Eight Steps to Reduce Autism Risk

Autism risk preconception care and pregnancy.jpg

One of the biggest worries we have as prospective parents is the possibility that our child will be diagnosed with a serious illness – and there are few diagnoses that are more devastating to a family than autism (also known as autism spectrum disorder or ASD). While it’s true that autism is on the rise, your child’s risk isn’t all down to chance! More and more research is emerging in the scientific community that points toward actionable steps we can take before and during pregnancy to reduce the likelihood of our child developing the disorder. Read on to learn more!

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What is Autism?

Autism is a neurodevelopmental disorder that affects a child’s behavior, communication, and social interaction. Children with autism usually present with a combination of symptoms, including repetitive or stimulatory behaviors (also known as “stimming”), difficulty interacting and connecting with others, and problems with language. However, the symptoms and degree of disability varies significantly from child to child. Some only show mild symptoms in these three areas and grow up to live relatively normal lives, while others suffer with severe disability and require lifelong care.

What Causes Autism?

The short answer is: we don’t know for sure yet. But, based on the studies that have been done to date, we do know that there are multiple contributing factors, including genetics, environmental exposures, and certain aspects of mom and dad’s health. 

It’s also pretty clear that autism is on the rise. The latest data from the CDC shows that about 1 in 59 children is identified as autistic, up from 1 in 150 in the early 2000s and 1 in 10,000 in the 1980’s. The diagnosis is also much more common in boys, with about 4 times more boys diagnosed than girls. 

With statistics like these, it’s understandable that we’re all at least a little worried about whether our child will develop autism. So let’s talk about some of the things we can do to reduce risk in our future babies.

8 Steps Parents Can Take to Reduce Autism Risk

Although we can’t do anything about our child’s genetic predisposition to autism, research suggests that genetics may only contribute to about 50% of the risk for developing autism. That gives us an enormous amount of control over the remaining 50% and there is a lot we can do to reduce environmental and health-related risk factors during preconception and pregnancy. Here are some things we can focus on, based on recent studies of autism risk.

Take a quality prenatal supplement with an active form of folate

A recent study published in Epidemiology found a decreased risk for autism in children whose mothers took a prenatal supplement during the periconceptional period (which includes the 3 months prior to conception and the first month of pregnancy). Multiple other studies have specifically linked folate supplementation to reduced ASD risk. However, most prenatal vitamins contain synthetic folic acid instead of a biologically active form of folate. And the active form is what your baby actually needs to support brain development.

Studies have shown that a high intake of synthetic folic acid from processed food and supplements can lead to increased levels of unmetabolized folate in the blood, which has been linked to health problems. In fact, a very recent study from 2017 actually found that extremely high blood levels of folate and B12 in the mother around the time of birth doubled the risk of a child developing ASD! Women with an MTHFR genetic variant would be particularly susceptible to this build-up of unmetabolized folate due to their reduced ability to convert synthetic folic acid to active folate. You can learn more about MTHFR here.

We recommend choosing a supplement that contains at least 800mcg of an active form of folate (L-methylfolate, L-5-MTHF, or folinic acid) and avoiding supplements and fortified foods that contain synthetic folic acid. This will help you reduce the risk of complications caused by unmetabolized folic acid, while still receiving the protective benefits of folate supplementation. You can find our top brand recommendations for prenatal supplements in our free online course.

Along with taking a prenatal multivitamin during preconception and pregnancy, it’s also important to increase your intake of essential nutrients from food. A healthy, nutrient-dense diet will include plenty of fruits and vegetables, fiber, healthy fats, and high-quality protein, while limiting processed foods and sugar.

Make sure you’re getting enough vitamin D

Did you know that low vitamin D levels in children are actually a risk factor for autism? Not only that, but low vitamin D levels in mom during pregnancy actually increase baby’s autism risk! Vitamin D is an essential fat-soluble nutrient that actually functions as a hormone in the body. We need it for brain development and mental health, gene regulation and expression, and immune system regulation. All three of these important functions have been shown to be severely disrupted in children with autism, so it makes sense that low levels in both mom and baby can increase ASD risk.

We recommend having your vitamin D levels tested before pregnancy so that you have a chance to correct a deficiency before it can impact your baby’s health. The blood test to ask your doctor for is called 25(OH)D, and we like to see levels between 40 and 80 ng/ml (100-200 nmol/l).

Although the primary way we’re meant to get vitamin D is by making it in our skin when we’re exposed to sunlight, most of us just aren’t getting enough sun throughout the year. If you’re living in a northern climate, you actually don’t make any vitamin D at all in the winter, even when it’s sunny. Food only contains small amounts of vitamin D and it’s really only found naturally in animal foods like cod liver oil, fatty fish, pastured egg yolks, beef liver, and full-fat dairy.

That means the most reliable way to make sure you’re getting enough vitamin D is through supplements. We recommend a minimum daily dose of 4000 IU of vitamin D3, which has been shown in research to be both a safe and effective dose during preconception and pregnancy. However, if you’re starting out already deficient, you’ll likely need to take more until you get your levels up. Just make sure you’re re-testing every 3 months to verify that you’re staying in a healthy range. You can learn more about vitamin D here.

