Nutrition and Bone Density in Boys with Autism Spectrum Disorder

Background

Boys with autism spectrum disorder (ASD) have lower bone mineral density (BMD) than typically developing controls. Differences in diet and exercise may contribute to low BMD.

The association among demographic factors,health behaviors and sleep quality in youth with Autism Spectrum Disorder

BackgroundA majority of youth with Autism Spectrum Disorder (ASD) have disrupted sleep patterns, but there has been limited research examining factors associated with sleep in this population. Objective: The objective of this study was to compare demographic and lifestyle behaviors with sleep quality in youth with ASD. Methods: A total of 49 children (12.44 years; 78% male) with ASD wore the Actigraph GT9X accelerometer over seven days and nights to assess moderate to vigorous physical activity (MVPA), sedentary behavior (SB), total sleep duration, and sleep efficiency. Parents reported their child’s weekly amount of screen time and demographic information. Participants were classified according to whether they met sleep criteria for duration and efficiency (8–9 h of sleep duration and ≥85% sleep efficiency). T-tests and ANOVA were used to compare demographic and lifestyle factors between the groups. Results: Participants who meet both sleep duration and efficiency criteria had greater minutes of MVPA per day (113.65 min/day) than participants who only met sleep efficiency criteria (40.27 min/day) and participants who did not meet either sleep criteria (67.5 min/day; p < 0.0001). Additionally, participants who met both sleep criteria had fewer minutes of SB compared to those who only met sleep efficiency criteria (384.79 vs 526.05 min/day; p = 0.02). Conclusions: Youth who had indicators of good sleep quality had greater amounts of MVPA and lower amounts of SB. Studies should further examine the relationship between sleep and health behaviors in youth with ASD to determine causal mechanisms, leading to more effective sleep interventions.     

Association between engagement in physical activity and adaptive behavior in young children with Autism Spectrum Disorder

This study explored whether frequency of engagement in physical activity (PA) was associated with differences in adaptive behavior (i.e., communication, socialization, daily living, and motor skills) among young children recent diagnoses of Autism Spectrum Disorder (ASD). A total of 118 children (32 ± 4 months; 72% boys) underwent physician specialist's evaluation at a university-based neurodevelopmental clinic, alongside their parent (35 ± 7 years; 81% mothers). Children were assessed using the Autism Diagnostic Observation Schedule, Mullen Scales of Early Learning, Vineland Adaptive Behavior Scales, and a physician examination. Parents completed the Weekly Physical Activity Checklist for their child, as well as a self-report depression and demographic questionnaire. After controlling for known confounders, there was a small positive association between frequency of engagement in PA and adaptive behavior (Cohen's d = 0.36, 95%CL = ±0.32) (p = 0.027). There was also a small positive association between PA and three of the four subdomains of adaptive behavior: socialization (d = 0.32, 95%CL ±0.27) (p = 0.018), daily living (d = 0.29, 95%CL ±0.25) (p = 0.026), and motor skills (d = 0.31, 95%CL ±0.29) (p = 0.038). Frequency of engagement in PA was not statistically significantly associated with children's communication skills (d = 0.09, 95%CL ±0.29) (p = 0.547). Children with ASD often exhibit delays in adaptive functioning. The associations between PA and adaptive skills observed in our study signals the potential contribution of increased PA as part of early intervention for children with such neurodevelopmental disorders to achieve greater functional outcomes.     

The association of physical activity,sleep, and screen time with mental health in Canadian adolescents during the COVID-19 pandemic: A longitudinal isotemporal substitution analysis

