Arizona State University, October 26, 2021

The practice of mindfulness was often touted throughout the pandemic as a useful tool for dealing with an unforeseen life stressor. As College of Health Solutions Assistant Professor Blair Braden recently discovered, mindfulness is also a useful tool for dealing with the particular stressors associated with autism spectrum disorder.

“Initially, most of the research in my lab was looking at how aging affects individuals with autism on a cognitive level,” said Braden, who directs the Autism and Brain Aging Laboratory at Arizona State University. “But one of the things we didn’t expect was that we saw very consistently a lot of struggles with depression and anxiety, as well as physical health, that contribute to quality of life.”

In a paper published this month in the journal Quality of Life Research, Braden and colleagues detail two separate studies in which they set out to better understand the factors that affect quality of life in adults with autism, whom studies have shown consistently report worse functional health and well-being compared with their neurotypical peers.

The researchers found that both age and sex play a role, and that both mindfulness and relaxation education can improve quality of life in adults with autism, but mindfulness provided specific benefits in relation to how autistic individuals view their disability-associated limitations that relaxation education did not.

The first study employed a survey to evaluate the effects of sex and age. Sixty-seven adults with autism spectrum disorder and 66 neurotypical adults answered questions about their physical and mental health. Both men and women with autism reported lower mental health quality of life compared with their neurotypical counterparts, but only women with autism reported lower physical quality of life compared with neurotypical adults.

“This is kind of consistent with the larger picture of how autism manifests in girls and women,” Braden said. “Women seem to carry a greater burden across the board.”

Interestingly, researchers also found that among adults with autism, older women reported better mental health than men, whom age didn’t appear to have an effect on.

The second study sought to compare the effects of a mindfulness-based stress reduction (MBSR) intervention to those of a relaxation education intervention on quality of life in adults with autism. Those who received the MBSR intervention were not only taught mindfulness techniques by a trained practitioner, they were also given time to practice the techniques during the class. Those who received the relaxation education intervention were provided with information on relaxation techniques from the National Institutes of Health, but were not given time to practice the techniques during the class.

Researchers found that the MBSR intervention improved disability-related quality of life (which includes both physical and mental health aspects of disability) in adults with autism over and above the relaxation education intervention, but both interventions improved mental health-related quality of life. In addition, both interventions were more effective for overall health-related quality of life improvements in women with autism compared with men with autism.

“There is some research about the psychosocial mechanisms of how mindfulness works in general,” Braden said about the difference in results between the sexes. “When it comes to personality characteristics like openness and empathy, which are thought to improve the effects of mindfulness, women tend to score higher in general than men. But people with autism are known to struggle with empathy, so we’re not sure why we’re seeing that here.”

Overall, the researchers were able to conclude a few things:

• Men and women with autism spectrum disorder do not experience equivalent health-related quality of life reductions, and difficulties associated with the disorder may change over the lifespan.
• Psychosocial interventions broadly may only be effective for improving health-related quality of life in women with autism spectrum disorder, rather than both sexes.
• MBSR may have specific efficacy for improving disability-related quality of life in men and women with autism spectrum disorder.

Ideally, the researchers say, these findings can be expanded and incorporated into precision medicine strategies for improving quality of life in adults with autism spectrum disorder, across the life span.

“Our findings show that we need to be thinking about how autism affects adults based on their age and sex,” Braden said. “We likely also need to take a personalized medicine approach to how we treat some of these difficulties in future interventions.”

Prior research findings regarding the use of cannabis-based products to treat depression and anxiety have been mixed. Some patients have shown improvements while others have not. Prior research has also found that other drugs developed to treat depression and anxiety also have mixed results—some have seen improvements while others have not, and some patients have found that they cannot tolerate the side effects of the drugs. Also, some people have begun using medicinally approved cannabis products to help with their depression, anxiety, chronic pain or sleep disorder, regardless of the research track record—either independently, or with assistance from a doctor. In this new effort, the researchers conducted a study to gauge the opinions of people who use such products, rather than focusing on reports from the medical communityregarding how well they thought they worked.

