The elusive link between obesity and autism.
Nicholas barvalo has always been bigger than his twin brother. He weighed nearly a pound more at birth than Christopher, and when the boys were just one year old, their mother, lynette, noticed something else. Christopher bab, with eye contact, pointed to his home in long island, New York. Nicholas didn’t – he was quickly diagnosed with autism.
The Bavarian family is obese, but their active lifestyle helps Christopher and the twins’ parents and sisters maintain extra weight. However, Nicholas did not share their love of sports. He has difficulty in sports and has very little speech – he often says “no” when others offer to ride a bike or walk long distances.
When Nicholas, his weight seems to be trivial, his communication difficulties and collapse, during this time, he would cry out, red face over ten hours, or in your room block. But by the time he was ten, his weight had soared to 170 pounds. At 5ft 3in, his body mass index (BMI) is the highest percentile of boys of his age. The pediatrician suggested that only his parents should count his calories. It doesn’t work.
Now, at the age of 15, Nicholas is 7 inches tall, weighs nearly 100 pounds and is very obese. Many parents were disappointed that he was not interested in the health benefits of weight loss and ignored the factors such as peer acceptance, which may sometimes motivate other children.
Nicholas’s condition is common among young people with autism. A 2014 study of more than 6,000 children and adolescents found that they were more than twice as likely to be overweight and nearly five times more likely to be obese than their peers. These statistics translate into a high percentage of related health problems. According to a 2016 analysis by the national health insurance research database in Taiwan, adolescents with autism are three times more likely to develop type 2 diabetes than their typical peers. To the United States in 2016 to review the records of 48762 children with autism, according to their other also significantly higher incidence of obesity related diseases, such as high blood pressure, high cholesterol and nonalcoholic fatty liver disease.
“We live in a fat environment,” said Carol Curtin, associate professor of family medicine and community health at Eunice Kennedy Shriver center in Worcester, mass. “Whether these children are more susceptible to this environment, or whether there is a unique risk factor, is not clear, and we haven’t been able to tell our longitudinal studies. “
So far, studies have shown that people with autism differ in obesity from the general population. First, the weight problem in autism seems to follow a specific process: weight begins to grow at a young age, and often persists into adulthood. Many people have a high sense of height, plus a fondness for routines, which makes them dislike new tastes and textures and is vulnerable to unhealthy eating patterns. Sports and social barriers, as well as an affinity for the screen, may limit physical activity.
Unfortunately for children like Nicholas, these differences have not been recognized, and the weight management plan is almost entirely aimed at the typical child. “If you have a special education every day after school, how will you fit in?” asks Sarabeth broder-fingert, a pediatrist at Boston university. “If you have a non-verbal child, it doesn’t work to talk about nutrition.”
Some researchers are tweaking the program to help children with autism expand their food choices and reduce sedentary behavior. The data show that these new programs offer the benefits of exceeding physical health: among some young people with autism, they can also improve social functioning and self-esteem.
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A 2002 report by the national center for health statistics showed that serious concerns about childhood obesity first appeared. A few years later, the same concern was reached with clinicians treating children with autism.
In 2005, curtin and her colleagues conducted a chart review of 140 children and teenagers at the special needs clinic at tufts medical center in Boston. They want to get the prevalence of obesity in this group. The records they provided included information from 42 autistic children, ages 3 to 18, and nearly one in five were overweight. They found that the proportion had risen to half among teenagers. Another third of children with autism have a body mass index higher than the 85th percentile, making them more likely to become overweight.
Larger studies later confirmed the pattern. In a 2015 study, researchers reported that weight problems began in early childhood: 16 percent were overweight, and 16 percent were obese between 2 and 5 years old. A study last year found that adolescents with autism often do not have autism compared to many typical children. The results are not surprising since the analysis in 2005 that curtin has been trying to raise awareness of obesity in people with autism. When curtin applied for more data, she was turned down. “No one believes this is a problem,” she said. “In autism, the focus is primarily on behavior; Physical health is largely ignored.
The physical consequences of autism or its treatment may seem less urgent, and almost all increase the risk of obesity, compared with aggression and other behavioral problems. Most children with autism have sleep problems or gastrointestinal problems, both of which can lead to weight problems. Many people take seizures, anxiety or depression medications, and may cause weight gain. Weight gain is a common side effect of antipsychotic drugs such as risperidone and aripiprazole, the only drug approved by the U.S. food and drug administration for the treatment of autism.
In addition, some autistic children are genetically predisposed to obesity. Broder-fingert said: “in such children, hormonal and biochemical differences may lead to obesity rather than excessive screening time.
In 2010, two groups of scientists found that individuals with 25 genes missing on chromosome 16 were more likely to develop autism, stunted growth and obesity than controls. The deletion, known as 16p11.2, affects only half of people with autism, but nearly 3 percent of people with autism also have it. More evidence suggests that these genes play a role in weight for the next year. Some of the same scientists have found that the reverse – along the chromosome 16 – increases the risk of extreme thinning. Repeat children often have autism and intellectual disabilities, plus birth weight deficiency. Children who repeat themselves may be more likely to be full and have difficulty gaining weight than those who are always hungry.
A significant loss of chromosome 11, associated with autism and attention deficit hyperactivity disorder, is a gene associated with mental disorders and obesity. A large number of deletions on chromosome 15 lead to prader-willi syndrome; This syndrome is characterized by intellectual disability, in some cases, autism. Early childhood, children with this syndrome are prone to overeating, leading to extreme obesity in early childhood.
These rare chromosomal deficits associated with autism seem to affect appetite and perception. Research scientist at the university of California Davis Paula cracow d ark (Paula Krakowiak) said, for without these missing children with autism, the natural regulation of appetite and diet may also change. The study has linked autism to inflammation, which interferes with metabolism and the body’s ability to balance food and energy expenditure, klakowiak said. “Immune disorders can produce positive feedback loops of inflammatory responses, weight gain, and then more inflammation, and so on,” she said. “These two systems interact and overlap.”
Inflammatory disorders such as diabetes, hypertension, CD and rheumatoid arthritis are also common in women with autism. In a 2016 study, warrior dance and her colleagues found that women with gestational diabetes sometimes develop anti-fetal antibodies -molecules that attack the fetal brain and increase the risk of autism. These antibodies are particularly prevalent in women with severe end-stage children. Maternal obesity produces high levels of certain immune molecules, which can lead to the production of these antibodies.
Since obesity is hereditary, the tendency of parents to gain weight can be passed on to their children. “A large percentage of these children are likely to have an unusually high risk of gaining weight,” klakowiak said.
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Some scientists are trying to determine the biological link between autism and obesity, and other scientists, including Mr. Curtin, have been developing strategies to treat teen weight gain. Curtin was one of the first scientists to apply for scientists when the American maternal and child health service launched a call to study obesity in children with developmental disabilities five years ago. In 2013, she and her colleagues won three years of funding to start a healthy weight research network. In 2017, the agency renewed its funding for another five years. The network has about a dozen core researchers who are conducting a secondary analysis of existing data sets. It also funded pilot projects and helped members apply for external funding to investigate obesity risk factors and treatments for special needs children.
One major research question is how autism amplifies the common risk of obesity. Kansas children’s charity weight management clinic’s medical director brooke Sweeney said: “most of children like to eat high in carbohydrates, high-fat, high-calorie foods, such as chicken and French fries. The children’s menu at every American restaurant. The typical child has gradually diversified over time and eventually even learned to like broccoli, spinach and other vegetables. But Sweeney says children with autism find it more challenging to separate from a high-calorie diet and the most popular diet. (different tastes may lead to other eating disorders in children.)