BackgroundThe impact of COVID-19 on adolescent mental health is a global concern. Increased screen time and reduced physical activity due to the lockdown measures have been linked to detrimental mental health outcomes; however, the literature remains limited by cross-sectional and retrospective designs, and consideration of behaviours in isolation. Prospective evidence is necessary to examine whether moderate-to-vigorous physical activity (MVPA), sleep and screen time influenced changes in mental health.MethodAnalyses used data from a prospective cohort study of secondary school students in Canada with baseline data from the 2018–2019 school year and linked follow-up data from online surveys completed during the initial COVID-19 outbreak (May–July 2020). Multilevel linear regression models were used to evaluate the within- and between-person isotemporal substitution effects of sleep, MVPA and screen time behaviours on depression, anxiety, subjective well-being, and trait emotional dysregulation.ResultsLinked longitudinal data from 2645 students attending 44 schools were available. Between-person effects indicated that individuals who engaged in more MVPA and sleep while minimizing screen time had lower depression scores, less severe emotional dysregulation, and better subjective well-being. While controlling for between-person effects, within-person year-on-year change suggests those who increased screen time while decreasing either MVPA or sleep experienced mental health decline on all outcomes.ConclusionMVPA and sleep were associated with youth mental health during the early COVID-19 lockdown. Increasing MVPA and sleep (or at least mitigating the increase of screen time) compared to the prior year was associated with better mental health during the early pandemic. A limitation to consider is that the screen time measure represents a combination of screen behaviours, and effects of replacing screen time may have varied if distinctions were made.     

The impact of misinformation on the COVID-19 pandemic

Since the inception of the current pandemic, COVID-19 related misinformation has played a role in defaulting control of the situation. It has become evident that the internet, social media, and other communication outlets with readily available data have contributed to the dissemination and availability of misleading information. It has perpetuated beliefs that led to vaccine avoidance, mask refusal, and utilization of medications with insignificant scientific data, ultimately contributing to increased morbidity. Undoubtedly, misinformation has become a challenge and a burden to individual health, public health, and governments globally. Our review article aims at providing an overview and summary regarding the role of media, other information outlets, and their impact on the pandemic. The goal of this article is to increase awareness of the negative impact of misinformation on the pandemic. In addition, we discuss a few recommendations that could aid in decreasing this burden, as preventing the conception and dissemination of misinformation is essential.     

Examine the associations between perceived neighborhood conditions,physical activity,and mental health during the COVID-19 pandemic

This study examined how neighborhood conditions changed and how neighborhood conditions were associated with physical activity and mental health during the COVID-19 pandemic among Americans. The major outcomes were stratified by the neighborhood's poverty and regression models were used to assess the associations between neighborhood conditions and their change during the pandemic and the outcomes of physical activity and mental health. The results show that low-poverty neighborhoods had more health-promoting neighborhood conditions before the outbreak and more positive changes during the outbreak. Health-promoting neighborhood conditions were associated with higher physical activity and moderate physical activity and lack of negative neighborhood conditions such as crime/violence and traffic were associated with a lower risk of mental health problems including loneliness, depression, and anxiety. Mental health problems were also significantly associated with the COVID-19 infection and death and household income level. Our findings suggest that it is plausible that the disparities of physical activity and mental health by neighborhood exacerbate due to the pandemic and people who living in socioeconomically disadvantaged neighborhoods bear increasingly disproportionate burden.     

Physical activity and the incidence of depression during the COVID-19 pandemic in Brazil: Findings from the PAMPA cohort

We examined the longitudinal association between physical activity (PA) and the incidence of self-reported diagnosed depression in adults in southern Brazil during the COVID-19 pandemic. Data from the PAMPA (Prospective Study About Mental and Physical Health) cohort was used. Data collection for baseline was carried out on June–July 2020, with two follow-up assessments taking place six months apart. An online, self-reported questionnaire assessed depression and PA. Depression was assessed by asking participants whether they were ever diagnosed with depression. We included 441 participants (women: 75.9%; mean age [SD]: 38.0 [13.5]) in southern Brazil. Over the follow-up, 21.8% (95% confidence interval [CI]: 18.1%–25.9%) were diagnosed with depression. Insufficiently active (<150 min per week of physical activity) (Incidence rate [IR]: 61.9; 95%CI: 39.5–102.4; p = 0.047) and active (≥150 min per week of physical activity) (IR: 50.4; 95%CI: 31.9–84.0; p = 0.015) participants had reduced IR of depression per 1000 persons-year at risk compared to inactive ones (0 min per week of physical activity) (IR: 99.9; 95%CI: 79.7–126.8). In the adjusted analyses, participants in the insufficient active (hazard ratio [HR]: 0.58; 95%CI: 0.34–0.98) and active (HR: 0.53; 95%CI: 0.31–0.93) group had a lower risk of developing depression than the inactive group. PA both at and out of home reduced the risk of incident depression (HR: 0.49; 95%CI: 0.25–0.98) compared to no physical activity. Endurance (HR: 0.52; 95%CI: 0.28–0.97) and endurance plus strengthening (HR: 0.40; 95%CI: 0.17–0.95) PA reduced the risk of incident depression compared to none. Being physically active during pandemic, regardless of the amount of PA practiced, reduced the incidence of depression in adults in southern Brazil.     

