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

Carnal Knowledge: Things About Sex You Probably Don’t Know

Carnal Knowledge: Ten Things You Probably Don’t Know About Sex

By Sean Kenniff, MD

Despite the sexual revolution of the 1960s and 1970s and recent scientific advancements, there is still a lot of mystery surrounding everyone’s favorite physical activity. And if you think you know everything about sex, think again. Take a look at these ten sex headlines you might have missed. 

SEX AND THE CITY

People living in New York City have twice the number of sex partners as the average American. NY’s Daily News took a look at the sex lives of the Sex and the City Characters to see how they compared to the real thing. In the 94 episodes of six seasons the four main characters managed to bed 94 men and one woman.  Samantha was the most prolific lover, shagging 41 men and 1 woman. Carrie hooked up with 18 men and so did Charlotte. Miranda bedded 17 men. When these fictitious sexual patterns were compared to similar groups of real NY City women, those numbers were right on target.

DIRTY WORDS

The word pornography is a combination of the Greek word for prostitute, or “porno”, and the word “graphia” which means writing. So literally pornography originated as writings about prostitutes.

BREAST IMPLANTS ARE LINKED TO SUICIDE

Several studies have documented an increased risk of suicide in women who have breast implants. A Swedish study published in 2007 found women with breast implants were nearly three times more likely to commit suicide compared to women without the implants. According to the study the increased suicide risk did not appear until 10-years after the breast augmentation surgery. But twenty years after the surgery the researchers found the rate of suicide in women with implants was six times the expected rate. Some studies have found women with breast implants also have triple the risk of dying from drugs or alcohol.

SIZE MATTERS

The largest medically verified human penis measured almost 14 inches. The shortest ever recorded was 0.39 inches long, or just about one centimeter. Today normal size is said to be between five and seven inches. Rorqual whales have the largest penises of any animal; 10-feet long, and 1-foot in diameter. But compared to body size the unassuming barnacle has the largest endowment, with a penis up to 42-times its own body length (below).

MINUTE MEN…AND WOMEN

A 2008 survey of U.S. and Canadian sex therapists say “satisfying sex” lasts anywhere from three-to-thirteen minutes. 7-to-13 minutes was declared “desirable”, whereas 1-2 minutes was deemed “too short”, and more than 14 minutes was deemed “too long”.

VIRGINITY GENES?

Genes may play an important role in determining the age at which a person first engages in sexual intercourse according to a 2009 study. Researchers from California State University in Fullerton studied 48 pairs of twins who were raised apart and found the age of virginity loss was roughly 33% due to genetic influences. Previous studies have found a gene, called DRD4, is associated with impulsiveness, increased risk-taking behavior and a lower age at first intercourse. June is often cited as the most common month for loss of virginity (all those proms and weddings).

RED WINE MAY BOOST A WOMAN’S LIBIDO

Doctors from the University of Florence in Italy say a glass or two of red wine may boost a woman’s level of sexual interest. They studied more than 800 normal women and found women who enjoyed drinking 1-2 glasses of red wine had higher levels of sexual desire compared to women who drank other forms of alcohol or those who abstained. It is possible compounds in red wine increase blood flow to key areas.

HANGING CHADS

In most men the left testicle hangs lower than the right testicle, and although the reason is not entirely clear it makes a lot of practical sense. The oval shape of the testes and their different heights may prevent them from banging into each other when men walk. Both testicles rise with physical exertion or sexual intercourse for the same reason. The cremaster muscle is responsible for this reflex. Plus being further apart may keep the testicles cooler which is important for sperm production.

300 ORGASMS A DAY!

Women suffering from a rare condition called Persistent Sexual Arousal Syndrome, or PSAS, can have 300 orgasms each day or more. The orgasms in women with PSAS are usually unrelated to sexual activity or sexual thoughts, and they often occur at inappropriate and embarrassing times. In fact the orgasms come so frequently they cease to be pleasurable. Brain abnormalities have been found in some cases, but the cause of most cases remains a mystery.

FERTILE STRIPPERS MAKE MORE MONEY

New Mexican psychologist Geoffrey Miller studied female strippers and found they earn more tips in the week before their period than any other time during the menstrual cycle. This is the time of peak fertility, and Miller theorizes pheromones are signaling the men and causing them to tip larger amounts. In fact during peak fertility exotic dancers made twice as much money as they did when they were menstruating. The same study also found women on ‘the pill’ did not experience the monetary increase during this most fertile time.  

