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Effects of Nutrition and Lifestyle on Impulsive, Compulsive, and Externalizing behaviours

Periodic Reporting for period 4 - Eat2beNICE (Effects of Nutrition and Lifestyle on Impulsive, Compulsive, and Externalizing behaviours)

Période du rapport: 2021-09-01 au 2023-02-28

Eat2beNICE tackled four main research lines. First, the epidemiological work completed the analysis of the associations between (types of) diet, behaviour, and biological readouts (i.e. genetics, brain volume) in large, deep phenotyped, highly powered samples. We were also able to show the effects of exercise and physical activity on behaviour and we validated an mHealth application that was successfully used in several scientific projects. Second, we were also able to complete three Randomized Clinical Trials where we were able to characterise the relationship between specific dietary interventions and the reduction of symptoms of ADHD or aggression. Third, Eat2beNICE contributed significantly to the description of the link between biological determinants, diet and behaviour. Our results focus on gut microbiota, brain structure and function and maladaptive behaviour and the different ways these different types of data interact. Finally, Eat2beNICE is actively sharing its content through educational and dissemination efforts. This last effort has been very productive and allowed us to create the www.newbrainnutrition.com website which is now the main communication platform of the project.
Eat2beNICE was able to generate high quality association analysis showing the link between different dietary interventions and behavior. On top of that we were able to characterize, properly, the effects sizes of dietary interventions on behaviour. In other words, we now know that diet exerts a true, significant effect on our brains and our behaviour and that this effect is (very) small. These results are significant to our stakeholders because it underscores and widens the effect diet has on our brain and the true effects diet exerts on neurobiology.
The RCTs from the project discovered true effects of several dietary exposures on behaviour. The TRACE RCT, shows the short-term effects of the tested dietary interventions on ADHD symptomatology. Initial results of the PROBIA RTC show a positive effect of the symbiotic product tested, in reducing ADHD, BPD and irritability. The PREDIMED RCT finished collection and multiple publications were produced. The VANTASTIC RCT tried hard to catch up on recruitment (there was less interest of potential participants to join the study after COVID). Unfortunately, the pharmacy responsible to randomize the distribution of the nutritional supplement and the placebo made a serious error which created an unbalanced active-placebo distribution across the Mannheim (GER) and Groningen (NL) sites. Although the data could not be analyzed as planned, clinically relevant data were found that are also relevant for future research.
Association analysis on the effects of exercise and physical activity on behaviour were carried out and several scientific publications were produced. Additionally, the validated mHealth application was successfully used in several scientific projects and data on mHealth was collected on several samples included some of the RCTs.

We created a dissemination and education platform where we evaluated population knowledge about links between diet and behaviour. We used the metrics of the visits to the project’s website and via twitter-based polls directed to (I.e.) people with ADHD and their families and friends. We also created a new e-cook book where we show, for the first time, a collection of food recipes associated with the reduction of symptoms of ADHD. We are paying special attention to the visits to the e-cook book which we recently launched.
The are being shared with relevant stakeholders via multiple channels. We generated a series of blogs, written by partners of the project were they tell an easy-to-follow account of their work, experiences and results from the project. Both junior and senior researchers took the time to talk about science, explain their work and share all of this with the general public.

Eat2beNICE collected multiple types of biological data. Feces collection form the RCTs finished and all fecal samples were processed, the bacterial DNA was isolated and sequenced (both 16S and metagenomics). Statistical analysis using gut microbial data is ongoing and initial association results will be available soon. Fecal samples the LORA study were also sequenced and analysed in relation to multiple behavioral readouts. The initial plan to investigate MRI data from the RCTs became unfeasible. We changed our plans and analyzed existing MRI data in the Generation R study in relation to maternal vitamin use during pregnancy in order to carry out the proposed aims and tasks. Finally, work on the (mediating) (epi)genetic effects on the diet-behavior relationship yielded very interesting set of candidate genes involved as mediators of this relationship. We will start the analysis of blood samples from the RCTs as funding to continue this work is secured.
In the past 5.5 years, Eat2beNICE, aimed to unravel the biological mechanisms that link diet to mental wellbeing. Eat2benICE clearly shows that Population studies, observational data and clinical trials all point in the same direction: mental health can be positively and negatively influenced by dietary habits. Unhealthy diets do not cause mental illness, but they do contribute to increased risk and worse outcomes. Inversely, healthy diets can constitute protective factors, improve outcomes and even reduce medication use. Importantly, Eat2beNICE helps to increase our knowledge on this by trying to answer the question What is a healthy diet? Is there something we should all eat, to improve our brain and behaviour? This message is unfortunately not so simple. Common recommendations, including those of the World Health Organisation (WHO), include eating plenty of fruits, vegetables and whole grain products, and choosing foods that are lower in saturated fat, salt and sugar. The Mediterranean diet contains similar recommendations, but puts more emphasis on the use of extra-virgin olive oil, moderate amounts of fish and poultry, and low amounts of dairy products. Furthermore, healthy diets should be accompanied by other lifestyle modifications, such as sufficient sleep, exercise and social contacts. Moreover, to further elucidate the causal, and potentially therapeutic role, of diet for mental health, more clinical trials are needed that are adequately powered and have an active control group. Such trials require investment in both time and money.
Eat2beNICE to translated scientific findings into easy understandable and accessible information, and provided the general public with hands-on solutions to improve their dietary habits. Eat2beNICE collaborated closely with patient organisations to investigate the needs of individuals with neuropsychiatric disorders. This resulted in an online cookbook with recipes and tips for healthy eating, aimed at individuals and families with ADHD. We have also successfully increased the clinical and societal impact of our educational videos describing the project and showing how to bring specific food items associated with a healthy diet (supported by scientific research) to the homes and tables of our stake holders (https://newbrainnutrition.com/).
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