Saturday, 5 September 2015

Vitamin D fortified mozzarella topped pizzas. Yum!

A slightly more light-hearted but nevertheless important post for you today as I bring to your attention the paper by Banaz Al-Khalidi and colleagues [1] and their conclusion that: "Vitamin D3 is safe and bioavailable from fortified mozzarella cheese baked on pizza."

Adding vitamin D3 - cholecalciferol - to mozzarella cheese, researchers assessed what happened to serum levels of 25-hydroxyvitamin D in a high (28,000 international units, IU) and low (200 IU) dose group of "96 apparently healthy, ethnically diverse adults" randomly assigned to one or other group. The results suggested that combined with pizza consumption "once weekly for 8 weeks" measurable levels of vitamin D did increase in both groups compared with baseline alongside the important finding that: "None of the subjects in either group developed any adverse events during the supplementation protocol."

Understanding that not everyone might be as enthusiastic about pizza (proper pizza!) and vitamin D as myself, the Al-Khalidi results might be something quite important. Calls for supplementing vitamin D grow louder in recent times (see here) following quite a bit of research linking vitamin D deficiency to various potential issues outside of just the 'English disease'. Although many health professionals might be a little reluctant to suggest that fortified pizza might be a route to increasing vitamin D levels as a function of society's tendency to go a little overboard when it comes to foods like pizza, I'd tend to favour such a model. If we further assume that vitamin D deficiency might stretch to a relationship with obesity and its partners for example [2], one can perhaps see how the risks attached to food fortification with vitamin D in such a manner might be outweighed by the potential population benefits.

Music: Lost Frequencies - Are You With Me.


[1] Al-Khalidi B. et al. Bioavailability and Safety of Vitamin D3 from Pizza Baked with Fortified Mozzarella Cheese: A Randomized Controlled Trial. Can J Diet Pract Res. 2015 Sep;76(3):109-116.

[2] Awad AB. et al. Vitamin d and metabolic syndrome risk factors: evidence and mechanisms. Crit Rev Food Sci Nutr. 2012;52(2):103-12.

---------- Al-Khalidi B MSc, Chiu W MSc, Rousseau D PhD, & Vieth R PhD (2015). Bioavailability and Safety of Vitamin D3 from Pizza Baked with Fortified Mozzarella Cheese: A Randomized Controlled Trial. Canadian journal of dietetic practice and research : a publication of Dietitians of Canada = Revue canadienne de la pratique et de la recherche en dietetique : une publication des Dietetistes du Canada, 76 (3), 109-116 PMID: 26280790

Friday, 4 September 2015

Brain glutathione and "ASD in intellectually able adult men"

A quote to start:

"[1H]MRS [proton magnetic resonance spectroscopymeasures of cortical and subcortical GSH [glutathione] are not a biomarker for ASD [autism spectrum disorder] in intellectually able adult men."

So said the study published by Alice Durieux and colleagues [1] (open-access available here) based on the measurement of "GSH concentrations in the basal ganglia (BG) and the dorsomedial prefrontal cortex of 21 normally intelligent adult males with ASD and 29 controls who did not differ in age or IQ."

On the basis of there being quite a body of evidence suggesting that functional levels of GSH might be an issue for some on the autism spectrum (see here), researchers set about looking at whether such findings might also translate into 'brain levels' of GSH. Comparing levels of GSH "in unmedicated adult men with ASD and healthy controls of similar age and IQ using [1H]MRS" the authors are pretty clear that the argument that "neuronal damage, secondary to oxidative stress caused by deficient GSH contributes to ASD pathogenesis" might not be universal to all autism.

That being said, I'm not one for sweeping generalisations on this blog and there are caveats to the findings. The authors add for example: "it remains possible that GSH abnormalities exist in other subgroups of individuals with ASD, for example, women, or those with intellectual disability" on the basis of their particular participant selection. The fact also that circulating concentrations of GSH and related metabolites in other tissues (e.g. blood) were not assayed for in the current study means that there may be still more to see in this area including the idea that age might also be an important variable. The brain is also much more than just the BG and prefrontal cortex too.

Although interesting, I'm not yet ready to remove glutathione as being a potentially important compound when it comes to [some] autism just yet. Other studies of post-mortem brain samples with autism and glutathione in mind have not reached the same conclusions as those of Durieux et al accepting that such precious samples are sometimes by no means research perfect. That glutathione issues as part of a wider involvement for oxidative stress in [some] autism might tie into other systems too (see here) invites quite a bit more investigation in this area; perhaps also extending outside of just GSH...

