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

DIET ADDICTION COULD BE DRIVING U.S. OBESITY EPIDEMIC, RESEARCH SUGGESTS…

DIETING MAY BE ADDICTIVE, PACK ON POUNDS

By Sean Kenniff, MD

Healthapalooza.com

Americans spend roughly $47 million dollars each year on Twinkies, and another $32 billion on pizza. That’s a lot of dough. So it is hard to imagine the kind of food that outsells all those pizzas and Twinkies combined. According to food industry statistics, diet products do just that. Each year U.S. consumers spend more than $40 billion trying to shake off the pounds with diet shakes, pills, and programs.

But take a look around, and take a good look in the mirror. Diets don’t work well for anybody—they don’t even work for rich and famous celebrities. After losing 160 pounds in 2005, talk show queen Oprah Winfrey regained all of her weight by 2009. Actress Kirstie Alley famously lost 75 pounds by using the diet program Jenny Craig. She gained it all back within three years. Dodger ex-manager Tommy Lasorda slimmed down using Slim Fast, and so did NFL Hall of Fame coach Bill Parcells. Both men saw weight loss victory quickly turn to defeat.

“While virtually all diets result in weight loss in the short term, 95-98 percent of people who go on a diet will gain the weight back,” says Judith Matz, co-author of The Diet Survivor’s Handbook: 60 Lessons in Eating, Acceptance and Self Care. “According to the research, two-thirds will end up heavier than their pre-diet weight.”

Matz says repeated phases of food deprivation, commonly called dieting, slows metabolism and makes our bodies store fat more efficiently. Recent evidence also suggests repeated dieting can alter brain chemistry in a similar fashion to drug or alcohol addiction.

“Diets give a high,” Matz says, “There is a virtuous feeling; you are on top of the world.”

So can you be addicted to dieting? And can a “diet addiction” be making you fatter?

The idea that a “diet addiction” could be driving our obesity epidemic is not a new one. Scientists have long known behaviors of yo-yo dieters—like food compulsions, obsessions, guilt, and shame, closely resemble the behaviors of relapsing addicts. What drives people to use drugs or alcohol in the first place, drives many others to extreme diets or eating disorders—genetics, emotional strain, mental illness, peer pressure and insecurity all playing important roles. Like alcoholics and drug addicts, dieters will often do destructive things to their bodies just to be thinner. Many abuse water pills, amphetamines, and laxatives to stay thin, or continue to smoke cigarettes out of fear that quitting will lead to weight gain. Still others resort to the dangerous bingeing and purging of bulimia.

But perhaps the most compelling evidence of diet addiction comes from experiments conducted by Dr. Pietro Cottone and Dr. Valentina Sabino at the Boston University School of Medicine. They studied the neurobiological responses of 155 rats. One group of rats was fed the standard, bland-tasting rat chow. Another group of rats was fed in diet cycles of standard rat chow for five days, followed by two days of a tasty, high sugar, chocolate flavored chow. The standard chow quickly became unacceptable to rats in the diet-cycled group, and they exhibited anxiety behaviors until they were able to get a fix of the chocolate chow. But when Dr. Cottone and Dr. Sabino examined the stress pathways in the brains of the rats, they found the “addictive” stress response was not caused by the tasty food, but rather by the deprivation phase. They found a key stress neurotransmitter, called CRF, was creating a negative emotional state nearly identical to that seen in animals withdrawing then bingeing on drugs or alcohol.

And it’s believed this same abnormal stress response could be one reason why so many people fail miserably on their diets, yet try and try again.

“CRF activation during abstinence from palatable foods induces a negative emotional state which is responsible for signs of anxiety and contributes to relapse to ‘forbidden foods,” Dr. Sabino said in a press release.

So how do you know if you are a diet addict?

ARE YOU A DIET ADDICT?

1.    Have you repeatedly tried and failed to control your weight with diets?

2.    Has dieting interfered with your life, social activities or employment?

3.    Do you have constant thoughts about dieting?

4.    Do you jump from diet to diet?

5.    Do you feel shame when you fail on your diet?

6.    Have you ever dieted dangerously?

If you answered yes to two or more of these questions you could be a diet addict.

But what about those people who are persistent and successful at dieting, like 65 year-old computer professional, Rose Lynn? She failed at Atkins, South Beach, and Weight Watchers, but recently lost fifty pounds on Nutra-System.

“I don’t believe the diets failed,” Lynn says, “I believe I failed to be ready and committed.”

Football Coach Jim Napoli lost forty pounds on the same diet program, after failing miserably on Atkins. “I lost weight, but I was mean as I’ve ever been, from the minute I woke up, until the minute I went to bed,” he says.

