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Title: Factors influencing children's neurodevelopment
Article Type: Correspondence
Section/Category:
Keywords: Children, neurodevelopment, methylmercury
Corresponding Author: Dr. Giorgio Tamburlini,
Corresponding Author's Institution:
First Author: Giorgio Tamburlini, MD, PhD
Order of Authors: Giorgio Tamburlini, MD, PhD; Fabio Barbone, Professor
Manuscript Region of Origin: ITALY
Abstract:
Letter
Hibbeln and colleagues challenge the belief that maternal fish consumption, by exposing the foetus
to methylmercury, may be detrimental for children’s brain development 1. Unfortunately the study
did not include methylmercury measurements, so that it is not possible to assess the relative
contribution of methylmercury and essential fatty acids to neurodevelopmental outcomes and
establish to which extent and under which exposure conditions an effect may outweigh the other,
which would be crucial for making sound recommendations. Nor, due to lack of detailed
assessment of fish intake, it is possible to tell whether consumption of specific fish should be
restricted. Ongoing research will address these issues by providing detailed information on all these
factors 2. But there is another issue that both the paper and the commentary seem to neglect. From a
public health perspective, we should be concerned about all factors, including those pertaining to
the social environment, that may impair children’s neurodevelopment and have long term adverse
effects on their cognitive performances. The benefits of a stimulating home environment are, for
example, comparable to the adverse effects of neurotoxicants such as PCBs 3. There is a wealth of
literature showing that lack of cognitive stimulation in early years may be catastrophic and,
conversely, that early cognitive stimulation and adequate nutritional intakes are crucial for cognitive
development, with effects that are still evident by 17-18 years 4,5. We should take into account all
factors influencing neurodevelopment and carefully assess their relative contribution in specific
population groups if we want to effectively protect and promote the cognitive development of our
children. To start, it will be important to disclose the results of the ALSPAC study with respect to
the independent effect of social variables on the neurodevelopmental outcomes.
We declare that we have no conflict of interest.
Giorgio Tamburlini, Fabio Barbone
[email protected]
Institute of Child Health IRCCS Burlo Garofolo, Trieste, Italy (GT) and
Institute of Hygiene and Epidemiology, DPMSC; University of Udine Medical School (FB)
1. Hibbeln JR, Davis JM, Steer C,et al. Maternal seafood consumption in pregnancy and
neurodevelopmental outcomes in childhood (ALSPAC study) : an observational cohort
study. Lancet 2007; 369:578-85.
2. http://phime.org
3. Walkowiak, J, Wiener JA., Fastabend A, et al. Environmental exposure to polychlorinated
biphenyls and quality of the home environment: effects on psychodevelopment in early
childhood. Lancet 2001; 358:1602-07.
4. Walker PS, Wachs TD, Meeks Gardner J, et al. Child development: risk factors for adverse
outcomes in developing countries. Lancet 2007; 369:145-57.
5. Walker SP, Chang SM, Powell CA, Grantham-McGregor SM. Effects of early childhood
psychosocial stimulation and nutritional supplementation on cognition and education in
growth-stunted Jamaican children: prospective cohort study. Lancet 2005; 366:1804-7.