Music: Scissor Sisters - I Don't Feel Like Dancin'.


[1] Durieux AM. et al. Cortical and subcortical glutathione levels in adults with autism spectrum disorder. Autism Res. 2015 Aug 20.

---------- Durieux AM, Horder J, Mendez MA, Egerton A, Williams SC, Wilson CE, Spain D, Murphy C, Robertson D, Barker GJ, Murphy DG, & McAlonan GM (2015). Cortical and subcortical glutathione levels in adults with autism spectrum disorder. Autism research : official journal of the International Society for Autism Research PMID: 26290215

Thursday, 3 September 2015

What will happen to my child when I'm gone?

From time to time I cover some uncomfortable topics on this blog as a function of what hand the autism research cards deal. Today is another one of those times as I bring to your attention the paper by Cathy Cox and colleagues [1] and their analysis of death concerns and psychological wellbeing in mothers of children diagnosed with an autism spectrum disorder (ASD).

What they observed based on completion of a "fear of death scale" and "measures of death-thought accessibility, positive and negative affect, depression, and anxiety" by some 70 mums of children with autism and 70 mums of "typically developing children" suggested that more investigation in this area is required. Aside from reporting "worse psychological health" than control mums, the autism mums group "evidenced greater death-thought accessibility" that in turn "mediated the influence of ASD diagnosis on negative affect, depression, and anxiety." In other words: "increased death-thought accessibility among mothers of children with ASD was associated with worse psychological health."

Thinking about one's own mortality and the idea that our time on this dusty rock called home is finite is not an uncommon feature of life. Death is a daily feature of life as any newspaper or news website informs us. Specifically with autism in mind, various viewpoints have been published by parents of children with autism on the topic of death concerns and the important question: what will happen to my child / children when I'm gone?

This is an uncomfortable question to try and answer given the multitude of factors around things like provisions, finances and family circumstances including the role that any siblings may need to play. That also a parents death will inevitably affect the child (or adult) with autism serves to further complicate any response. It's perhaps not surprising that some parents have written some fairly extreme material with titles like 'Why I can never die' when it comes to this topic.

There is no easy way through this important subject. Cox et al talk about how training care providers to "better discuss thoughts of death may help to alleviate stress and foster greater psychological well-being" for parents of children with autism as being one answer. I agree that death needs to figure more in conversations but am slightly unsure as to how talk without positive action and planning is going to put minds at rest and reduce an already heavy burden of stress and risk of adverse psychological health. That there may also be some fairly unique circumstances associated with the presentation of anxiety in some mums [2] (see here for further reading on intolerance of uncertainty) perhaps adds to the requirement for quite a bit more study and action in this important area.


[1] Cox CR. et al. Death concerns and psychological well-being in mothers of children with autism spectrum disorder. Res Dev Disabil. 2015 Aug 6;45-46:229-238.

[2] Uljarević M. et al. Brief Report: Effects of Sensory Sensitivity and Intolerance of Uncertainty on Anxiety in Mothers of Children with Autism Spectrum Disorder. J Autism Dev Disord. 2015 Aug 9.

---------- Cox CR, Eaton S, Ekas NV, & Van Enkevort EA (2015). Death concerns and psychological well-being in mothers of children with autism spectrum disorder. Research in developmental disabilities, 45-46, 229-238 PMID: 26256841

Wednesday, 2 September 2015

Sub-threshold autistic traits and creativity

I was intrigued by the results reported by Catherine Best and colleagues [1] recently and the suggestion that yet another sweeping generalisation attributed to autism (or at least autistic traits) might turn out to be not as accurate or universal as we might have all been led to believe.

Based on the analysis of data from over 300 people who completed an on-line questionnaire (anonymously) measuring autistic traits, researchers reported that creative ideas as measured by a divergent thinking task might show some connection to self-reported autistic traits. Further: "autistic traits were associated with high numbers of unusual responses on the divergent thinking tasks." Ergo, thinking outside of the box may show something of a relationship to autistic traits and creativity may not be an alien concept for those on the autism spectrum (a shocker I know).

