation, hygiene and improved nutrition – and pinpointing exactly when and how these change a child’s physiology – these measures may be easier for a government to implement than psychosocial interventions.

And yet, Lin said the improvements her team reported showed that the physical interventions were comparable to the impact of psychosocial measures. In their article, the study authors wrote: “The magnitude of the effects of this environmental and nutritional intervention on cortisol production is within the range of the intervention effects of psychosocial interventions reported in early childhood.”

Combining these physical interventions with psychosocial interventions could yield even greater health benefits, Lin explained.

Continued research

The first participants in the WASH Benefits study were enrolled in 2012, and researchers continue to monitor them. The hope is that the trial will evolve into a longitudinal study that will allow researchers to see the downstream effects of physiological changes caused by interventions introduced during the first two years of a child’s life.

“You often hear that what happens in the womb affects you for the rest of your life, especially when it comes to your health and the development of certain diseases,” Lin said.

“The experimental design of this trial will serve as a powerful platform to find links between the interventions we introduced early on and the health trajectories of our study participants.”

Lin will teach her first research methodology course at UC Santa Cruz this fall, which suits her. It will be housed in the university’s Department of Microbiology and Environmental Toxicology and included as part of the interdisciplinary Global and Community Health Program.

More information:
Audrie Lin et al., A Cluster Randomized Trial of Water, Sanitation, Handwashing, and Nutritional Interventions on Stress and Epigenetic Programming, Nature communication (2024). DOI: 10.1038/s41467-024-47896-z

Presented by the University of California – Santa Cruz


Quote: Improved Nutrition, Sanitation Linked to Beneficial Changes in Childhood Stress and Epigenetic Programming (2024, May 6), Retrieved May 7, 2024 from https://medicalxpress.com/news/2024-05-nutrition-sanitation-linked-beneficial- child. html

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