Seven Steps to Reduce Risk of Autism
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 devasting to a family than autism (also known as autism spectrum disorder or ASD). While it is true that autism is on the rise, more and more research is emerging in the scientific community that provides us with valuable information on what we can do before and during pregnancy to reduce the likelihood of our child developing the disorder. Read on to learn more!
What is Autism?
Autism is a neurodevelopmental disorder that impacts behavior, communication, and social interaction. Children with autism usually exhibit some combination of repetitive or stimulatory behaviors, difficulty interacting and connecting with others, and language impairment. However, the symptoms and level of disability can vary significantly amongst individuals. Some children display mild symptoms in these three areas and grow up to live relatively normal lives, while others experience severe disability and require increased care throughout life.
What Causes Autism?
Scientists have not yet been able to identify a cause for autism. However, there is a growing body of research to suggest multiple contributing factors, including genetics, environmental exposures, and parental health factors.
Unfortunately, autism does appear to be increasing in prevalence. 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. Autism is also significantly more common in boys, with about 4 times more boys diagnosed than girls.
With statistics like these, it is understandable that parents have concerns over whether or not their child will develop autism and whether there is anything they can do to reduce their child’s risk.
7 Steps Parents Can Do 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 parental 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
A recent study published in Epidemiology found a decreased risk for autism in children whose mothers reported prenatal supplement use 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. These studies add to the pile of science that demonstrates an important connection between maternal nutrition and childhood health and disease risk.
In addition to taking a prenatal multivitamin during preconception and pregnancy, women should also increase their intake of essential nutrients from food. A healthy, nutrient-dense diet will include plenty of fruits and vegetables, fiber, healthy fats, and adequate protein, while limiting processed foods and sugar.
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. Pregnant women and those trying to conceive should take special care to avoid exposure to these chemicals, especially those who live in close proximity to pesticide application sites. Do not spray pesticides on your own property and be conscious of what may be sprayed on neighboring properties or at nearby parks and green spaces.
Although exposure to pesticides through diet was not addressed in these studies, we do know that pesticide residues can be found on conventionally grown produce and in our water supply. Buying organic produce and purchasing a quality water filter can help reduce pesticide exposure in the diet.
Avoid endocrine disrupting chemicals
Multiple studies have found a link between endocrine disrupting chemicals and autism risk. This review article provides an overview of the findings of 21 studies related to endocrine disruptors and the risk of both autism and ADHD. 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 buying only 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
Purchasing a quality water filter that removes pesticide residues and heavy metals
Keeping your home clean and vacuuming with a HEPA filter
Buying organic produce and organic, grass-fed, or pasture-raised animal products
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 particulate matter pollution measuring less than 2.5µm in diameter. Exposure during the third trimester of pregnancy was found to carry the highest risk. This fine particle pollution is produced primarily by motor vehicles and industrial processes 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 in a number of ways.
Avoid traveling during rush hour
Use the air recirculation setting in heavy traffic (air out periodically to avoid buildup of CO2)
Keep an eye on the air quality index in your area and stay indoors during high pollution times
Consider an air purifier for your home if you live in an area with high levels of particle pollution
Avoid smoking or exposure to second-hand smoke
Keep your vehicle and home air filters clean and replace 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 during the preconception period. If you are taking antidepressant medications, discuss your options with your doctor prior to trying for a baby.
Test for MTHFR genetic mutation
MTHFR is an enzyme that converts folic acid into its biologically active form, L-methylfolate, in the body. The gene that provides the instructions for making this enzyme is also called MTHFR. A mutation in the MTHFR gene affects a person’s ability make enough MTHFR enzyme to properly convert folic acid to the active form of folate. This activated form of folate is needed for a number of biological processes in the body and is required for proper brain development during pregnancy. Up to 60% of the population has an MTHFR mutation.
Because folate is known to be critical to fetal brain development, some studies have begun to investigate MTHFR mutations in relationship to autism. This study showed a decreased risk for autism in children of women with MTHFR defects who supplemented with folic acid in the periconceptional period. Average daily intake of folic acid in the study was 600mcg, which is considered the minimal amount needed to prevent birth defects.
However, other studies have demonstrated that a high intake of folic acid from food and supplements can lead to increased levels of unmetabolized folate in the blood, which can contribute 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 MTHFR mutations would be particularly susceptible to increased serum levels of unmetabolized folate due to their inefficient folate metabolism.
It is important to note that the synthetic folic acid in most supplements and fortified foods is not the same as the active form L-methylfolate or the natural folates found in unfortified foods (like leafy greens, legumes, liver, etc). Concerns from these studies appear to be specific to excess intake of synthetic folic acid. Fortunately, many prenatal vitamin brands have begun to use L-methylfolate (or another biologically active form called folinic acid) instead of folic acid in their products. Women with MTHFR should consider using a supplement containing L-methylfolate or folinic acid to avoid potential issues from unmetabolized folic acid, while still receiving the protective benefits of folate supplementation.
You can easily request an MTHFR genetic test from your doctor. If positive, you can work with your doctor or a qualified nutritionist to optimize your folate intake with food and the correct supplements.