Bearing in mind headlines such as 'Scientists discover people with autism have 'fewer ideas but are more creative and think outside the box'' that don't really reflect the study design and findings in their entirety (only 75 of the study participants said they had received a diagnosis of autism), I do think that the Best study findings call for quite a bit more research inspection in this area. Previous investigations have for example, suggested that there may be quite a bit more to see when it comes to verbal creativity and [some] autism [2] bearing in mind the small participant numbers included in such trials.

Divergent thinking and it's links to creativity is not necessarily a new concept when it comes to autism despite the increasing recent popularisation of this phenomenon. Viewers in the UK might have already seen the Channel 4 series 'The Autistic Gardener' detailing how a diagnosis of autism may not be a hurdle to good design skills; also over-turning other generalisations about perceived interests and vocations for those on the autism spectrum too (see here).

Caution does need to applied to the Best findings as they stand bearing in mind the study methodology used and the application of their findings to "a non-clinical sample." As per other commentary on the paper, it is still a little unclear as to how listing alternative uses for a brick or paper clip actually translates into a real-world setting. That also aspects of creativity have been previously associated with other labels (see here) and the lack of information on study participants with some of these other aspects in mind (e.g. comorbidity), and one needs to be mindful not to push the findings beyond their original scope however desirable they may be.

Still, the study results do make for some interesting reading and reiterate that all minds potentially have something rich to offer to society. Indeed, playing to strengths is a key theme of other recent research as per the concept of 'attention to detail' and threat detection [3] for example.

Music: Daft Punk - One More Time.


[1] Best C. et al. The Relationship Between Subthreshold Autistic Traits, Ambiguous Figure Perception and Divergent Thinking. Journal of Autism & Developmental Disorders. 2015. August 14.

[2] Kasirer A. & Mashal N. Verbal creativity in autism: comprehension and generation of metaphoric language in high-functioning autism spectrum disorder and typical development. Front Hum Neurosci. 2014 Aug 11;8:615.

[3] Rusconi E. et al. XRIndex: a brief screening tool for individual differences in security threat detection in x-ray images. Front Hum Neurosci. 2015 Aug 10;9:439.

---------- Best, C., Arora, S., Porter, F., & Doherty, M. (2015). The Relationship Between Subthreshold Autistic Traits, Ambiguous Figure Perception and Divergent Thinking Journal of Autism and Developmental Disorders DOI: 10.1007/s10803-015-2518-2

Tuesday, 1 September 2015

Let's talk about sex and autism (reviewed)

The review from Nicola Beddows and Rachel Brooks [1] highlighting the important issue of sexual behaviour with autism in mind is brought to your attention today.

Trawling through the peer-reviewed literature looking at reports of inappropriate sexual behaviour present in adolescents diagnosed with an autism spectrum disorder (ASD), the authors concluded that various behaviours were included and that there were a variety of possible reasons for said behaviours. Indeed they report that: "Despite being such a common problem for schools, institutions and families to manage, it is surprising how sparse literature is particularly regarding why inappropriate behaviour occurs and what education is effective."

Sex education is a topic that has cropped up quite early on in the life of this blog (see here). Although jesting with the inclusion of an excerpt from a Seinfeld episode in that particular entry, the important message was that more efforts need to be made to talk about sex and the various details around the topic with young people on the autism spectrum. And when I say 'young people' I mean young people (not just as and when hair starts sprouting and other bodily changes start happening to accompany that golden time called PUBERTY).

Beddows & Brooks make some important points about how to approach the topic of sex education with autism in mind: "It is suggested that individualized, repetitive education should be started from an early age in an accessible form. Social skills development is also important before more technical aspects of sex education are taught." I can't disagree with such sentiments, although would also link you to some writings from an expert in this area (Dr Lynne Moxon) about sex education and the 'special' child and a document from NHS Choices covering an equally important area: sexual health. I might also add that some research groups seem to be listening to the idea that sex education training could be a useful add-on for some people on the autism spectrum [2]...

'Don't be afraid to talk about sex' is the message. So also said Salt-N-Peppa...


[1] Beddows N. & Brooks R. Inappropriate sexual behaviour in adolescents with autism spectrum disorder: what education is recommended and why. Early Interv Psychiatry. 2015 Aug 12.

[2] Visser K. et al. Study protocol: a randomized controlled trial investigating the effects of a psychosexual training program for adolescents with autism spectrum disorder. BMC Psychiatry. 2015 Aug 28;15(1):207.