Person-reported perspectives on support availability for people with disabilities during the COVID-19 pandemic in Quebec

ObjectivesTo identify the perception of the availability of community support and the support needs of autistic people and people with disabilities, from their own perspectives and from those of their caregivers at the time of the COVID-19 pandemic in Quebec, to assess the association between the available support and the perceived stress levels to evaluate the role of perceived social support as a potential buffer of this association.MethodsA total of 315 respondents participated in a 4-min online survey across the province of Quebec by snowball sampling. Community support was defined as availability of adapted healthcare, adapted information, adapted educational services and community services.ResultsThe community support and services during the COVID-19 pandemic were not available or were not sufficiently adapted to their needs. About 40% of autistic people or people with disabilities and 44% of their caregivers perceived their days as being quite stressful or extremely stressful. This is twice the rate of that of the general population in non-pandemic time. Nevertheless, social supports can play a mediating role in attenuating the effects of the absence of adapted services on the stress level of this vulnerable population.ConclusionThe non-availability of adapted services was related to an increase in the stress level in this population. Our study adds that other than social support, adapted healthcare/tele-healthcare and in-home support services could reduce the impact of the pandemic on the stress level of autistic people and people with disabilities. Adapted educational services and necessary equipment for online education for people without resources could reduce the impact on the stress level in caregivers. People with disabilities and their caregivers are one of the most vulnerable groups in our society. Public health measures of containment and mitigation need to consider more their specific needs.     

Changes in physical activity and basic psychological needs related to mental health among people with physical disability during the COVID-19 pandemic in Norway

BackgroundPeople with a physical disability are more inactive than the general population. Due to the positive effects of physical activity (PA) on physical and mental health, maintaining a physically active lifestyle is important especially during challenging periods of life.ObjectiveExplore whether people with a physical disability experienced changes in PA, health status, and psychological need satisfaction (autonomy, competence and relatedness) during the first wave of the COVID-19 pandemic in Norway. Further, explore whether changes in psychological need satisfaction were associated with changes in PA level and mental health.MethodsCross-sectional retrospective study using an online self-reported questionnaire after the first wave during the COVID-19 pandemic.ResultsOf the 298 participants with physical disabilities (Age_M = 49yr; 62% females; 66% using mobility aids), 66% reported decreased PA compared to the same period in the previous year, 45% reported declined health status due to increased pain and reduced physical functioning. Regarding psychological need satisfaction, it was primarily the change in need for autonomy and competence for PA that were associated with change in PA and mental health.ConclusionsMost of the participants indicated decreased PA and about half decreased Health status during the COVID-19 pandemic. Further, the results indicated that it is important to nurture the basic psychological needs of autonomy and competence for PA when aiming to maintain or increase PA levels and mental health for this population living under restrictions of a pandemic.     

