Sarah Oboh is a Nutritionist, dedicated to promoting well-being through a focus on gut health. With a keen interest in functional medicine and a deep commitment to enhancing people’s lives, she decided to pursue a role at OptiBac, where she supports practitioners in their recommendation of probiotics in practice.
In this episode, we focus on ADHD and autism, and Sarah shares what she has learnt from her research in this area, particularly in relation to the gut microbiota. She explains how important it can be to provide support in the first 1000 days from conception, and details specific probiotic strains that may be useful at various stages.
Highly recommended for anyone working nutritionally with preconceptual care, pregnancy and infant care.
This episode is sponsored by Optibac. Visit them at https://www.optibacprobiotics.com/uk/
--
The IHCAN magazine Podcast is provided for professional education and debate and is not intended to be used by non-medically qualified individuals as a substitute for, or basis of, medical treatment.
Sarah Oboh is a Nutritionist, dedicated to promoting well-being through a focus on gut health. With a keen interest in functional medicine and a deep commitment to enhancing people’s lives, she decided to pursue a role at OptiBac, where she supports practitioners in their recommendation of probiotics in practice.
In this episode, we focus on ADHD and autism, and Sarah shares what she has learnt from her research in this area, particularly in relation to the gut microbiota. She explains how important it can be to provide support in the first 1000 days from conception, and details specific probiotic strains that may be useful at various stages.
Highly recommended for anyone working nutritionally with preconceptual care, pregnancy and infant care.
This episode is sponsored by Optibac. Visit them at https://www.optibacprobiotics.com/uk/
--
The IHCAN magazine Podcast is provided for professional education and debate and is not intended to be used by non-medically qualified individuals as a substitute for, or basis of, medical treatment.
Transcript
Speaker 3
Hi and welcome to the IHCAN magazine podcast. I'm Kirsten Chick nutritional therapist and author and on today's episode I'm talking with Sarah Obey, nutritionist and practitioner support lead at Opti, BAC, about autism and ADHD. The first thousand days. Sarah, thanks for joining me.
Speaker 2
Hello, Kirsten. It's so nice to be here.
Speaker 3
So first of all, tell me a little bit about how you came to nutrition and also more specialist interest in ADHD and all. Listen.
Speaker 2
OK, so the short version is that my dad had diabetes and but we didn't know about it until unfortunately he had a heart attack and then it got revealed to the family and I remember not feeling like I didn't know how to help him. And so I literally went online to type in. In the in the list of university courses cause this happened at the around the time I was applying for university and I typed in diabetes and what came up for was nutrition and I was like that's it. That's the course. That's what I'm going in for and that's the short of the story. And so that's how I started my journey into nutrition. And yeah, I've been here ever since.
Speaker 3
Wow. And then autism and ADHD is, is there any particular reason why you're you're intrigued with that topic?
Speaker 2
I think it's just cause I found the research fascinating. So we do a lot of webinars at Optum back where we dig into the gut microbiome and specific conditions. And one of the recent ones we've done was into depression, anxiety and neuropsychiatric disorders. And I think as I went through so many research papers. I started to see a link in the gut microbiome and autism and ADHD, and I just felt that it wasn't well known. And it wasn't maybe talked about, so, you know, frequently, but it's something that can really change lives if we know how to manipulate the gut microbiome. So that's where the interest came from. And ever since then, I've just been talking about it to.
Speaker 3
Yeah.
Speaker 2
Whoever would listen.
Speaker 3
So we're autism and ADHD. And it seems like they're on the rise. Is that is that actually the case or is it just the perception and it if it is, why? Why is that happen?
Speaker
Thanks.
Speaker 2
Yeah. So it definitely is on the rise. I mean, the recent statistics that we have shows us that between 2017 to 2022, it rose by 226% and.
Speaker 3
Well, that this five years.
Speaker 2
In five years, that's a huge jump, and I think, you know, researchers are asking the same question. Why is this happening? And it's something I'm interested in as well. And what I would like. To. Know. And so I know we know that it can be quite multifactorial. You know, there's genetic factors, environmental factors, epigenetic factors, that can all contribute. But I think what's becoming more apparent from recent studies is that those months in utero can really set the stage for the development of these disorders. And so This is why I like talking about the 1st 1000 days of life, which refers to a child's life from the moment they're conceived up until two years of age. Stage, as I believe this is a crucial stage where we can help to reduce the risk of these disorders.