---------- Beddows N, & Brooks R (2015). Inappropriate sexual behaviour in adolescents with autism spectrum disorder: what education is recommended and why. Early intervention in psychiatry PMID: 26265030

Monday, 31 August 2015

Mesenchymal stem cell transplantation and a mouse model of autism

I once again tread carefully in this brief post talking about stem cells and autism on the back of what seems to be some growing research interest in this area (see here).

The paper by Hadar Segal-Gavish and colleagues [1] adds to this increasing interest with their efforts detailing what happened to a mouse model of autism (the BTBR mouse) following "intracerebroventricular MSC [mesenchymal stem cells] transplantation."

Looking at what happened when MSC transplantation was used, the authors highlight various behavioural and biological effects including: "a reduction of stereotypical behaviors, a decrease in cognitive rigidity and an improvement in social behavior." BDNF (brain-derived neurotrophic factor) was also reported to show changes following transplantation: "elevated BDNF protein levels in the hippocampus accompanied by increased hippocampal neurogenesis in the MSC-transplanted mice compared with sham treated mice."

The authors conclude: "Our study suggests a novel therapeutic approach which may be translatable to ASD [autism spectrum disorder] patients in the future."

Acknowledging that stem cells and autism is still a little bit of a hot potato in terms of the limited available research and more ethical questions about its use, these are interesting results. A recent opinion paper from Simberlund and colleagues [2] on the topic of MSC and autism highlighted the 'pitfalls and potential promises' of this line of investigation, and how despite almost universal scientific approval in terms of 'success' of this type of intervention so far, "substantial methodological and theoretical challenges and pitfalls remain before this can be considered a viable therapeutic option."

I'm gonna leave it at that for now.

Music: Aerosmith - Walk This Way.


[1] Segal-Gavish H. et al. Mesenchymal Stem Cell Transplantation Promotes Neurogenesis and Ameliorates Autism Related Behaviors in BTBR Mice. Autism Res. 2015 Aug 10.

[2] Simberlund J. et al. Mesenchymal stem cells in autism spectrum and neurodevelopmental disorders: pitfalls and potential promises. World J Biol Psychiatry. 2015 Jul 31:1-8.

---------- Segal-Gavish H, Karvat G, Barak N, Barzilay R, Ganz J, Edry L, Aharony I, Offen D, & Kimchi T (2015). Mesenchymal Stem Cell Transplantation Promotes Neurogenesis and Ameliorates Autism Related Behaviors in BTBR Mice. Autism research : official journal of the International Society for Autism Research PMID: 26257137

Saturday, 29 August 2015

Maternal obesity and offspring autism meta-analysed

So: "The meta-analysis results support an increased risk of autism spectrum disorder in children of women who were obese during pregnancy. However, further study is warranted to confirm these results."

That was the conclusion reached by Ya-Min Li and colleagues [1] looking at the collected peer-reviewed data currently available on how maternal weight might impact on offspring neurodevelopmental outcomes. Without wishing to blame or stigmatise (this is a blog based on the examination of cold, objective, peer-reviewed science) such results are not altogether unexpected based on instances where maternal weight might impact on offspring autism risk have been discussed (see here).

There are caveats to ideas of such an association. Not least that observational studies for example, often provide little information on 'cause and effect'. That not every child born to a mum who is overweight and/or obese develops autism should also be kept firmly in mind, as should the idea that overweight and/or obesity can sometimes sit with other comorbidity as part of the 'metabolic syndrome' so potentially introducing other variables into any association (see here). I might add that an array of other factors cross obesity and autism risk areas, not least mothers' nutritional status before and during pregnancy for example (see here).

That all being said, there is more science to do in this area. Thinking back to other discussions on data about how father's weight might also influence offspring autism risk (see here) and the idea of foetal programming [2] based to a large extent on the writings of the late David Barker, one gets some ideas of where science might want to start heading in continuing this line of inquiry.

Music: Keane - Everybody's Changing.


[1] Li YM. et al. Association Between Maternal Obesity and Autism Spectrum Disorder in Offspring: A Meta-analysis. J Autism Dev Disord. 2015 Aug 9.

[2] Lau C. & Rogers JM. Embryonic and fetal programming of physiological disorders in adulthood. Birth Defects Res C Embryo Today. 2004 Dec;72(4):300-12.

---------- Li YM, Ou JJ, Liu L, Zhang D, Zhao JP, & Tang SY (2015). Association Between Maternal Obesity and Autism Spectrum Disorder in Offspring: A Meta-analysis. Journal of autism and developmental disorders PMID: 26254893