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

Birth Control Basics

  Roughly six out of every ten pregnancies in the United States are unplanned, according to the Institute of Medicine. Many experts think this high rate of unintended pregnancies results from a lack of knowledge about contraception. But it’s important to remember that no form of birth control is 100% effective at preventing pregnancy. Here are the stats on effectiveness.

  Tubal ligation and vasectomy procedures are probably the most effective means of contraception, preventing pregnancy more than 99.5 percent of the time. Intrauterine devices, or IUDs, fail to prevent pregnancy in roughly 1 to 2 percent of women who use them for a year. For women injection of birth control hormones or implantation of hormones has just about the same effectiveness, but these hormones carry an increased risk of developing dangerous blood clots. So do oral contraceptives, and the pills are a bit less effective at preventing pregnancy. About 5 percent of women taking oral contraceptive for one year will conceive inadvertently. Typical condom use has an unintended pregnancy rate of about 14 percent per year, and the conception rate for women using the vaginal sponge and diaphragm is about 20 percent.

  The emergency birth control method ‘Plan-B’, which is often called the morning after pill, prevents pregnancy in roughly 75 percent of cases if taken within 72 hours of unprotected sex, but it is most effective if started within 24 hours. -Sean Kenniff, MD

What is Your Love Personality?

What is Your Love Personality?

by Sean Kenniff, MD 

   Finding your perfect mate may come down to ‘chemistry’ after all-the chemistry inside your brain according to a new relationship theory. Dr. Helen Fisher, a Rutgers University anthropologist, has studied brain responses to relationships for decades, and she says there are four distinct personality types based on your brain chemistry.

The Builder: Builders are fueled by the feel-good brain chemical serotonin. Serotonin is the same neurotransmitter that is believed to be critical in alleviating depression. Builders are calm, orderly and managerial in their approach to love. Although they can be pleasingly social, sometimes they are criticized for being humdrum homebodies. Builders are reliable, stable and consistent, but they can be a bit predictable and lack some spontaneity.

The Explorer: Explorers are governed by the novelty-seeking brain chemical dopamine. Imbalances of dopamine have been connected to heightened impulsivity, risk-taking behaviors, drug addiction, delusions, and even schizophrenia. Driven by dopamine explorers constantly seek excitement in relationships. Sometimes they move from relationship to relationship once the monotony sets in. Explorers are highly spontaneous and often fun lovers, but they become bored easily and are often criticized for being flighty.

The Director: The male sex hormone testosterone is thought to predominate in the brains of directors, but both men and women can fall into this personality type. In studies testosterone has been associated with aggression and competitiveness. In relationships the testosterone-driven directors are focused, rational, daring and direct. They are logical lovers, but at times they can be coldly analytical, bossy and controlling.

The Negotiator: Negotiators are governed by the female hormone estrogen, but both men and women can fall into this category. Estrogen has been associated with mothering behaviors, emotional connectivity, and selfless reasonability. Negotiators are socially skilled, idealistic peacemakers and they often find themselves at the gravitational center of relationships. They are empathetic lovers, and willing to compromise on almost every issue. 

So what types make the best matches? 

Explorers: Explorers often want to date themselves and they should. The other personality types are often frustrated by the explorer’s flights of fancy, irrationality, and unwillingness to commit to long-term relationships. So explorers should seek other explorers to keep fueling the excitement. Explorers can sometimes ground themselves by dating builders, but they run into trouble by dating directors. The no-nonsense approach of the director leaves explorers feeling confined or trapped. 

Builders: Builders value loyalty, consistency, and thrive on routine. Dating another builder is the most common and it may be the most successful relationship strategy. Two builders together often form a stable family unit, guided by shared goals and teamwork. Builders can sometimes ground an explorer, but the builder’s love of routine can often clash with the explorer’s love of novelty.   

Negotiators and Directors: Directors often need a negotiator to temper their frank, methodical approach to romance, and negotiators often benefit from the stronger backbone of directors. However negotiators, given their pleasing nature, can suit just about other personality type. Directors, on the other hand, find it very difficult to date anyone without good negotiating and peacemaking skills.

Pill-Free Prescription for Depression

Dr. Sean’s Pill-Free Prescription for Depression

by Sean Kenniff, MD

    Contrary to popular belief depression comes in many forms. Seasonal Affective Disorder (SAD) is characterized by depressed mood during the winter months. Dysthymia is marked by a generalized and fairly persistent moderate level of depression. Post-partum Depression (PPD), which occurs in roughly ten percent of new moms, is often characterized by severe emotional distress following childbirth. Reactive Depression is a depressive disorder that occurs in response to a particular event. There are several other forms of depression but the most notable of all the depressive disorders is Major Depression, also called Major Depressive Disorder (MDD). MDD It is a severe and often debilitating chronic mental illness.