Speaker 3
So there's first thousand days. Then you're talking about starting actually in the.
Speaker 2
Womb. Yes, from the time of conception.
Speaker 3
Right. And why are they so important then?
Speaker 2
So at this stage it really is a critical window of early childhood development. And it's defined by rapid development of metabolic immune endocrine pathways, which can strongly influence and support child growth and development. And of course, that can have a lifelong impact on their health and well-being. But it's so interesting that not only science recognises it as important, but we also see that the government does. As well. So in the House of Commons in 2019, they had a report that was titled the 1st 1000 Days of Life and they recognise that this is a critical phase where the foundation of a child's development are laid. And this is really where the gut microbiome comes in, because in these first few years of life, this is when the foundations of the microbiome are formed and what we see is that if there's any dysbiosis, or if there's any delay in beneficial bacteria colonisation at this stage, then that can contribute to an increased risk of these disorders. But also other disorders as well, such as allergies, asthma, IBD and even obesity. And so, yeah, I would say it's crucial. It's an important time that offers us an intervention window, so. It this is a time for us to maximise the opportunity to support the healthy development of the gut microbiome.
Speaker 3
OK, So what should it? Look like then what should an ideal gut microbiome look like in those first thousand days? Presumably it it shifts quite a lot during that time.
Speaker 2
Yeah, I mean, it shifts throughout our life, man, really. But during that first found thousand day period, typically speaking we want it to be rich in a type of beneficial bacteria which is known as bifidobacteria. So you think of Bifidobacteria as the keystone or the homework of a healthy infant. I am. And the reason why is because they have numerous health benefits, so they can help us to provide a barrier of protection for the gut, to reduce the risk of opportunistic pathogens. They also help with absorption of nutrients they can produce neurotransmitters, of course, beneficial for brain health. They can help with immune regulation. They produce short. In fatty acids and they're rich in lactase enzymes, which can help the newborn to break down milk and so.
Speaker
But.
Speaker 2
It's really key at this stage because in these first thousand days, 50% of an infant's energy goes towards their brain development and approximately 75% of the whole the human brain develops during that time. So yeah, well, all of those great benefits, we definitely want the gut microbiome to be rich in bifidobacteria. But just to mention, we can get more specific when we talk about beneficial bacteria. And So what I mean by. That is, that Bifidobacteria refers to a genus or a family of bacteria. But when we look at the research, it shows us that that there are beneficial species that are within that family of bacteria that have been found in healthy, breastfed babies, and these species include Bifidobacterium bifidum. Bifidobacterium Infantis, bifidobacterium breve. They and you have Bifidobacterium longum and know all long names. If if you're not familiar with them. But those are species that we find in healthy infants that we we'd like to see, you know, in the microbiome. And I think what's interesting for me is that formula fed infants tend to have lower levels of beneficial bacteria and actually lower levels of. Microbial diversity on a whole. And so you know, it's no wonder why some formula milk manufacturers tried to supplement the formula with prebiotics and probiotics in an attempt to mimic breast milk cause it's so important to have high levels of bifidobacteria at this stage.
Speaker 3
So these are the, you know, the two things that we often think about with babies, in particular in terms of their, their microbiota is the whether or not they're breast fed and also or what their delivery was like was it a caesarean section or was it a vaginal delivery? And those two things most practitioners will be looking out for. In terms of recovery from those, so where where's the research at the moment? Cause I remember years ago seeing a piece of research saying that actually the, the, the two year old microbiome can recover really quite well from that given the right opportunities. So is that something that's still there in the research?
Speaker 2
Yeah. And I think that definitely is still there in the research. I think if we. Know how to manipulate the gut microbiome. Then we have a better chance of it recovering, and that's what the awareness is all about. With prebiotics, probiotics having a great gut health protocol, learning how we can manipulate the microbiome with specific strains of bacteria in order to for it to recover.
Speaker 3
Brilliant. So it's it's all in there. It's something that that we know a lot about already. It's obviously a very complex topic and we'll be learning more about it for decades and.
