IS THE OBESITY EPIDEMIC BEHIND THE RISE IN AUTISM? A Glasses on the Head Moment…

IS THE OBESITY EPIDEMIC BEHIND THE RISE IN AUTISM?

A Glasses on the Head Moment

By Sean Kenniff, MD

www.healthapalooza.com

Sometimes we just don’t notice the obvious, even if we are scientists. This is a tale of two epidemics.

Forty years ago we were a lean and robust nation. But at some point during the 1970s, our bellies and backsides began to steadily balloon, and our weight gain accelerated through the eighties and nineties. Today, two thirds of all American adults are overweight or obese according to CDC statistics. Nowhere is the obesity epidemic causing more concern than in the delivery room. Many normal weight women become overweight or obese during their pregnancies, and roughly 30 percent of women are overweight or obese at the time of conception. Obesity, at any point during pregnancy, places the health of the mother and her unborn baby in serious jeopardy.

If you were born in the 1970s your chances of developing autism were pretty slim—about 4 in 10,000. Today, 1 in every 110 children has an autism spectrum disorder (ASD). This dramatic rise in the number of children with autism is partly due to improved diagnostic methods and more inclusive diagnostic criteria. However, even by conservative estimates, the number of children with autism has significantly increased since the 1980s. Addressing the most recent rise, Dr. Catherine Rice from the CDC suggested the data was perplexing.

“These new numbers are concerning, and indicate that even more individuals, families and communities are struggling to find answers,” Rice said.

But are researchers asking the right questions? These two modern epidemics—obesity and autism—seem to have evolved in parallel and during the same time period. Could obesity be fueling the rise in autism?

If you are starting to put the puzzle pieces together, congratulations. Because it appears scientists have yet to do so.

Somebody Must Have Studied This Already…Right?

Using Medline, the database of scientific studies maintained by the National Library of Medicine, a search for “pregnancy obesity and autism” yields just five results. A search for “maternal obesity and autism” yields twenty-one results. In both searches none of the studies cited directly examines the possibility of a link between prenatal obesity and autism. Not to be sexist, a search for “paternal obesity and autism” proves equally fruitless. By contrast, a search for “pregnancy obesity and hypertension” yields 802 scientific studies—many of which are direct investigations into a link, and a search for “pregnancy obesity and risks” yields 2588 studies.

Why hasn’t the connection between autism and obesity been explored? For one thing, autism is not a single disease, and as such, it probably does not have a single cause. A combination of genetics and environmental factors is thought to play a critical role in increasing the risk of autism. The risk of obesity is also heavily influenced by genetics and the environment, but psychological and emotional factors are thought to be equally significant. With two such unpredictable and multifaceted disorders, it is difficult to pinpoint any correlation, says Dr. Jacob Seligsohn, a primary care pediatrician who also specializes in childhood autism at Joe DiMaggio Children’s Hospital and Pediatric Associates in Hollywood, Florida.  

“Autism is a very complex condition and simply two variables themselves—maternal obesity and autism—are hard to correlate with each other,” Dr. Seligsohn says.

Although the scientific evidence to support a link between obesity and autism is circumstantial, it is compelling. 

Though the World Health Organization does not track global statistics on autism, the available data suggests the world’s most overweight nations—namely the United States, the United Kingdom, and Australia—also have the highest prevalence of autistic disorders. And across the world as the rates of obesity have risen, so have the rates of autism.

It is well known that maternal obesity can have a devastating impact on the baby’s developing nervous system. Obesity during pregnancy raises the risk of hydrocephalus—or “water on the brain”—by 60 percent and it doubles the risk of neural tube defects, like spina bifida and anencephaly.

The rate of diabetes during pregnancy has doubled in recent years, and the obesity epidemic is believed to be chiefly responsible for the increase. Gestational diabetes doubles the risk of autism according to 2009 a meta-analysis published in the British Journal of Psychiatry. It’s possible that the high blood sugar levels or growth factor disturbances seen with diabetes may adversely affect the developing brain.

A November 2009 study published in the Journal of Child Psychology and Psychiatry found maternal obesity was associated with a two-fold increase in Attention Deficit Disorder in children. Interestingly the researchers found maternal obesity only increased the risk of inattentive behaviors in the children, not hyperactive behaviors. Most children with autism have difficulties maintaining attention.

