ANNALS OF IBADAN POSTGRADUATE MEDICINE
Brain And Body Foundation, Abuja, Nigeria
Introduction: A nutraceutical is a pharmaceutical grade nutrient or nutrient complex that may be used for medicinal purposes. Most nutraceuticals are derived from plants and have been shown to be generally safe when used as food supplements. There is growing interest in the use of these natural products in delaying, ameliorating, and treating acute and chronic diseases. Ong W.Y and co-editors in 2016 edited a special collection of reports on beneficial effects of nutraceuticals in the management of neurodegenerative diseases and aging. However, there is paucity of reports of their use in subSaharan Africa.
Case Reports: Here we describe a case series of some of the children managed at our center using nutraceuticals and other supportive care. Details of the observed effects are described in this report.
Discussion: Globally, there is rising evidence of improved treatment outcomes with use of nutraceuticals. Our experience in the management of Nigerian children with neurodevelopmental disorders suggests that they may be beneficial and are deserving of well-controlled studies. We hope that this case series will raise interest of researchers in Nigeria in designing observational studies and clinical trials aimed at generating evidence for or against their use.
Keywords: Autism, Autism spectrum disorders, Neurodevelopmental disorders, Nutraceuticals, Nigeria
Dr. A.D. Ajibade
Brain And Body Foundation,
No. 39 Suez Crescent,
Abacha Estate, Abuja,
Autism spectrum disorders (ASD) are neurodevelopmental disorders that are characterized by varying degrees of impairments in psychosocial development. They are caused by disruptions in early stages of central nervous system development and are usually diagnosed in the first few years of life. 1 These disorders may result from genetic mutations (or “misreadings”) during pregnancy, maternal exposure to infections, and other harmful elements during critical stages of brain development. Mishaps before, at, or shortly after delivery, and neonatal period to three years of age (as in the case of autism) are other risk factors.1 Poor maternal health or inadequate access to health care, disempowering socio-cultural and religious beliefs, poverty, ignorance, complacency, among other reasons, are other risk factors that may result in children being born with defects or suffering trauma during the birth process. These may result in irreversible brain damage (or dysfunction) requiring a lifetime of visits to neurologists. Conventional therapies and interventions can be challenging and expensive with little or no improvements in many cases. Neurologists and pediatricians at hospitals in the Federal Capital Territory (FCT) and all over Nigeria routinely see and manage cases of ranging from mild to severe brain disorders, but unfortunately see very little by way of resolution.
Patterns of Presentation in Nigerian Children: Our Experience at the Brain Centre (at No. 39 Suez Crescent, Abacha Estate, Zone 4, Abuja, FCT)
Our experience (unpublished) in the management of children with autism related conditions suggests the following:
1. Infections, whether in-utero, or in the early stages of life, seem to occur much more commonly among Nigerian children than among Caucasian children.
2. Speech seems to be much more severely affected among Nigerian children.
3. Regardless of the cause of the neurodevelopmental condition, poor digestive system function is a common denominator, with patients presenting with constipation in at least 90% of cases.
4. Nigerian parents are more apt to report that their children display greater physical strength and have a higher pain threshold than their peers or their siblings at that age.
5. Hyperactivity is more pronounced among Nigerian children.
6. There appears to be a much later average age of presentation in Nigerian children as opposed to children in the western world which may be attributable to ignorance, cultural beliefs, denial, financial constraints, etc.
Use of Nutraceuticals
A nutraceutical is a pharmaceutical grade nutrient or nutrient complex that may be used for medicinal purposes. Nutraceuticals have been shown to have health as well as nutritional benefits.2,3 The term “nutraceutical” combines two words – “nutrient” (a nourishing food component) and “pharmaceutical” (a medical drug). The name was coined in 1989 by Stephen DeFelice, founder and chairperson of the Foundation for Innovation in Medicine, an American organization located in Cranford, New Jersey.
Most nutraceuticals are derived from plants and have been shown to be generally safe when used as food supplements. There is growing interest in the use of these natural products in delaying, ameliorating, and treating acute and chronic diseases. Ong W.Y and coeditors in 2016 edited a special collection of reports on beneficial effects of nutraceuticals in the management of neurodegenerative diseases and aging. 4 However, there is paucity of reports of their use in sub-Saharan Africa.
Our approach, which focuses on providing the brain with the nutrients it requires for healing, suggests improvement in some of the children we managed for neurodevelopmental diseases. This paper describes cases of children with neurodevelopmental disorders in whom the use of nutraceuticals appear to be of benefit. However, there remains a need for controlled observational studies and clinical trials to verify these preliminary observations. The objective of this case series is to raise interest in the use of nutraceuticals in the treatment of children with similar neurodevelopmental disorders. There is also a need for controlled clinical trials to generate evidence for the effects described here.