Speaker
To come but.
Speaker 3
There's enough there now for us to be confident that this is a really crucial time to be addressing the gut bacteria.
Speaker 2
Settings.
Speaker 3
So are there any any risk factors during the first 1000 days that might increase the likelihood of things like ADHD and autism?
Speaker 2
Definitely so there. Are numerous risk factors, but I just mentioned a few. So when it comes to mother, what we know is that her health and well-being her diet, her stress levels during pregnancy can affect the development of the baby. After birth, there's other factors such as the child's physical environment or their nutrition that can have a long term effect on their cognitive development. But just to touch on the mother in a bit more detail, because the research is really interesting here. They found that stress or depression or the presence of infections such as sepsis or pneumonia or UTI's during pregnancy can increase the risk of ADHD and autism in the newborn. And unfortunately, there's also research that shows the treatment for those conditions. So let's say the mother is on antidepressants for depression, or she's on antibiotics for an infection that can further increase the risk of developing ADHD and autism in her offspring. And you know, not only that we also see quite similar results with the infant as well. So in another study, which was a Swedish nationwide population based study and it included over 480,000 births and it monitored them over a 10 year period. And I really love studies. That really stretch and look at what's happening further down the. Line and the researchers found in this study that in early life, antibiotic use, so antibiotics that were given directly to the baby and antibiotic use during pregnancy was associated with an increased risk of autism and ADHD. And so it's it's, you know, antibiotics. I mean, I don't think it's uncommon. That we know it's quite harmful, but when we think of the fact that they're at the top of the list of the most commonly prescribed paediatric medications, we can see the effect that this might have. And in addition to that, when we look at the gut microbiome as well before and after a single course of antibiotics, we see that it's not the same. You know, there's research showing that it may take months or even years to recover the original species like you, you mentioned earlier, but that's following just one course of antibiotic use and so. This is one of the reasons why it's so important to recommend the probiotic alongside antibiotic use, but also post antibiotic use as well.
Speaker 3
Yeah, and. And so for anybody listening, he's wondering still about that. So you you sing probiotics whilst on antibiotics. What what's the best protocol? You don't wanna be taking them, you know, together with the same glass of water. Or does it? Yeah. How how would you recommend that that happens?
Speaker 2
Yeah. So generally, antibiotics can destroy probiotics, but if you use specific strains, then you can take them at exactly the same time. And so there's specific strains that have been clinically researched exactly the same time as the antibiotic and found to be effective and so. For those strains we have them in our for those in antibiotics product and for the with those strains, you can recommend them at exactly the same time, which is great. But I would also go a step further to recommend a probiotic following antibiotic use. So let's say you're on a 10 day course, you take those 10 day probiotics, then you move on to one that's more long. Term that can really offer that protection on the gut and help. It to recover.
Speaker 3
So that makes it much easier for people, for example, who are taking antibiotics four times a day, and they're like, how can I take my probiotic, you know, 6?
Speaker 2
Exactly.
Speaker 3
Or 4 hours. Apart or whatever. When I'm taking it so regularly. So yeah, that's that's a. Really good call.
Speaker 1
At Opti VAC we are probiotic experts with a leading brand in the UK that specialises entirely in live cultures with a wide range of supplements for different life stages and individual needs. We only partner with leading laboratories. Worldwide, to bring you the most well researched, high quality strains of friendly bacteria backed by credible clinical research. We have one of the widest ranges of probiotic strains in the UK and our expert formulas complement the natural microbiome, which can help with conditions such as depression, anxiety, women's intimate health and allergies. We're passionate about education and sharing the importance of the microbiome and so to learn more. About how different probiotic strains work for different conditions, which will help you make more effective probiotic recommendations. For your client. Join us for a complementary one hour online training session by contacting us at practitioners at Opti, back probiotics.com, and we have a dedicated practitioner support team who are available over the phone or by e-mail for your client related questions, so please do get in touch.
Speaker
Yeah.
Speaker 3
And then you're continuing to work on the gut house afterwards. It's not just about thinking. Ohh. I've done my antibiotics. I've done my probiotics. I can go back to normal now. It's really thinking about what else can you do afterwards? That's what you're saying.