It has also been recently discovered that obesity can impair the immune system, making expectant mothers more prone to infections. Infections during pregnancy—like CMV and rubella—can result in autistic behaviors in children.

Do Autism and Obesity Have a Common Enemy?

The sweetener high fructose corn syrup (HFCS) was rapidly introduced into the U.S. food chain between 1975—1985. While HFCS has long been a suspect in causing, or contributing to the obesity epidemic, the sweetener has never been connected to autism. But two recent studies from the Institute for Agriculture and Trade Policy (IATP) are raising some concerns. In the first study almost half of the commercially available HFCS samples they examined tested positive for mercury. In the second study the researchers found mercury in one-third of 55 popular consumer products that listed HFCS as the first or second ingredient. While neither study identified the form of mercury detected, methylmercury is known to impair neural development in the developing fetus, and exposure to the heavy metal has been implicated as an autism risk in the past. More recent studies however suggest there is no link between autism and mercury.

Obesity recently surpassed smoking cigarettes as the nation’s leading cause of preventable disease. Obesity is known to raise the risk of at least 30 other conditions—including heart disease and several types of cancer. Having excess fat tissue alters metabolism, impairs the immune system, increases levels of inflammation, and often renders important hormones ineffective. Any of these physiological disturbances could pose a theoretical risk to the brain of a developing baby.

“Because so much is unknown about autism, any reasonable hypothesis is worth exploring in my opinion,” says, Dr. Hannah Gardener, a neurologist and researcher at the University of Miami. “The intra-uterine environment has profound effects on so many aspects of health throughout the lifecourse.”

It is true that autism existed long before the obesity epidemic, and most overweight or obese parents will never have a child diagnosed with autism. Conversely thousands of children born to normal weight parents will be diagnosed with autism this year. It is not likely that obesity is solely responsible for the increased rates of autism seen over the last three decades.

But have you ever been looking for your sunglasses, or reading glasses, only to find them sitting on the top of your head? I have, and now that’s the first place I check. The simultaneous evolution and parallel course of these two epidemics points to a connection that deserves to be investigated.

Sean Kenniff, MD is a neurologist, television health journalist, radio host and author living in Miami, Florida. He can be reached at 786-360-2705. 

Jacob Seligsohn, MD is a pediatrician in Hollywood, Florida. He can be reached at 954-966-8000, or by visiting the Pediatric Associates website at www.pediatricassociates.com 

Dr. Hannah Gardener is a neurologist and researcher at the University of Miami. She can be reached at 305-243-9283, or by visiting the University of Miami Miller School of Medicine Website at www.med.miami.edu

The “I Do” Blues: Postnuptial Depression

THE “I DO” BLUES: Postnuptial Depression

By Sean Kenniff, MD

  A wedding is usually one of the most joyous days in a young couple’s life; a time to celebrate love and hope for a lifetime of happiness. But for some newlyweds the big day is soon followed by a big letdown. 

  “It should be described as the day the prince falls off his horse, and we change from girls into women,” one blogger writes. 

  “What begins the day after marriage? Misery,” replies another. 

  In many cases once the honeymoon is over, humdrum reality sets in, and that can leave unprepared couples coping with postnuptial depression-also called the ‘I Do Blues’. 

  “Building a happy, productive partnership is not easy.  The unrealistic expectations set up by our culture, media images of connubial bliss, romantic novels and song lyrics soon prove to be impossible to create, and reality then sets in,” says Dr. Tina Tessina.

  Dr. Tessina, better known as “Dr. Romance,” is a distinguished California psychotherapist and author of the book, Money Sex and Kids: Stop Fighting About the Three Things That Can Ruin Your Marriage. She says both men and women are at risk of postnuptial depression, because their expectations are often out of step with day-to-day marital life. 

  “Any situation in which the expectations are unrealistic can be considered a ‘set up’ for disappointment, which some people experience as depression,” she says. 

  In the months leading up to the wedding day the bride and groom often become the gravitational center of activity for family and friends. Some couples, especially the brides-to-be, spend so much time planning a wedding that they often fail to plan a survival strategy for the days afterwards; and when the wedding day spotlight disappears, so can a sense of purpose.  

  “People who are emotionally resilient rise to this challenge and work together to solve the problems and improve the relationship.  Those who are not resilient sink into despair and depression, and stop trying,” Dr. Tessina says. 

