Friday, 15 July 2016

Another study to watch... vitamin D and/or fatty acid supplements for autism

Hot on the heels of a recent post about a study to watch for (see here) details of yet another "randomised, double-blind, placebo-controlled trial" have been published in the form of the trial protocol by Hajar Mazahery and colleagues [1].

This time around the aim is to "investigate the effect of vitamin D, n-3 LCPUFAs [omega-3 long chain polyunsaturated fatty acids] or a combination of both on core symptoms of ASD [autism spectrum disorder]" and hopefully with it, the generation of some interesting data over the 12 month period of study. I might add that the trial details have also been registered on the Australian New Zealand Clinical Trial Registry.

I'm impressed that as with the Santocchi trial [2] talked about in that other recent post, the aim is not only to look at the behavioural side of autism but also "gastrointestinal symptoms" as a secondary outcome. The idea coming from the fact that: "Gastrointestinal problems have also been reported to be common in children with ASD" (indeed they have) and "Vitamin D deficiency has been implicated in the pathophysiology of some gastrointestinal diseases, including inflammatory bowel disease..., and thus might play a role in ASD-related gastrointestinal problems." The authors even find time to mention "abnormal gut flora" and "increased intestinal permeability" in this context too. Minus any sweeping generalisations (autisms people, autisms) I'd be minded to say that although correlation is not the same as causation, there have been some hints about aspects of vitamin D being 'linked' to intestinal permeability (see here) for example, that may be relevant to such statements. Unfortunately however, the Mazahery study doesn't seem to be actually measuring intestinal permeability...

No mind, there does look like there will be plenty for researchers to discuss as their study progresses including that relevant to the groupings to be included: "vitamin D (2000 IU), n-3 LCPUFAs (722 mg DHA), vitamin D (2000 IU) + n-3 LCPUFAs (722 mg DHA) or placebo [750-mg capsules of olive oil plus alpha tocopherol (antioxidant)]." Accepting that there has been some initial research 'excitement' about vitamin D and autism (see here) including some very preliminary results published following supplementation (see here) we'll wait to see what (if anything) is revealed when results hit the peer-reviewed domain. As to the whole fatty acids and autism story, well, I might not sure that supplementation will be globally effective on the basis of other research so far (see here) but once again, we will see bearing in mind the concept of potential non- and best-responders.

"If this trial is able to identify nutritional interventions that can make even a small difference to the lives of children with ASD by reducing their symptoms, the benefits will be considerable in terms of social and emotional well-being and educational achievements." I couldn't agree more; given also that vitamin D and/or fatty acids are pretty inexpensive interventions and importantly, readily available, assuming no serious side-effects from their use one could see a potentially clinically-effective and also cost-effective intervention strategy potentially arriving for at least some on the autism spectrum. If anything, general physical health probably stands to benefit from such a supplementation strategy...

To close, "sorry I can't hear you, there is some geezer on a megaphone."


[1] Mazahery H. et al. Vitamin D and omega-3 fatty acid supplements in children with autism spectrum disorder: a study protocol for a factorial randomised, double-blind, placebo-controlled trial. Trials 2016; 17:295.

---------- Mazahery H, Conlon C, Beck KL, Kruger MC, Stonehouse W, Camargo CA Jr, Meyer BJ, Tsang B, Mugridge O, & von Hurst PR (2016). Vitamin D and omega-3 fatty acid supplements in children with autism spectrum disorder: a study protocol for a factorial randomised, double-blind, placebo-controlled trial. Trials, 17 (1) PMID: 27334138