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    • The cAMP pathway has been implicated in physiological and pa

    2018-11-05

    The cAMP pathway has been implicated in physiological and pathological learning, but cognitive enhancement in healthy individuals has not been previously observed. In Drosophila, cAMP signaling during development is required for fine-tuning mushroom-body output neurons, a key component of learning and memory (Hige et al., 2015). Similarly, reducing cAMP degradation postnatally (inhibiting cAMP phosphodiesterase) in wild-type Drosophila did not enhance learning and memory (Choi et al., 2015). The cognitive effect observed in this study, mediated through cAMP, appears to be dependent on developmental changes occurring in the myd88 pathway that cannot be recapitulated by post-natal supplementation. However, our study cannot determine if activation of the cAMP pathway alone during gestation is sufficient to enhance learning. Further research is required to identify the signaling pathways, funneling through cAMP, that are affected by the fruit-derived diet. Fruit may improve learning and memory through improved antioxidant status. Increased antioxidant consumption is associated with improved learning and memory in older adults (Polidori et al., 2009; Peneau et al., 2011; Galli et al., 2002; Hritcu et al., 2014; Joseph et al., 1999) and antioxidant deficiency with adverse pregnancy outcomes. Lycopene deficiency is associated with preterm labor and intrauterine growth restriction (Sharma et al., 2003). A study of infants who died during the first year of life found that preterm infants had lower carotenoid levels in the frontal cortex and hippocampus, compared with term infants (Vishwanathan et al., 2014). Future Drosophila model studies will allow us to test the hypothesis that increased prenatal antioxidant status improves offspring learning and memory. There are several strengths associated with this study. The relatively large sample size with a rich CHILD dataset allows us to control for confounders associated with fruit consumption and neurodevelopment. Pre-natal nutrition was prospectively collected reducing recall bias and 1-year cognitive development was objectively assessed using the current gold standard. While the CHILD sample is somewhat biased towards higher SES and advanced maternal education, the use of an approach combining human and Drosophila investigations helps address concerns around sample generalizability and potential bias due to unmeasured confounders. Cognitive development at 1year has a low correlation with cognitive development at 3years (Aylward, 2004; Hack et al., 2005). Future studies are needed to examine the long-term impact of gestational fruit consumption. There is some evidence to suggest that the impact of fruit may be long lasting. We observed that the enhanced fruit-associated learning in Drosophila was persistent with increasing age. The Western Australian Pregnancy Cohort (RAINE) reported that increased fruit consumption at 1year was positively associated with cognitive development at 10years (Nyaradi et al., 2013). We did not find that post-natal fruit supplementation influenced learning in humans or the Drosophila model. The RAINE study did not control for gestational fruit intake that may have confounded their results; we found that increased prenatal fruit consumption was associated with increased odds of the infant being fed fruit at 6months of age (supplemental results). CHILD excluded significantly pre-term infants (below 34weeks). Extreme prematurity or low birth weight is associated with subsequent lower mental development indices (Hack et al., 2005; Wood et al., 2000). The influence of fruit was greatest in late pre-term infants (at 34weeks GA) with diminishing effects towards term. We could not determine the influence of prenatal fruit intake on infants born before 34weeks GA. The mean calorie intake for the sample was consistent with recommendations for pregnant women from1800 calories in the first trimester to 2400cal in the third trimester (National Institutes of Health and Services USDoHaH, 2016). However, we could not verify the accuracy of the nutrient or calorie intake as these are calculated value based on an analysis of the entire FFQ using the NDSR software (Dennis et al., 1980). Future studies are required to determine if gestational fruit consumption can mitigate the adverse neurobehavioral impact of prematurity. Related is identifying if fruit intake is differentially important during different trimesters.