Zeisel S H
Adv Pediatr. 1986;33:23-47.
Diet clearly influences neurotransmission. This can be important in grossly undernourished children. It can also be important in children in whom normal homeostatic mechanisms governing food intake are bypassed. Subtle differences in behavior can occur with physiologic variation in food intake. Components of foods can also be used as drugs. Starvation can impair neuronal maturation and can have lasting effects upon behavior and intellectual performance. The extent of starvation's impact upon the brain depends upon whether undernutrition occurred during a critical phase in brain development. Short-term fasting has small, but significant, effects upon intellectual performance. Even when gross malnutrition is not present, subtle changes in diet may modulate brain function. Tryptophan, tyrosine, and choline in the diet are used as precursors for neuronal synthesis of serotonin, dopamine and norepinephrine, and acetylcholine, respectively. It is likely that the brain's sensitivity to certain components of the diet exists to permit monitoring of food intake by the central nervous system. Tryptophan, tyrosine, and choline may be useful in treatment of humans with sleep disorders, pain depression, mania, hypertension, shock, or dyskinesias. Other components of the diet that may affect behavior include food additives, sugar, and caffeine. Food additives may exacerbate hyperactive symptoms in a small proportion of children with attention deficit disorder. Given that there is little potential for harm and that there is a subpopulation that may respond, a trial of a diet that contains no food additives may be a valid diagnostic approach for children with attention deficit disorder who do not respond to stimulant therapy or for children for whom stimulant therapy is not desired. Refined sugar has been blamed for many behavioral abnormalities. Subtle effects of carbohydrate upon behavior have been reported, but the existing data do not support the hypothesis that sucrose or fructose exert special effects upon neurotransmission. Caffeine is easily detected as a stimulant by humans, but it has little effect upon cognitive function. Administration of large doses of vitamins has no beneficial effect in most humans with schizophrenia, attention deficit disorder, autism, Down's syndrome, or drug addiction. Large doses of niacinamide may even be harmful, as they may cause hepatic damage.
饮食显然会影响神经传递。这在严重营养不良的儿童中可能很重要。在那些正常的食物摄入稳态机制被绕过的儿童中也可能很重要。食物摄入量的生理变化可能会导致行为上的细微差异。食物成分也可以用作药物。饥饿会损害神经元成熟，并可能对行为和智力表现产生持久影响。饥饿对大脑的影响程度取决于营养不良是否发生在大脑发育的关键阶段。短期禁食对智力表现有微小但显著的影响。即使不存在严重营养不良，饮食中的细微变化也可能调节大脑功能。饮食中的色氨酸、酪氨酸和胆碱分别用作神经元合成血清素、多巴胺、去甲肾上腺素和乙酰胆碱的前体。大脑对饮食中某些成分的敏感性可能是为了让中枢神经系统监测食物摄入量。色氨酸、酪氨酸和胆碱可能对治疗患有睡眠障碍、疼痛抑郁、躁狂、高血压、休克或运动障碍的人有用。饮食中其他可能影响行为的成分包括食品添加剂、糖和咖啡因。食品添加剂可能会使一小部分患有注意力缺陷障碍的儿童的多动症状加重。鉴于危害可能性很小且存在可能有反应的亚群体，对于对兴奋剂治疗无反应或不希望接受兴奋剂治疗的患有注意力缺陷障碍的儿童，尝试不含食品添加剂的饮食可能是一种有效的诊断方法。精制糖被认为是许多行为异常的原因。已有报道称碳水化合物对行为有细微影响，但现有数据不支持蔗糖或果糖对神经传递有特殊影响的假设。咖啡因很容易被人类检测为兴奋剂，但它对认知功能影响很小。对大多数患有精神分裂症、注意力缺陷障碍、自闭症、唐氏综合征或药物成瘾的人来说，大剂量服用维生素没有益处。大剂量的烟酰胺甚至可能有害，因为它们可能会导致肝损伤。
