Many autistic individuals live a sedentary life. Reclusion prevents them from stressful social interactions and shields them from the emotional impact of unforeseen changes to their routines and general environment. According to a recent press release: “A new Oregon State University study of children with autism found that they are more sedentary than their typically-developing peers, averaging 50 minutes less a day of moderate physical activity and 70 minutes more each day sitting.”
With the advent of computers, tablets and video game consoles autistic individuals can spend many hours of entertainment in their own homes (see previous blog about social interactions and the internet). Furthermore, many people take their laptops and tablets to bed with them. This late-night activity compounds sleep problems in autism, as the blue light emitted by these devices depresses the levels of melatonin (i.e., the hormone that helps establish our circadian rhythm). Melatonin is also a powerful antioxidant and is being studied as a possible treatment for cancer. I have to believe that some reports of an increased oxidative load/stress in autism may be due or compounded by reduced levels of this hormone.
When we lose sleep and avoid exercise we increase our amount of stress. This leads to a decrease immune response, poor wound healing, chronic pain, and depression. People get sick more often when stressed. Adding to the problems of a sedentary life some people tend to overeat when they are stressed. The end results of stress are difficult to convey by those in the general population, more so by autistic individuals. In many cases, this leaves parents and caretakers playing a guessing game.
Inactivity predisposes to obesity and heart disease. The use of neuroleptics to treat some autistic individuals increases the risk for becoming obese. In addition to weight gain these drugs alter glucose/lipid metabolism and promote endocrine disorders (e.g., diabetes). In many cases, obesity can lead to treatment non-adherence and decreased quality of life (Correll et al., 2011).
A sedentary life conveys twice the death rate as obesity alone. Although I once read that just standing still, not necessarily moving your limbs, would prevent some of the side effects of a sedentary life, instituting lifestyle changes is a difficult proposition. The United States has invested a lot of money in health care and its fight against obesity without proper results. Two thirds of Americans are overweight or obese, and our society now sees this as normal. The modern sedentary life is killing us and people greatly underestimate its harmful effect.
The problems associated with a sedentary life in autism need more publicity. It requires that patients get educated and take a greater role in their treatment. We need to institute regimens of physical activity. The effects of exercise increases endorphins and promotes a sense of accomplishment that motivates us to keep moving forwards. Many of our patients use Fitbit or other sports watches to keep a record of their daily activity. In some cases, these watches allow you to become involved within a virtual community where you participate in friendly exercise competitions.
In addition to exercise, be attentive to the secondary problems of the sedentary life. Consider integrative medicine approaches to relive stress. In some cases and where appropriate, thai chi or yoga may become useful family activities. Consider dieting to control obesity. Depending on the needs of an individual a Mediterranean diet is a healthy choice. This diet helps control weigh, prevents, heart disease, stroke, and diminishes the risk for dementia.
Correll CU, Lencz T, Malhotra AK. Antipsychotic drugs and obesity. Trends Mol Med 17(2):97-107, 2011