Signs of postnuptial depression may include

• 1. Lack of energy
• 2. Emotional withdrawal
• 3. Lack of sexual intimacy
• 4. Feelings of hopelessness, or despair
• 5. Frequent crying
• 6. Sleeplessness

  Roughly half of all U.S. marriages end in divorce, so it is normal to have some reservations about the sustainability of a new marriage, or suitability of a new spouse. It’s also difficult for some to move from the ‘me’ mindset of being single, to the ‘we’ mindset of being married. Unfortunately few people want to talk about postnuptial depression for fear it might trigger some trouble-in-paradise rumors, but experts say couples should communicate their difficulties to each other, and a professional. Antidepressant medications can help in severe cases, but most cases of postnuptial depression can be treated effectively with psychological therapy.

  “Counseling will also help you handle situations more effectively,” Dr. Tessina says, “and help you not create more drama and dysfunction in the relationship. “ 

  The best way to avoid postnuptial depression is through careful planning and maintaining perspective. First try not to put overblown significance on the wedding day. Certainly it is an important day, but it is still just another day. Before the big day it may help to delegate wedding responsibilities wherever you can, think about having a less lavish reception, try to avoid obsessions or being a perfectionist, and talk to friends and family about your stress. 

  It’s important to remember loving relationships are like flowers; they blossom quickly, need constant care and change with the seasons. Just watch out for the thorns and expect bees. 

Sean Kenniff, MD is a neurologist, radio host, and television journalist in Miami, Florida. 

Tina B. Tessina, PhD, also known as ‘Dr.Romance’, is a licensed psychotherapist in Southern California with over 30 years of experience counseling couples and individuals. She is the author of thirteen books on relationships including Money, Sex and Kids: Stop Squabbling About the Three Things That Can Ruin Your Marriage. Dr. Tessina also writes the Dr. Romance blog, and is a Relationships Expert for Redbook Love Network, Divorce360.com, and she answers relationship questions at Yahoo! Personals. She can be reached by visiting her website  http://www.tinatessina.com

What is Your Health Horoscope?

What is Your Health Horoscope?

By Sean Kenniff, MD

  The secret to living a longer and healthier life may not be as simple as eating a balanced diet and getting a lot of exercise. Recent research suggests your ‘health horoscope’ may be increasing or decreasing your odds of developing diseases. First-born children in large families tend to live the longest. In fact first-born children are 2-3 times more likely to reach age 100 than later-born children. Babies born to younger mothers may also enjoy an increased lifespan according to some reports. People living in rural environments tend to live longer than those living in urban and suburban environments. Some studies have even concluded that you are more likely to die near your birthday, or in the three months following it. Stress is believed to play a role. So what does your birthday say about your health risks?

JANUARY

Children conceived in the spring and summer months, and born from January through March may be at increased risk of birth defects according to a large U.S. study. In-utero exposure to pesticide residues during the warmer months may be playing a role.

A 2004 study published in the journal Neurology found people born during January and February are at the highest risk for developing malignant and benign brain tumors. Those born in the summer months of July and August had the lowest risk.

Women born in the first 6-months of the year might have a higher risk of developing breast cancer according to a report published in Oncology Reports.

People born in January and December have the highest lifetime risk of developing Alzheimer’s disease, epilepsy and narcolepsy. Those born during the spring and summer months are less likely to develop these conditions.

Lower air temperature at birth has been associated with the development of increased insulin resistance and increased triglycerides as adults. So U.S. babies born during the colder winter months may be at an increased risk of developing coronary artery disease earlier in life.

February

Children conceived in the spring and summer months, and born from January through March may be at increased risk of birth defects according to a large U.S. study. In-utero exposure to pesticide residues during the warmer months may be playing a role.

Lower air temperature at birth has been associated with the development of increased insulin resistance and increased triglycerides as adults. So U.S. babies born during the colder winter months may be at an increased risk of developing coronary artery disease earlier in life.

Women born in the first 6-months of the year might have a higher risk of developing breast cancer according to a report published in Oncology Reports.

A 2004 study published in the journal Neurology found people born during January and February are at the highest risk for developing malignant and benign brain tumors. Those born in the summer months of July and August had the lowest risk.

