Image by André Santana AndreMS from Pixabay

April 24, 2023

1) "By nearly every metric, student mental health is worsening. During the 2020–2021 school year, more than 60% of college students met the criteria for at least one mental health problem, according to the Healthy Minds Study, which collects data from 373 campuses nationwide (Lipson, S. K., et al., Journal of Affective Disorders, Vol. 306, 2022).

In another national survey, almost three quarters of students reported moderate or severe psychological distress (National College Health Assessment, American College Health Association, 2021)." (Abrams Z. 2022) Although these are pandemic associated numbers, this issue has been on the rise for a decade. Teen and college age young adults are continuing a trend that is negative for all mental health metrics tested. This is absolutely playing out in the clinic. We are seeing high volumes of youth with mental health struggles weekly.

The traditional school based counseling services model is not capable of handling the deluge of struggling students. We need to take a different approach to this problem. I think that campuses should start promoting some form of meditation/prayer/giving/calming practices for students to choose to be a part of. College and high school can be a struggle for many socially through isolation or FOMO/being left out. Having many groups that offer these services can be a lifeline for young men and women.

The brain is functional when the correct inputs are provided. After the fact support is important but also after the fact. I would challenge schools to provide healthy food every meal and limit the junk food. This is a no brainer. Sleep is critical. Students would benefit from short videos discussing the effects of sleep loss on mental health.

2) The world is getting more interesting. In a new scientific endeavor, researchers at UCSF in California are going to use CRISPR technology to alter genes of bacteria that are associated with dysbiosis in asthma in order to treat the disease. A certain bacteria in the lungs releases a metabolite that is thought to be partially causative in asthma patients. By altering the genome of the bacteria the researchers hope to stop the production of this molecule thus reducing asthma triggers of inflammation.

This is a whole new world of therapeutics that could be immensely powerful for human disease treatment. the implications go far beyond asthma. Autism, CVD, Obesity and many other diseases are likely amenable to this form of therapy!

3) Neurosceince News article discusses "safetyism" which is a big issue today driving fear in children and young adults. I remember growing up pretty free in the 70's through 90's. Somewhere after the initiation of cable TV networks pushing fear narratives to everyone about death and safety risk nationally, everything shifted for parents despite the statistics nationally showing improved safety. From the article, "Crime rates began to come down in the 1990s, but fear among parents remained. This is where the problem of being over cautious begins. The concept of safety started to extend beyond children’s physical safety to emotional and psychological comfort. This denied children experiences they needed to learn and grow. Parental overprotection has been shown to foster unhealthy coping mechanisms in children. Overprotected children are more likely to both internalize problems (as in anxiety and depression) and externalize them (as in delinquency, defiance or substance abuse). Some psychologists propose that overprotection can morph into what they call “safetyism,” which teaches kids negative thought patterns similar to those experienced by the anxious and depressed. Safetyism can over-prioritize a young person’s safety to the exclusion of other practical and moral concerns." (Neuroscience News)

The major problem with the lack of independence is that children and young adolescents do not trust themselves to be growth oriented. They default to parents for all decisions which is completely counterintuitive for the age of development. They are supposed to be independent and pulling away from mom and dad.

4) Super interesting new research in the journal Nature: "Skin is exposed to various environmental assaults and undergoes morphological changes immediately after birth. Proper localization and function of immune cells in the skin is crucial for protection and establishment of skin tissue homeostasis. Here we report the discovery of a developmentally programmed process that directs preferential localization of invariant natural killer T (iNKT) cells to the skin for early local homeostatic regulation. We show that iNKT cells are programmed predominantly with a CCR10+ skin-homing phenotype during thymic development in infant and young mice. Early skin localization of iNKT cells is critical for proper commensal bacterial colonization and tissue development. Mechanistically, skin iNKT cells provide a local source of transferrin that regulates iron metabolism in hair follicle progenitor cells and helps hair follicle development. These findings provide molecular insights into the establishment and physiological functions of iNKT cells in the skin during early life." (Wang et. al. 2023)

In laymen's terms, this means that immune cells have homing technology to help fight diseases at the skin surface. They start as naive T cells in the thymus gland in the neck and migrate to the skin surface where they cooperate with skin bacteria after birth and there on after. They are programmed by the bacteria to be in cooperation for hair growth and healthy skin function. If the homing properties are broken for any reason, then bacterial skin dysbiosis can occur potentially leading to diseases of the skin. This remains to be proven but appears likely.

5) In the journal Pediatrics, "A total of 18.6% (n = 77) of offspring experienced Rapid Weight Gain, RWG. Maternal pre-pregnancy BMI and RWG were both positively associated with offspring BMI z score and %FM. RWG amplified the association between pre-pregnancy BMI and BMI z score, especially among females. Females exposed to maternal obesity and RWG had an average BMI at the 94th percentile (1.50 increase in childhood BMI z score) compared with those exposed to normal ppBMI and no RWG (average childhood BMI at the 51st percentile). RWG had a weaker effect on the association between ppBMI and %FM. Adjustment for breastfeeding status or childhood daily caloric intake did not significantly alter findings." (Gilley et. al. 2023)

Is this an epigenetic finding or not. I think that it is. I think that mothers with elevated prepregnancy weight and children with rapid weight gain in infancy are signs of broken metabolism leading to chronic caloric storage into childhood. Obesity is the beginning reality of so many diseases of aging.

The simple answer is also the hard one. Control maternal pre-pregnancy caloric intake, exercise, sleep and stress to set the metabolic table for a child's healthy metabolism.

That's all this week,

Dr. M

Abrams American Psychological Association

UCSF Article

Neuroscience News Article

Wang Nature Immunology

Gilley Pediatrics