Work on your gut health

You might be surprised to learn that your digestive health before and during pregnancy can influence your baby’s autism risk. It probably seems a little far-fetched at first, but it starts to make a lot more sense once you understand that immune system dysfunction plays a central role in autism and that 80% of the immune system is located in digestive tract!

One of the main determinants of our gut health is the number of beneficial bacteria we have growing in our intestines. Having too few of these friendly bacteria (or too many unfriendly bacteria) is called dysbiosis, and research shows that dysbiosis in mom increases ASD risk in baby. Your baby inherits his gut bacteria from you and, if yours are out of balance, his will be too. This may set him up to be more susceptible to immune dysregulation, which is a major driving factor in autism.

Your child is also at a higher risk of autism if you or others in your family have an autoimmune condition. Gut health and autoimmunity are intimately linked and studies show that poor gut health may actually be a precursor to the development of autoimmunity!

We can all benefit from some TLC for our guts before trying to conceive. However, it’s especially important to address gut health during preconception if you have chronic digestive symptoms or any type of immune system disorder (including allergies, asthma, eczema, or autoimmunity).

You can start improving your gut health by:

  • Taking a high-quality probiotic supplement (find our favorite brand recommendations here)

  • Removing sugar and processed foods from your diet or trying an elimination diet

  • Getting plenty of fiber daily (mostly from non-starchy vegetables)

  • Consuming bone broth and fermented foods daily (sauerkraut, kimchi, yogurt, kombucha, etc.)

If your digestion doesn’t significantly improve with dietary changes and probiotic supplements, then we highly recommend stool testing to get to the bottom of what’s going on in your gut. Learn more here.

Get dad on board

Women are not the only ones with the power to reduce autism risk. A study published in Pediatrics in 2014 showed paternal obesity as an independent risk factor for autism. Dads can reduce their child’s autism risk by participating in preconception preparation along with their partner, focusing on healthy eating and exercise for weight management.

Reduce exposure to pesticides

Both a 2007 study and a 2014 study have linked exposure to pesticides during preconception and pregnancy to increased autism risk. If you’re currently pregnant or trying to conceive, take special care to avoid exposure to these chemicals, especially if you live close to places where pesticides are sprayed regularly. Definitely don’t spray them on your own property and be conscious of what may be sprayed by your neighbors or at nearby parks and green spaces. 

Although exposure to pesticides through diet wasn’t addressed in these studies, other research shows that conventionally grown food is 4 times more likely to contain pesticide residues than organically grown food. We also know that pesticides used in agriculture do end up in our water supply. Buying organic produce and purchasing a quality water filter that filters out pesticides can help reduce dietary exposure.

Avoid endocrine disrupting compounds

Endocrine disrupting compounds (EDCs) are chemicals that interfere with hormone function and signaling in the body. They’re found in an alarming number of consumer products and multiple studies have started linking them to autism risk. This review article looked at findings from 21 studies related to endocrine disruptors and the risk of both autism and ADHD - and its conclusion was pretty eye-opening. A positive association with autism risk was found for ALL chemicals investigated in these studies! Endocrine disruptors include BPA, phthalates, pesticides, heavy metals, and many other toxic chemicals. You can limit your exposure through several small actions, including:

  • Avoiding plastics – especially for any items that come into contact with your food or water

  • Limiting contact with thermal receipt paper

  • Reducing canned food consumption or only buying cans that are labelled BPA-free

  • Reducing or eliminating hair spray, nail polish and perfume from your personal care routine

  • Looking for hair and skin care products labelled phthalate-free

  • Switching to non-toxic, plant-based cleaning products labelled fragrance-free or phthalate-free

  • Ditch air fresheners and other scented household products (switch to essential oils for fragrance)

  • Replacing non-stick cookware with safer alternatives (ceramic, stainless-steel, or cast iron)

For a more information on endocrine disruptors and ways to avoid them, visit the Environmental Working Group website.

Reduce exposure to air pollution

In 2015, a study on air pollution exposure during pregnancy showed a significant increased risk of ASD in women exposed to small particle air pollution (particles less than 2.5µm in diameter). Exposure during the third trimester of pregnancy carried the highest risk. This type of pollution mostly comes from vehicles and industrial off-gassing and is usually responsible for the hazy appearance of the air during high pollution times. You can reduce your exposure to this type of pollution by:

  • Avoiding travel during rush hour

  • Using the air re-circulation setting in heavy traffic

  • Keeping an eye on your area’s air quality index and staying inside during high pollution times

  • Considering an air purifier for your home if you live in an area with high levels of particle pollution

  • Keeping your vehicle and home air filters clean and replacing them on schedule

You can learn more on the EPA website devoted to air quality.

Avoid the use of antidepressants

Multiples studies have reported a link between maternal use of antidepressants in preconception and pregnancy to autism risk. This review of the 10 relevant studies to date found that use of antidepressant medications before and during pregnancy did significantly increase risk of ASD, especially when taken during preconception. If you’re currently on medication for depression, don’t panic! The good news is that natural and integrative therapies can be very effective at treating depression, so definitely discuss your options with your doctor before you start trying to conceive.

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