Food insecurity in households of children with ASD in COVID-19 pandemic: A comparative analysis with the Household Pulse Survey data using stabilized inverse probability treatment weights

BackgroundBefore the COVID-19 pandemic, households of children on the autism spectrum were more likely to be food insecure than households of children without disabilities. With the unprecedented social, public health, and economic disruption caused by the pandemic, food insecurity has likely increased among families of children on the autism spectrum.ObjectiveThis analysis aims to compare the prevalence of food insecurity between the Autism Speaks' Food Insecurity Survey (ASFIS) administered during the Fall of 2020 and a nationally representative sample from the Household Pulse Survey (HPS) data collected during a similar timeframe.MethodsA propensity score analysis was utilized to create stabilized inverse probability treatment weights for adjusting background differences between the two groups. A logistic regression model was computed to estimate the odds of food insecurity in the ASFIS participants compared with those in the HPS data.ResultsAfter adjusting for background differences, households of children on the autism spectrum in the ASFIS were about four times more likely to be food insecure than households in the general population contained in the HPS data (OR = 3.7; 95% CI: 3.1–4.4).ConclusionsThe breakdown of social and economic supports during the COVID-19 pandemic contributed to a significantly higher likelihood of food insecurity among families of children on the autism spectrum.     

中国国家出生队列孤独症谱系障碍亚队列建设概况

孤独症谱系障碍作为儿童神经发育障碍的代表性疾病,发病率呈现不断上升的趋势,给家庭和社会带来巨大压力和经济负担,探讨其病因及发病机制意义重大。本研究依托中国国家出生队列开展孤独症谱系障碍亚队列建设,并利用该出生队列采用的辅助生殖和自然妊娠同期纳入并随访的平行设计,评价辅助生殖技术对子代神经行为发育的影响,并结合队列采集的...     

The public health response to the COVID-19 pandemic for people with disabilities

With the rapidly changing landscape of the COVID-19 outbreak, how to best address the needs and continue to protect the health and well-being of people with disabilities (PwDs) is a global public health priority. In this commentary we identify three public health areas of ongoing need and offer possible strategies to address each. These areas include: the types of data that would help clarify risks for PwDs and help assure their safety long term; the prevention, treatment and mitigation measures for PwDs that are needed through the duration of the outbreak; and the issues of equity in access to and quality of medical care for PwDs. Because of the rapid nature of the public health response, it is critical to reassess and readjust our approach to best address the needs of PwDs in the months and years to come and to incorporate these new practices into future emergency preparedness responses.     

新冠肺炎疫情背景下公共卫生安全问题反思

新冠肺炎疫情的暴发与蔓延,给公共卫生安全体系带来巨大挑战。文章以新冠肺炎疫情为例,剖析疫情暴发与应对过程中所暴露的公共卫生安全问题及其链锁机制,从多层面、多主体探析公共卫生安全危机产生的深层次原因。目前,亟待提高全社会安全意识、完善公共卫生法律体系、整合社会资源,引导社会合作与社会参与共同建立常态化应急准备机制,同时建立卫生问题国内多部门协同治理的联防联控机制以及国际合作机制协同,强化事后反思与容错机制,以期铸就公共卫生安全的严密防线。     

The COVID-19 pandemic and weight management: Effective behaviors and pandemic-specific risk factors

BackgroundObesity and comorbid conditions are associated with worse outcomes related to COVID-19. Moreover, social distancing adherence during the COVID-19 pandemic may predict weight gain due to decreased physical activity, increased emotional eating, and social isolation. While early studies suggest that many individuals struggled with weight management during the pandemic, less is known about healthy eating and weight control behaviors among those enrolled in weight loss programs.MethodsThe present study evaluated weight management efforts among weight loss program participants during the COVID-19 pandemic. Participants’ (N = 55, 90.9% female, 36% white, M_age = 49.8) demographics and body mass index were collected two months prior to the COVID-19 statewide shutdown. During the lockdown, an online survey assessed health behaviors, coping, COVID-19 experiences (e.g., social distancing, loneliness), and weight gain. Logistic regressions examined demographics, health behaviors, and COVID-19 factors as predictors of weight gain.ResultsMost participants (58%) reported gaining weight during COVID-19. Weight gain was predicted by challenges with the following health behaviors: physical activity, monitoring food intake, choosing healthy foods, and emotional eating. Loneliness and working remotely significantly related to emotional eating, physical activity, and choosing healthy foods.ConclusionsLoneliness and working remotely increased the difficulty of weight management behaviors during COVID-19 among weight loss program participants. However, staying active, planning and tracking food consumption, choosing healthy foods, and reducing emotional eating protected against weight gain. Thus, these factors may be key areas for weight management efforts during the pandemic.     