Studies have shown people born in February and March (late winter to early spring in the northern hemisphere) are more prone to develop schizophrenia. But the difference is small, about a 10% increase compared to the lowest risk months (September and August). It’s been proposed that a lack of sunlight during these months may result in a vitamin-D deficiency. A lack of adequate vitamin-D in a newborn, or a pregnant mother might influence a child’s brain development.

March

Studies have shown people born in February until March (late winter to early spring in the northern hemisphere are more prone to develop schizophrenia. But the difference is small, about a 10% increase compared to the lowest risk months (September and August). It’s been proposed that a lack of sunlight during these months may result in a vitamin-D deficiency. A lack of adequate vitamin-D in a newborn, or a pregnant mother might influence a child’s brain development.

People born in the spring months tend to have the shortest lifespans, about 5-months shorter than those born during the autumn months according to a study of 15-million U.S. death certificates.

Women born in the first 6-months of the year might have a higher risk of developing breast cancer according to a report published in Oncology Reports.

Italian researchers claim that women born in March are more likely to go through menopause earlier than women born in the fall months. On average, women in the study who were born in March went through menopause at age 48-years and 9-months, whereas women born in October went through menopause 18-months later (age 50-years and 3-months).

Children conceived in the spring and summer months, and born from January through March may be at increased risk of birth defects according to a large U.S. study. In-utero exposure to pesticide residues during the warmer months may be playing a role.

April

A study published in the British Journal of Psychiatry examined data from nearly 27-thousand suicides over a 22-year period and found people born during April, May, and June are 17% more likely to commit suicide. The increased risk was higher for women (29.6%) compared to men (13.7%). It’s possible that seasonal hormone fluctuations in pregnant women may influence the developing fetal brain.

A U.S. team of researchers found children conceived during the spring and summer months are more likely to be born with birth defects including cleft lip and palate, club foot, Down Syndrome, and spina bifida. Increased exposure to pesticides may be playing a role the researchers said.

People born in the spring months tend to have the shortest lifespan, about 5-months shorter than those born during the autumn months according to a study of 15-million U.S. death certificates.

Women born in the first 6-months of the year might have a higher risk of developing breast cancer according to a report published in Oncology Reports.

People born during the spring and summer months are more at risk for alcohol dependence, autism, and dyslexia, but are less likely to develop Alzheimer’s disease, epilepsy and narcolepsy.

May

People born in the spring months tend to have the shortest lifespan, about 5-months shorter than those born during the autumn months according to a study of 15-million U.S. death certificates.

A study published in the British Journal of Psychiatry examined data from nearly 27-thousand suicides over a 22-year period and found people born during April, May, and June are 17% more likely to commit suicide. The increased risk was higher for women (29.6%) compared to men (13.7%). It’s possible that seasonal hormone fluctuations in pregnant women may influence the developing fetal brain.

People born during the spring and summer months are more at risk for alcohol dependence, autism, and dyslexia, but are less likely to develop Alzheimer’s disease, epilepsy and narcolepsy.

Women born in the first 6-months of the year might have a higher risk of developing breast cancer according to a report published in Oncology Reports.

A U.S. team of researchers found children conceived during the spring and summer months are more likely to be born with birth defects including cleft lip and palate, club foot, Down Syndrome, and spina bifida. Increased exposure to pesticides may be playing a role the researchers said.

Babies born in May have the highest risk of developing multiple sclerosis as adults according to a 2004 study published in the British Medical Journal.

Children born in May and November are the least likely to develop Acute Lymphoblastic Leukemia (ALL).

June

A U.S. team of researchers found children conceived during the spring and summer months are more likely to be born with birth defects including cleft lip and palate, club foot, Down Syndrome, and spina bifida. Increased exposure to pesticides may be playing a role the researchers said.

A study published in the British Journal of Psychiatry examined data from nearly 27-thousand suicides over a 22-year period and found people born during April, May, and June are 17% more likely to commit suicide. The increased risk was higher for women (29.6%) compared to men (13.7%). It’s possible that seasonal hormone fluctuations in pregnant women may influence the developing fetal brain.

People born during the spring and summer months are more at risk for alcohol dependence, autism, and dyslexia, but are less likely to develop Alzheimer’s disease, epilepsy and narcolepsy.

Being born in June, April or May is associated with the shortest overall life expectancy.