Speaker 2
100% what else can we do to help the gut recover?
Speaker 3
Fantastic. So when you've looked at, you've mentioned that there have been these studies showing that that there are changes in the gut and also studies linking things like antibiotic use and and then ADHD and autism diagnosis. Have there been any trends noticed in? That the changes that actually happen within the microbio to visit those bifidobacteria that that reduce.
Speaker 2
Yes, there have been changes noted and I'll touch on the bifido bacteria cause could you ask there are there are we do see changes in bifidobacteria levels in those who have autism and ADHD, but just to touch on the research it is. I would say fairly new, you know it spanned over 20 years. There's still a need for more research to be done in into the gut microbiome in these conditions and and the multifactorial and varying nature of these conditions can make them very difficult to research. And so it can be hard to, you know, draw from the research any definite. Conclusions. But what we can draw. What we can see are trends and that can, you know, provide some useful insights that can help inform us in clinical practise. So for example, we've seen in research that's 70% of children with autism suffer with GI symptoms that can range from diarrhoea, Constipation, abdominal pains. So that can help us. You know to inform our clinical practise but in other studies we also see microbial differences between autistic and non autistic. Children where autistic children tend to harbour more pathogenic bacteria, which include Clostridia, proteobacteria and Candida, and they tend to have lower levels of difficult bacteria, as you mentioned. And so again that can inform our probiotic recommendations. But there was one thing I found. Really interesting in in terms of the gut microbiome and autism severity. So there's a few studies actually that have reported this and what they found was that Clostridia in the colon correlated with autism severity. And even one recent study highlighted one species of Clostridia to be a diagnostic marker for autism, and so that just tells us in future that we might be able to identify autism based on an individual's microbial profile, which is something that hasn't been seen before, but it does show us how important. The microbiome is.
Speaker 3
And that's the real sea change, isn't it? When we're starting to diagnose based on on factors like that, that's that's really new in any realm of of health and Wellness, isn't it or or disease diagnosis? Yeah.
Speaker 2
Exactly, exactly. It really is revolutionary.
Speaker 3
Amazing. Brilliant. OK, So what are some of these ways that we can support infants then in those first thousand days, say that given that the the first, you know several 100 days of that are going to be in the room is going to be supporting the mother, isn't it?
Speaker 2
Exactly, exactly. It has to take a dual approach. So we support the mother and we also support baby and and I think, you know, touching on. The the I guess I could start with the baby. One thing I didn't mention before in terms of the gut microbiome, I think if we understand how what is happening happening in the gut microbiome, then we can. Understand what to do or how we can possibly manipulate it to help. So in autism and we talked about before we saw that they have high levels of pathogenic bacteria. Lower levels of bifidobacteria in ADHD. Recent studies show that they have when they were given Lactobacillus, a specific strain. Lactobacillus rhamnosus GG for the first six months of life. They found that it reduced the risk of autism and ADHD. When they tested these children at age 13. And so.
Speaker
And.
Speaker 2
Again, when we think of supporting the mother, the the baby, then we can say, OK, so Lactobacillus run Nosis Gigi probably may be a good strain to recommend in these conditions because of that research. And so that helps us to understand what to do in terms of probiotics, but. There's of course other things that can be done, so it's not just probiotics. Probiotics aren't a panacea for all disease. We know that we need to have protocols that involve detoxification and elimination because environmental toxins and heavy metals are implicated in these conditions. And it's always important to address the diet as well. We know food allergies, intolerances, nutritional deficiencies, that can all contribute to the development and progression of these conditions and some more specific nutrients to look out for in terms of nutrient deficiencies are omega-3, zinc, magnesium. Vitamin A, vitamin D, folate and B6, and so these are the the key ones. I guess that would be. Quite good to watch out for, and of course you might consider supplements that offer mitochondrial support as well, just to help support the brain. We know that glutamines casomorphins they've also been implicated in being detrimental in how the brain will function. Then you've got inflammation to consider, right? We have to address inflammation or any immune dysfunction, as that can be a key driver of these conditions. And then you've got test as well, so you can conduct some tests that will evaluate how well those detoxification pathways are working. And that might be quite useful to know. And then of course, we have to heal the gut, I think. That's a big, big thing that needs to take place, and this is where the use of probiotics and prebiotics come in, as they can help to improve symptoms and reduce the risk. And so all of these things I've mentioned can be done to support the mother, but also directly to support the baby when they. They're out of the womb.
