Bourre J M
French Academy of Medicine. INSERM, U705 ; CNRS, UMR 7157 ; Universités Paris 7 et 5, Department of Neuro-pharmaco-nutrition. Hôpital Fernand Widal, 200, rue du Faubourg Saint-Denis, 75475 Paris cedex 10.
J Nutr Health Aging. 2006 Sep-Oct;10(5):377-85.
The objective of this update is to give an overview of the effects of dietary nutrients on the structure and certain functions of the brain. As any other organ, the brain is elaborated from substances present in the diet (sometimes exclusively, for vitamins, minerals, essential amino-acids and essential fatty acids, including omega- 3 polyunsaturated fatty acids). However, for long it was not fully accepted that food can have an influence on brain structure, and thus on its function, including cognitive and intellectuals. In fact, most micronutrients (vitamins and trace-elements) have been directly evaluated in the setting of cerebral functioning. For instance, to produce energy, the use of glucose by nervous tissue implies the presence of vitamin B1; this vitamin modulates cognitive performance, especially in the elderly. Vitamin B9 preserves brain during its development and memory during ageing. Vitamin B6 is likely to benefit in treating premenstrual depression. Vitamins B6 and B12, among others, are directly involved in the synthesis of some neurotransmitters. Vitamin B12 delays the onset of signs of dementia (and blood abnormalities), provided it is administered in a precise clinical timing window, before the onset of the first symptoms. Supplementation with cobalamin improves cerebral and cognitive functions in the elderly; it frequently improves the functioning of factors related to the frontal lobe, as well as the language function of those with cognitive disorders. Adolescents who have a borderline level of vitamin B12 develop signs of cognitive changes. In the brain, the nerve endings contain the highest concentrations of vitamin C in the human body (after the suprarenal glands). Vitamin D (or certain of its analogues) could be of interest in the prevention of various aspects of neurodegenerative or neuroimmune diseases. Among the various vitamin E components (tocopherols and tocotrienols), only alpha-tocopherol is actively uptaken by the brain and is directly involved in nervous membranes protection. Even vitamin K has been involved in nervous tissue biochemistry. Iron is necessary to ensure oxygenation and to produce energy in the cerebral parenchyma (via cytochrome oxidase), and for the synthesis of neurotransmitters and myelin; iron deficiency is found in children with attention-deficit/hyperactivity disorder. Iron concentrations in the umbilical artery are critical during the development of the foetus, and in relation with the IQ in the child; infantile anaemia with its associated iron deficiency is linked to perturbation of the development of cognitive functions. Iron deficiency anaemia is common, particularly in women, and is associated, for instance, with apathy, depression and rapid fatigue when exercising. Lithium importance, at least in psychiatry, is known for a long time. Magnesium plays important roles in all the major metabolisms: in oxidation-reduction and in ionic regulation, among others. Zinc participates among others in the perception of taste. An unbalanced copper metabolism homeostasis (due to dietary deficiency) could be linked to Alzheimer disease. The iodine provided by the thyroid hormone ensures the energy metabolism of the cerebral cells; the dietary reduction of iodine during pregnancy induces severe cerebral dysfunction, actually leading to cretinism. Among many mechanisms, manganese, copper, and zinc participate in enzymatic mechanisms that protect against free radicals, toxic derivatives of oxygen. More specifically, the full genetic potential of the child for physical growth ad mental development may be compromised due to deficiency (even subclinical) of micronutrients. Children and adolescents with poor nutritional status are exposed to alterations of mental and behavioural functions that can be corrected by dietary measures, but only to certain extend. Indeed, nutrient composition and meal pattern can exert either immediate or long-term effects, beneficial or adverse. Brain diseases during aging can also be due to failure for protective mechanism, due to dietary deficiencies, for instance in anti-oxidants and nutrients (trace elements, vitamins, non essential micronutrients such as polyphenols) related with protection against free radicals. Macronutrients are presented in the accompanying paper.
本次更新的目的是概述膳食营养素对大脑结构和某些功能的影响。与其他任何器官一样,大脑由饮食中存在的物质构成(对于维生素、矿物质、必需氨基酸和必需脂肪酸,包括ω-3多不饱和脂肪酸,有时完全依赖这些物质)。然而,长期以来,食物会对大脑结构进而对其功能(包括认知和智力功能)产生影响这一观点并未得到充分认可。事实上,大多数微量营养素(维生素和微量元素)已在脑功能的背景下得到直接评估。例如,神经组织利用葡萄糖产生能量意味着需要维生素B1的存在;这种维生素可调节认知能力,尤其是在老年人中。维生素B9在大脑发育期间保护大脑,并在衰老过程中维持记忆力。维生素B6可能有助于治疗经前抑郁症。维生素B6和B12等直接参与某些神经递质的合成。维生素B12可延缓痴呆症状(以及血液异常)的出现,前提是在首次症状出现之前的精确临床时间窗内给药。补充钴胺素可改善老年人的大脑和认知功能;它经常改善与额叶相关的功能,以及认知障碍者的语言功能。维生素B12水平处于临界值的青少年会出现认知变化的迹象。在大脑中,神经末梢中的维生素C浓度在人体中仅次于肾上腺,是最高的。维生素D(或其某些类似物)可能在预防神经退行性或神经免疫疾病的各个方面具有重要意义。在各种维生素E成分(生育酚和生育三烯酚)中,只有α-生育酚能被大脑主动摄取,并直接参与神经膜的保护。甚至维生素K也参与了神经组织的生物化学过程。铁对于确保大脑实质中的氧合作用和产生能量(通过细胞色素氧化酶)以及神经递质和髓磷脂的合成是必需的;注意力缺陷/多动障碍儿童中存在铁缺乏现象。胎儿发育期间脐动脉中的铁浓度至关重要,并且与儿童的智商有关;伴有铁缺乏的婴儿贫血与认知功能发育紊乱有关。缺铁性贫血很常见,尤其是在女性中,例如与冷漠、抑郁和运动时快速疲劳有关。锂的重要性,至少在精神病学领域,早已为人所知。镁在所有主要代谢过程中都发挥着重要作用:例如在氧化还原和离子调节方面。锌尤其参与味觉感知。铜代谢稳态失衡(由于饮食缺乏)可能与阿尔茨海默病有关。甲状腺激素提供的碘可确保脑细胞的能量代谢;孕期饮食中碘的减少会导致严重的脑功能障碍,实际上会导致克汀病。在众多机制中,锰、铜和锌参与了对抗自由基(氧的有毒衍生物)的酶促机制。更具体地说,由于微量营养素缺乏(即使是亚临床缺乏),儿童身体生长和智力发育的全部遗传潜力可能会受到损害。营养状况不佳的儿童和青少年容易出现心理和行为功能的改变,这些改变可以通过饮食措施得到纠正,但只能在一定程度上。事实上,营养成分和饮食模式可以产生即时或长期的影响,有益或有害。衰老过程中的脑部疾病也可能是由于保护机制失效,例如由于饮食中缺乏抗氧化剂和与对抗自由基相关的营养素(微量元素、维生素、非必需微量营养素如多酚)。大量营养素将在随附的论文中介绍。