Children with autism are more likely to be overweight or obese compared to neurotypical children (Sarabeth Broder-Fingert, Karisa Brasauskas, Kristen Lindgren, Dorothea Iannuzzi, Jeanne Van Cleave, "Prevalence of Overweight and Obesity in a Large Clinical Sample of Children with Autism," Academic Pediatrics 14, no. 4 (July-august 2014): 408-414, doi:10.1016/j.acap.2014.04.004). When individuals are overweight or obese, they may start to consume artificially sweetened drinks. However, a recent study showed that consuming such drinks is associated with an increased risk of dementia and stroke, (Matthew P. Pace, Jayandra J. Himali, Alexa S. Beiser, Hugo J. Aparicio, Claudia L. Satizabal, Ramachandran, S. Vasan, Sudha Seshadri et al., "Sugar- and Artifically Sweetened Beverages and the Risks of Incident Stroke and Dementia A prospective Cohort Study," Stroke 48, No. 6 (June 2017): doi:10.1161/STROKEAHA.116.016027). The study involved 2,888 participants. Even though the individuals are not children, children who are overweight or obese often continue to be so in adulthood. Having at least one can a day was associated with an increased the risk of all-cause dementia up to almost two and a half times as much and the associated risk of stroke and Alzheimer's dementia was almost up to three times as high. Although is not possible at this time without further study to definitively establish causation, it still is a good idea to cut back on these drinks.
Autism, Behaviors and Vitamin D
A recent double blind randomized controlled trial involving 109 subjects showed that children with Vitamin D supplementation had a significant improvement in symptoms of autism compared to placebo, (Khaled Saad, Ahmed A. Abdel-Rahman, Yasser M. Elserogy, Amira A. El-Houfey, Hisham A. K. Othman, Geir Bjorklund, et. al., "Randomized Controlled Trial of Vitamin D Supplementation in Children with Autism Spectrum Disorder," Journal of Child Psychiatry and Psychology (October 2016): doi: 10.1111/jcpp.12652. Improvements were seen in the Childhood Autism Rating Scale (CARS) in relating to people, emotional response, imitation, body use, object use, adaptation to change, listening response, visual response and general autistic impression. There were improvements in the Social Responsiveness Scale (SRS) in autistic mannerisms, social cognition and social awareness, in the Autism Treatment Evaluation Checklist in sociability. cognitive awareness and behavior, and the Aberrant Behavior Checklist (ABC) in irritability, hyperactivity, social withdrawal, stereotypical behavior and inappropriate speech subscales. although this was a small study and more research needs to be done to further validate these results, it is prudent to check Vitamin D levels and if low to ask a physician or other qualified health care professional regarding supplementation.
Side Effects of Drugs Identified After FDA Approvals
According to a recent study, involving 222 medications FDA approved between 2000 and 2010, 32% of these drugs were found to have safety risks after being on the market, (Nicholas S. Downing, Nilay D. Shah, Jenerius A. Aminawung, Alison M. Pease, Jean-David Zeitoun, Harlan M. Krumholz, Joseph S. Ross, "Theraputics Approved by the US Food and Drug Administration Between 2001 and 2010," JAMA 317, no. 18 (2017): 1854-1863, doi:10.1001/jama.2017.5150). The risks were higher for psychiatric medications, medications that received accelerated approval and near-regulatory deadline approval. The median follow-up time for the study was 11.7 years. After these medications were approved, the median time for the FDA to either withdraw the drug, issue a boxed warning or a safety communication was 4.2 years. This poses a greater concern for individuals with autism or other communication impairments, who may not be able to communicate side effects, posing an increased risk of morbidity and mortality.
Autism, Fractures and Psychiatric Medication
A study which used data from the National Emergency Department Sample database which consists of information from over 28 million emergency department visits at 961 hospitals, showed that "[p]eripubertal boys with autism spectrum disorder have lower bone mineral density than typically developed controls." (Ann M. Neumeyer, Julia A. O'Rourke and Madhusmita Misra, "Brief Report: Bone Fractures in Children and Adults with Autism Spectrum Disorders," Journal of Autism and Developmental Disorders, 45, No. 3 (March 2015): 881-887, doi: 10.1007/s10803-014-2228-1). Both male and female children and adults with autism had a significantly increased risk of hip fractures Furthermore, adult women with autism had a higher risk of forearm and spine fractures compared to controls. The study further discusses that hip fractures in particular often require surgery and can cause life-long disability and individuals with autism may have more difficulty adhering to treatment including rehabilitation. In addition, individuals with autism may not understand risk and be more prone to accidents. Interestingly, another study showed peripubertal boys with autism on gluten- and casein- free diets have even lower bone mineral density, Ann M. Neumeyer, Amy Gates, Christine Ferrone, Hang Lee and Madhusmita Misra, "Bone Density in Peripubertal Boys with Autism Spectrum Disorders," Journal of Autism and Developmental Disorders, 43, No. 7 (July 2013): 1623-1629, doi: 1007/s10803-012-1709-3). What is concerning is that a recent study involving 68,730 individuals, demonstrated a significantly increased risk of hip and nontraumatic major osteoporotic fractures in individuals on psychiatric medications, including selective serotonin reuptake inhibitors, antipsychotics and benzodiazepines, (James M. Bolton, Suzanne N. Morin, Sumit R. Majumdar, "Associations of Mental Disorders and Related Medication Use with Risk for Major Osteoporotic Fractures, JAMA Psychiatry, published online (April 19, 2017): doi: 10.1001/jamapsychiatry.2017.0449). All these types of medications are commonly prescribed in individuals with autism spectrum disorders, which may further increase the risk for fractures in this population which is already at an increased risk.
ADHD, Medications and Adult Height
Individuals with autism commonly have ADHD symptoms. A recent study involving 519 children taking stimulants and 289 without stimulants were followed into adulthood. (James M. Swanson, L. Eugene Arnold, Brooke S. G. Molina, Margaret H. Sibley, Lily T. Hechtman, Stephen P. Hinshaw, Howard B. Abikoff et al., "Young Adult Outcomes in the Follow-up of the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder: Symptom Persistence, Source Discrepancy and Height Suppression," Journal of Child Psychiatry and Psychology, (March 10, 2017): doi: 10.1111/jcpp.12684). Long term use of stimulant medication was associated with a reduction in adult height, yet no reduction in ADHD symptoms.