Speaker 3
And with some of these, you know, we're going actually further back to pre conceptual care, aren't we? So you know, making sure that a lot of this is in place before the pregnancy even happens.
Speaker 2
100% I mean the best, the better the preparation. Hopefully the better the outcome, yeah.
Speaker 3
But if, but if there's been very little preconceptual care and very little pregnancy support.
Speaker
But the the.
Speaker 3
Child has been born and now the parents are thinking ohh. Actually we really want to put some. Really key supporting for. This child is it too late?
Speaker 2
Definitely not. Definitely not. It's always best to of course try and do one's best to try and recover the health and recover the microbiome, and I think there's there's many ways. Like I mentioned before, there's many ways that one could do that with looking at all those factors of a protocol that may help. But it can be done using specific strains of probiotic in addition to a protocol. So with probiotics. It's important to be specific in the strains we choose so that we can have greater effect on the body and so one of the strains that are really good for the pregnant mother. And then I'll talk about the baby. That's, you know, an infant that's been born already. But for the pregnant mother, they could recommend Lactobacillus acidophilus LA 14. And this particular strain has been shown to reduce the symptoms and the recurrence of bacterial vaginosis and thrush. Now we know that BV is a most common vaginal infection. It increases the risk of preterm birth and it increases the need for antibiotics. And both of these things can increase the risk of autism and ADHD. And so having a strain that has been clinically chilled on pregnant women shown to be safe, shown to be effective. Is is really good to have here?
Speaker 3
And that's good. Sorry, that that's also going to reduce the the need for potentially for antibiotic use in pregnancy as well, which is another.
Speaker 2
Another Walker.
Speaker 3
Big win.
Speaker 2
Exactly. Huge win, huge win and that's what we need. And then, yeah, there's another strain. So we know that depression during pregnancy can contribute to an increased risk of the baby's developing autism or ADHD, and so strain for depression specifically for pregnant mothers would be Lactobacillus rhamnosus HN 001. And that strain has been clinically trialled for post Natal depression, and it's shown to be effective, and so This is why we we would recommend it in this situation, but it also has an added bonus of supporting natural immune development in the baby in utero as well. So almost like you're getting two in one with with that strain. Which is great.
Speaker 3
So is there so there's two particular strains that you've mentioned there, would you? And you said it's really important to be specific. Would you also give those alongside a more general probiotic or would you just really stick with those two?
Speaker 2
You could take a general probiotic, so it would depend on I guess the other conditions that might be being. I guess the mother may be experiencing. So. You know, let's say she has other gut issues that she would want to address that she might have nausea, bloating, anything like that. Then she could take other strains as well. So we have a product called pregnancy. And in that product it has four different strains that are clinically researched specifically for pregnancy and it addresses different. Aspects of pregnancy. So you it addresses the immune health, the gut health, the vaginal health and the. Ohh, was their 4th 1 immune health gut health and the Vagina health maybe just three so it addresses all those 3 components of the mother and so it's quite, you know, I don't say holistic, but it covers a a wide range of symptoms that she could go through during pregnancy. And so it's perfectly fine.
Speaker
Yeah.
Speaker 2
Take a blend of different strains. Just find the ones that. Are specific to the condition that you know you're trying to address.
Speaker 3
Which is getting easier these days, isn't it, though? It's easier to find those individual strains. There's a bit more research that's been done on them, so it's it's more accessible to to practitioners and and people going through pregnancy as well. Exactly. Yeah. Fantastic. So that's, yeah, you've you've given us a really lovely little deep dive there into this whole world. Is there anything else that you've learned about autism and ADHD along the way?