Women born in the first 6-months of the year might have a higher risk of developing breast cancer according to a report published in Oncology Reports.

July

A U.S. team of researchers found children conceived during the spring and summer months are more likely to be born with birth defects including cleft lip and palate, club foot, Down Syndrome, and spina bifida. Increased exposure to pesticides may be playing a role the researchers said.

Women born in the second half of the year have the lowest lifetime risk of developing breast cancer according to a 2000 study in Oncology Reports.

People born during July and August have the lowest risk of developing benign and malignant brain tumors according to a 2004 study published in the journal Neurology.

People born during the spring and summer months are more at risk for alcohol dependence, autism, and dyslexia, but are less likely to develop Alzheimer’s disease, epilepsy and narcolepsy.

August

People born in August and September have the lowest lifetime risk of schizophrenia. People born during February and March have the highest risk.

People born during July and August have the lowest risk of developing benign and malignant brain tumors according to a 2004 study published in the journal Neurology.

Children born in August may be at an increased risk of developing a form of childhood leukemia called ALL. The other peak risk is in February and the increased risk may be related to peaks in infectious diseases.

Women born in the second half of the year have the lowest lifetime risk of developing breast cancer according to a 2000 study in Oncology Reports.

People born during the spring and summer months are more at risk for alcohol dependence, autism, and dyslexia, but are less likely to develop Alzheimer’s disease, epilepsy and narcolepsy.

September

People born in August and September have the lowest lifetime risk of schizophrenia. People born during February and March have the highest risk.

September, October, and November babies have the highest risk of developing asthma according to some studies.

Women born in the second half of the year have the lowest lifetime risk of developing breast cancer according to a 2000 study in Oncology Reports.

People born from September to December may be more prone to developing panic disorder later in life.

October

People born in the autumn months of October and November are most likely to live the longest. A study of 15 million U.S. death certificates published in 1997 found on average people will live roughly five months longer if born in one of these two fall months.

Women born in the second half of the year have the lowest lifetime risk of developing breast cancer according to a 2000 study in Oncology Reports.

People born from September to December may be more prone to developing panic disorder later in life.

September, October, and November babies have the highest risk of developing asthma according to some studies.

Women born in October are also most likely to stay fertile the longest. A study conducted by Italian researchers found women born in October experienced menopause at 50-years, 3-months. Women born in March experienced menopause the earliest at age 48-years and 9-months.

November

People born in the autumn months of October and November are most likely to live the longest. A study of 15 million U.S. death certificates published in 1997 found on average people will live roughly five months longer if born in one of these two fall months.

Women born in the second half of the year have the lowest lifetime risk of developing breast cancer according to a 2000 study in Oncology Reports.

Babies born in November are least likely to develop multiple sclerosis according to a 2004 report in the British Medical Journal.

People born from September to December may be more prone to developing panic disorder.

September, October, and November babies have the highest risk of developing asthma according to some studies.

Children born in May and November may be at the lowest risk of developing acute lymphoblastic leukemia.

December

Babies born in December have a lower risk of developing multiple sclerosis later in life, but November had the lowest risk.

Women born in the second half of the year have the lowest lifetime risk of developing breast cancer according to a 2000 study in Oncology Reports.

People born in December are at increased risk of developing Alzheimer’s disease, epilepsy, narcolepsy. People born during the spring and summer months had the lowest risk of these diseases.

Lower air temperature at birth has been associated with the development of increased insulin resistance, coronary artery disease and increased triglycerides as adults. So U.S. babies born during the colder winter months may be at an increased risk of having heart attacks earlier in life.

People born from September to December may be more prone to developing panic disorder later in life.

Twinning is Sometimes a Family Affair

   Statistics vary but about one in every ninety births in the United States are twins, and sometimes the propensity to have twins can run in families. There are two main types of twins, identical and fraternal. Identical twins occur when a single fertilized egg splits in two, usually before the eighth day of development. Each then develops into two separate but genetically identical embryos. Heredity and family history seem to play no role in the occurrence of identical twins.  

   Nutrition may also increase the odds of having fraternal twins. The highest rates of fraternal twinning in the world are found in certain parts of West Africa where a lot of cassava is eaten. The peel of this potato-like root is thought to contain a substance that causes women to hyper-ovulate.

-Sean Kenniff, MD