    A report published by the CDC’s National Center for Health Statistics in 2008 found that in any 2-week period roughly 1-in-20 people are depressed. Serious signs include feelings of overwhelming sadness, suicidal thoughts, bouts of crying for no reason, loss of interest in daily activities, feelings of hopelessness, difficulties with sleep, irritability, and loss of interest in pleasurable activities like sex.

    The cause of depression isn’t entirely understood. There are strong genetic factors that seem to predispose someone to depressive conditions. Negative life experiences can also increase the risk. There is some evidence that serotonin and norepinephrine may be playing a role, and medications that alleviate depression often seem to work by altering levels of these two brain neurotransmitters.

    Treatment with antidepressant medications is essential in many cases, but they can cause some troubling side effects. So here’s how to alleviate some of the signs and symptoms of depression without popping any pills. 

Dr. Sean’s Pill-Free Prescription for Depression

Sunlight

    Lack of sunlight in the winter months can lead to Seasonal Affective Disorder in some people. An ultraviolet sunlamp can help but natural sunlight seems to work best at alleviating the symptoms. So try to get more sunlight or head to a sunnier climate. Just why a lack of sunlight leads to depression is not clear. Some researchers suspect melatonin, a hormone produced by the pineal gland in response to dim light, may have a depressing effect on mood. Other experts have suggested vitamin-D deficiency is playing a role. Vitamin-D is made in our skin during sun exposure and some studies have found a vitamin-D deficiency can lower mood.

Fish

    Countries with the highest rate of fish consumption have the lowest rates of depression, and a diet high in fish, or fish oil supplements containing omega-3 fatty acids, can improve symptoms of depression and stabilize mood swings. A 2002 study that appeared in the Archives of General Psychiatry found taking fish oil supplements resulted in a fifty percent decrease in depressive symptoms. It appears that omega-3 fatty acids in fish help raise the level of serotonin in the brain. One study even suggested that a diet rich in omega-3 fatty acids might help improve depression in people who have not been helped by antidepressant medications.

Walnuts

    Have you ever noticed that walnuts look like the human brain? Well there may be good reason for that because walnuts also contain omega-3 fatty acids. Just ¼ cup of walnuts each day can provide you with an entire day’s worth of omega-3s. Walnuts are also a good source of magnesium and vitamin-B6 which are also important for mood stabilization and brain cell functioning.

B-Vitamins

    The brain uses B-vitamins to manufacture neurotransmitters like serotonin, norepinephrine, epinephrine and dopamine. These neurotransmitters play a critical role in mood elevation and mood stabilization. So fill your plate with healthy sources of B-complex vitamins like whole grains, eggs, bananas, and soy beans. 

Avoid Alcohol

    It’s important to mention that alcohol is well known to depress mood. But alcohol also interferes with the absorption of B-vitamins in the body which can worsen or lead to neurotransmitter imbalances. In fact it is very common for alcoholics to be severely depressed and many of them have significant deficiencies of B-complex vitamins. Alcohol abuse also increases the risk of suicide in people who have depressive symptoms.

Daily Exercise

    Just about every study ever conducted on exercise and mood has shown that regular physical activity improves mood and alleviates depressive symptoms. It’s thought that exercise increases levels of feel good chemicals, called endorphins, in the body. Plus exercise reduces stress, improves self-esteem, improves sleep, and increases energy levels. 

Cognitive-Behavioral Therapy (CBT)

    Cognitive behavioral therapy (CBT) is a specific form of talk therapy that psychologists often use to treat depression. During a CBT session the patient and therapist analyze negative behavioral patterns and dysfunctional emotions through positive insight exercises and systematic goal setting. CBT concentrates on present problems and symptom removal. Several studies have found combining CBT with antidepressant medications improves results and lessens depression relapses. Some studies have suggested CBT alone may be as effective as taking antidepressant medications.

Mindful Meditation

    There is some evidence that mindful meditation may help alleviate some of the symptoms of depression. Unlike traditional forms of meditation where thoughts are cleared, mindful meditation focuses the mind on the present. When done properly the technique allows the person to explore thoughts and actions without judgment. Some practitioners have combined mindful meditation with cognitive behavioral therapy (CBT) into a new technique called mindfulness-based cognitive therapy or MBCT. Studies have shown MBCT may also improve depression in some people. 

    It is important to reiterate that for many people with moderate or severe depression medications will be an important, if not critical element of their therapy. So make sure you discuss all of your options with a skilled mental health professional.