Older adolescents and young adults willingness to receive the COVID-19 vaccine: Implications for informing public health strategies

ImportanceThe success in ending the COVID-19 pandemic rests partly on the mass uptake of the COVID-19 vaccine. Little work has been done to understand vaccine willingness among older adolescents and young adults. This is important since this age group may be less likely to adhere to public health guidelines.ObjectiveTo understand willingness of getting a vaccine and reasons for vaccine hesitancy among a sample of older adolescents and young adults.DesignData were from the Well-Being and Experiences study (The WE Study), a longitudinal community-based sample of older adolescents and young adults collected from Winnipeg, Manitoba, Canada from 2017 to 2020 (n = 664).SettingThe study setting was a community-based observational longitudinal study.ParticipantsParticipants for the study were aged 14 to 17 years old at baseline in 2016–17 (n = 1000). Data were also collected on one parent/caregiver. Waves 2 (n = 747) and 3 (n = 664) were collected in 2019 and 2020, respectively.ExposuresThe main exposures were sociodemographic factors, health conditions, COVID-19 knowledge, and adversity history.Main OutcomesThe main outcomes were COVID-19 vaccine willingness, hesitancy, and reasons for hesitancy.ResultsWillingness to get a COVID-19 vaccine was 65.4%. Willingness did not differ by age, sex, or mental health conditions, but did differ for other sociodemographic characteristics, physical health conditions, COVID-19 knowledge, practicing social/physical distancing, and adversity history. The most common reasons for not wanting a vaccine were related to safety, knowledge, and effectiveness. Sex differences were noted.Conclusions and RelevanceIncreasing uptake of the COVID-19 vaccine among older adolescents and young adults may rely on targeting individuals from households with lower income, financial burden, and adversity history, and generating public health messaging specifically aimed at vaccine safety, how it works to protect against illness, and why it is important to protect oneself against a COVID-19 infection.     

The impact of the COVID-19 pandemic on vaccine coverage in Kilifi,Kenya: A retrospective cohort study

The COVID-19 pandemic caused unprecedented disruption in health service delivery, globally. This study sought to provide evidence on the impact of the pandemic on vaccine coverage in Kilifi County, Kenya. We conducted a vaccine coverage survey between April and June 2021 within the Kilifi Health and Demographic Surveillance System (KHDSS). Simple random sampling was used to identify 1500 children aged 6 weeks–59 months. Participants were grouped into three retrospective cohorts based on when they became age-eligible for vaccination: before the pandemic, during the first year, or during the second year of the pandemic. Survival analysis with Cox regression was used to evaluate the association between the time-period at which participants became age-eligible for vaccination and the rate of vaccination within a month of age-eligibility for the third dose of pentavalent vaccine (Pentavalent-3) and within three months of age-eligibility for the first dose of Measles vaccine (MCV-1). A total of 1,341 participants were included in the survey. Compared to the pre-COVID-19 baseline period, the rate of vaccination within a month of age-eligibility for Pentavalent-3 was not significantly different in the first year of the pandemic (adjusted hazard ratio [aHR] 1.03, 95 % confidence interval [CI] 0.90–1.18) and was significantly higher during the second year of the pandemic (aHR 1.33, 95 % CI 1.07–1.65). The rate of vaccination with MCV-1 within three months of age-eligibility was not significantly different among those age-eligible for vaccination during the first year of the pandemic (aHR 1.04, 95 % CI 0.88–1.21) and was 35 % higher during the second year of the pandemic (95 % CI 1.11–1.64), compared to those age-eligible pre-COVID-19. After adjusting for known determinants of vaccination, the COVID-19 pandemic did not adversely affect the rate of vaccination within the KHDSS.