The study was carried out over four years. At the onset, the researchers received responses from 368 people who reported using cannabis products to reduce their depression and/or anxiety, or to help them sleep. As a control group, they also received responses from 170 people who were not using cannabis products but who were considering doing so due to their problems with depression or anxiety.

The researchers found that those people taking cannabis products (mostly those containing CBD rather than THC) reported lower levels of depression than the control group, although they saw no difference in anxiety. They also found those taking cannabis products reported a higher quality of life and better sleep than the control group. The researchers also found reduced levels of depression later on in those who continued to take cannabis products and also in those who began using them during the study. And interestingly, they also found that those who began taking the products during the study also reported improvements in anxiety and quality of life.

Karolinska Institute (Sweden), October 12, 2021

Research on the role of diet in the development of type 1 diabetes is generally of low evidence, but there are some high-quality studies indicating that longer breastfeeding and later introduction to gluten may reduce the risk of disease. That is according to a systematic review and meta-analysis of available research on foods that may be linked to the risk of developing the type 1 diabetes in childhood. The study by researchers at Karolinska Institutet is published in the journal EBioMedicine.

Increasing numbers of children are developing the autoimmune disease type 1 diabetes. In Sweden, 40 children per 100,000 are diagnosed every year, which is the second highest incidence in the world. This negative trend seems to depend on a combination of genetic and environmental factors, but the question of possible prevention remains unanswered.

Research on the role of diet in the development of type 1 diabetes has not produced any unequivocal results so far. Now, researchers at Karolinska Institutet in Sweden have reviewed and analyzed the available research on the links between the diets of mother and child, during infancy and childhood, and the risk of developing type 1 diabetes.

“Our meta-analysis indicates that breastfeeding and later introduction to gluten may have a protective effect against type 1 diabetes,” says the study’s first author Anna-Maria Lampousi, doctoral student at the Institute of Environmental Medicine, Karolinska Institutet. “At the same time, it is important to note that both genetic and various environmental factors likely affect risk of type 1 diabetes, and that on an individual level, the risk of being affected is still low regardless of whether you receive infant formula or gluten during the first months of life.”

Analyzed 26 dietary factors

The researchers screened 5,935 articles published in medical journals up to October 2020. Of the total number of studies, 96 could be included in the meta-analysis as they contained results on diet and risk of type 1 diabetes in children and were of sufficient quality.

All in all, 26 dietary factors were evaluated, such as breastfeeding, age of introduction to different foods, in utero nutrient exposure and childhood diet.

The studies with the strongest evidence indicated that longer breastfeeding and later introduction to gluten were associated with a lower risk of type 1 diabetes. For babies nursed for at least six to 12 months, the risk of developing type 1 diabetes was 61 percent lower than in other babies. Babies who had been introduced to gluten at three to six months of age were 64 percent less likely to develop type 1 diabetes than those who were introduced to gluten earlier.

The researchers did not study which mechanisms may explain the associations. However, previous research has shown positive effects of breastfeeding in general, for example on the development of the child’s immune system and gut biome, while experimental studies have shown that gluten may harm insulin-producing beta cells.

The review also found evidence of moderate quality for an association with lower risk of type 1 diabetes in children who were breast fed exclusively for at least two months and had a later introduction to cow’s milk (after two to three months of age) and fruit (four to six months of age instead of earlier).

There was also an association with increased risk of type 1 diabetes and consumption of at least two to three portions of cow-milk based products per day during childhood, but this finding had low certainty of evidence and should be interpreted with caution, according to the researchers. The studies also pointed to a protective effect of vitamin D supplementation during infancy. The diet of the mother during pregnancy was not associated with type 1 diabetes in her baby.

“With this meta-analysis, we have tried to decipher which dietary factors with strong or moderate evidence may be linked to risk of type 1 diabetes,” says Sofia Carlsson, senior lecturer at the Institute of Environmental Medicine, Karolinska Institutet, and the study’s senior author. “Our analysis suggests that there are reasons to look closer at the protective effects of breastfeeding on type 1 diabetes as well as the importance of later introduction to gluten, cow’s milk and fruit during infancy. At the same time, the evidence for most dietary factors was generally low and we need more high-quality research to be able to draw any definitive conclusions.”