Speaker 2
Yes. I think. I didn't mention the the children's probiotics, so something that you could give to a child, I think that's one of your questions where what could you do when a child has been born already made these things weren't followed? What? What could we give to the child? So there are some strains again specific for the child. You've got Bifidobacterium, breve, M16V, and you have Lactobacillus rhamnosus GD. Now, if you remember, the G strain was the one that was in the clinical research that was given in the first six months and, you know, prevented well, reduce the risk of developing ADHD and autism in later life. So great strain to recommend. Directly to the newborn. It can be given and you've got the M16 V strain, which is known as the baby Biome booster because it significantly increases the levels of bifidobacteria and the great thing about that strain is that even for babies that are born via C-section, it can increase their levels of photobacterium as well. And and so that's. That's really useful to know. And then also Saccharomyces boulardii, so if the child is above the age of 1, you can consider that strain. It's quite known amongst practitioners already. But that strain has anti-inflammatory action and we talked about inflammation being a key driver of these conditions and it also strongly inhibits a number of pathogenic bacteria. And again, we we looked at research that shows that there's a high level of pathogenic bacteria in these conditions. And so another great strain to know about and so. Yeah, I'd say. You know, we've targeted and specialist probiotic strains, it can be possible to help encourage good cognitive development and truly give babies the best start in life and protect their future health.
Speaker 3
Amazing. Thank you. So and is there anybody in the world of nutrition either connected? With all of this, or. Completely separate from all of this. He's he's. Particularly inspiring you right now.
Speaker 2
Yes, there are quite a few people I listen to so many different people. Honestly, it's really difficult to choose one person. But if I had to choose one, and I'd probably say this is probably just for the moment that I'm listening to is Mark *****. He just seems to be a fierce advocate for. Everything functional, medicine, and I really do enjoy how he makes nutrition and lifestyle information accessible and providing those easy to digest chips and chips tips. You. I'm hungry, honey. And he provides those easy to digest tips that everyone can learn, something from. And I think that inspires me because that's where we really we we need the nutritional information to go out to the general public, you know. And so, yeah, I'd say him if I had to choose one.
Speaker 3
That's a good point, isn't it? Because it, you know, it's really got to the level where, you know, science has taken a keen interest in in a lot of nutrition and aspects and we can get really geeky when we're researching it all. But actually turning that into something that's. Achievable and feasible and useful and practical for somebody who just wants to improve their nutrition. That that's a bit of a skill in itself, isn't it?
Speaker 2
Absolutely, absolutely. And that's what really changes lives. If people understand the information, they can use it and you know, it can be a benefit for them. So yeah, really love how he does that.
Speaker 3
Brilliant. And what do you enjoy most about your work?
Speaker 2
Hmm. I would have to say that. It is the feedback I think when we get feedback from practitioners about cause my my role is training practitioners on how to use probiotics in clinical practise. And so when we get feedback from them saying how they recommended a strain and it's been so effective for their clients, I think that makes me feel fulfilled. You know in. I I feel as though in some way it might be a small way or big way depending on how you look at it. I'm helping someone to have a better quality of life and so if I had to choose one thing I think that would be it. Just knowing that I'm contributing positively to someone feeling better.
Speaker 3
And it's no. Small thing is that if you're contributing. One small thing to one individual that can be life changing for that one that is. Huge. Yeah, even one thing. So.
Speaker 2
I believe.
Speaker 3
Marvellous. Well, thank you so much for joining me today. Sarah. That was really so interesting. So yes, thank you. That was Sarah Osborne, nutritionist and lead practitioner support at Opto back chatting with me. Kirsten Chick, I hope you enjoyed listening and gained some. Useful insights about autism and ADHD and those first thousand days.
Speaker 1
At Opti VAC we are probiotic experts with a leading brand in the UK that specialises entirely in live cultures with a wide range of supplements for different life stages and individual needs. We only partner with leading laboratories worldwide. To bring you the most well researched, high quality strains of friendly bacteria backed by credible clinical research, we have one of the widest ranges of probiotic strains in the UK and our expert formulas complement the natural microbiome, which can help with conditions such as depression. Anxiety, women's intimate health and allergies. We're passionate about education and sharing the importance of the microbiome and so to learn more about how different probiotic strains work for different conditions, which will help you make more effective probiotic recommendations for your clients, join us for a complementary. One hour online training session by contacting us at practitioners at Opti back probiotics.com and we have a dedicated practitioner support team who are available over the phone or by e-mail for your client related questions. So please do get in touch.