Funnyman and morning DJ Jeff Martin, who lost nearly thirty pounds on Quick Weight Loss, takes a more absurdist view on dieting, saying, “Try the garlic, limburger cheese, scallions, and red onion diet. From a distance, you will LOOK thinner.”

Will their success lead to long term weight loss? Matz says, slim chance—a two to five percent chance to be specific. Matz claims the secret to lifelong thinness is to break the diet addiction for good. Don’t avoid your favorite foods, because deprivation triggers overeating. Instead eat them in moderation. And honor your hunger. Hunger is your body’s natural way of telling you to eat. But be wary of emotional eating. If hunger is not your problem, then eating is not your answer.

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

To contact Judith Matz, or for more information about The Diet Survivor’s Handbook: 60 Lessons in Eating, Acceptance and Self Care, visit www.dietsurvivors.com or you can read her blog at www.dietsurvivorsgroup@blogspot.com

Dr. Pietro Cottone and Dr. Sabino Valentina can be reached by contacting the Boston University School of Medicine.

Does ‘Carb-Loading’ Improve Athletic Performance?

  For generations, endurance athletes have practiced ‘carb-loading’, consuming large amounts of carbohydrates the night before the competition. Studies have found several different carb loading strategies can give athletes a competitive edge.

  During digestion carbohydrates are rapidly turned into glucose, a sugar that is the body’s primary and most immediate energy source. Excess glucose is then stored in the liver and muscles as glycogen. About four hours after a meal, the glycogen in the liver begins to break down and supply the body with glucose, but the glycogen in the muscle is reserved almost exclusively for muscle activity. By eating a high carbohydrate meal the night before a competition, athletes maximize the glycogen stores in their muscles, ensuring that the muscles will have enough glucose for strenuous activity.

  Studies have shown carb-loaded athletes perform better and their muscles do not fatigue as easily. However it is important to watch your calories. Excess calories of any kind have been shown to impair athletic performance. -Sean Kenniff, MD

The Ten Most Effective Abdominal Exercises: #3 The Exercise Ball Crunch

  If you’re trying to tone your tummy, and want that washboard look, try these top ten abdominal exercises. Using electromyography (EMG) Dr. Peter Francis and his team from the Biomechanics Lab at San Diego State University measured abdominal muscle activity, and put some of the most commonly performed exercises to the test. They ranked them from most effective to least effective. The study was sanctioned by the American Council on Exercise (ACE). 

#3 The Exercise Ball Crunch 

  Dr. Francis found the most effective abdominal exercises combined continuous abdominal contraction and rotation of the torso. Overall the Bicycle Maneuver ranked #1 and the Captain’s Chair ranked #2 (see below). The Exercise Ball Crunch was the third most effective exercise for working the abs (it also finished #6 for working the oblique muscles). Here’s how to perform the Exercise Ball Crunch properly according to the ACE.

1. Sit on the ball with your feet flat on the floor.

2. Lie back on the ball until your thighs and torso are parallel to the floor.

3. Cross your arms over your chest, or place them lightly behind your head. Do not pull on your neck.

4. Contract your abdominals raising your torso no more than 45 degrees.

5. Move your feet closer together to work your obliques.

6. Repeat sets of 12-20 repetitions.

  Check the Healthapalooza.com Special Reports section tomorrow when we will reveal the exercise that ranked #4 in the study. -Sean Kenniff, MD

The Ten Most Effective Ab Exercises: #2 The Captain’s Chair

  If you want washboard abs this summer, you might want to try the ten exercises most likely to give them to you. Dr. Peter Francis from the Biomechanics Lab at San Diego State University measured abdominal muscle activity with electromyography (EMG) devices, and put some of the most commonly performed exercises to the test, ranking them from most effective to least effective. The study was sanctioned by the American Council on Exercise (ACE).

#2 The Captain’s Chair

  Dr. Francis found the most effective abdominal exercises combined continuous abdominal contraction and rotation of the torso. Overall the Bicycle Maneuver ranked #1 (see below), but the ‘Captain’s Chair’ finished a close second and it strengthened both the abdominal and oblique muscles the best. Here’s how to perform the exercise properly according to the ACE.

     1. Stabilize your upper body by gripping hand holds.

     2. Lightly press your back against the back pad.

     3. Slowly lift your knees to your chest, then return legs to starting.

     4. The motion should be controlled and deliberate, not fast or jerking.

Check the Healthapalooza.com Special Reports section tomorrow when we will reveal the exercise that ranked #3 in the study. -Sean Kenniff, MD