Unhealthy patterns of diet, exercise, and sleep linked to high risk of cardiovascular disease in autistic people

The results are published today in the journal Molecular Autism.

Earlier research suggests that autistic people die 16-35 years younger than expected, and that greater health problems may contribute to this risk. The present study is the first to consider the diet, exercise, and sleep patterns of autistic adults and how these patterns may relate to health outcomes.

The team at the Autism Research Centre in Cambridge developed an anonymous, online survey about lifestyle choices and daily habits, personal medical history, and family medical history. The final study included 1,183 autistic adults and 1,203 non-autistic adults aged 16-90 years.

The results showed that autistic adults were far less likely than non-autistic adults to meet very minimal health recommendations for diet, exercise, and sleep. Autistic adults were also far more likely to have atypical eating patterns (including limited diet) and sleep disturbance. They were more likely to be underweight or obese than non-autistic individuals.

These poor lifestyle habits were associated with greater risk of cardiovascular conditions such as high blood pressure, heart disease, and stroke among autistic males, and this was a stronger association even than a family history of a cardiovascular condition. Though it is not possible to say conclusively that a poorer lifestyle led to cardiovascular problems, the findings provide the first indication that promoting healthy choices regarding diet, exercise, and sleep may help to reduce the excess risks of health conditions in autistic adults. 

While the results indicate that there may be other biological or environmental factors that leave autistic individuals at greater risk of health conditions, they also provide a clear target for intervention. Difficulties with maintaining a healthy lifestyle may also have knock-on effects beyond physical health, including limiting opportunities for social interaction (which may centre around mealtimes or exercise), and could contribute to worsening mental health, and affect employment or education.

The lead researcher of the study, Elizabeth Weir, a PhD student at the Autism Research Centre in Cambridge, said: “These findings help us to better understand the experiences of autistic adults, and have wider implications for quality of life. We need to understand the reasons for restricted diet, limited exercise, and lack of sleep, to provide better support. This may include programmes for health education, and additional mental health support or supported living and working schemes.”

Dr Carrie Allison, Director of Research Strategy at the Autism Research Centre and a member of the research team, said: “The challenges we see among autistic children regarding lifestyle behaviours extend into adulthood. Given the implications for risk of chronic disease and length of life, it is critical that we work to identify effective strategies for supporting health choices by autistic people of all ages.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre and a member of the team, said: “The wider picture suggests that autistic adults experience vulnerability in a variety of contexts, and this is just one new area that we should consider. Seeing that autistic adults are having such a hard time comparatively with healthy lifestyle habits has clear healthcare and policy implications: we need to create new and better support systems tailored to the specific needs of autistic people.”

Reference
Weir, E.,  et al. An investigation of the diet, exercise, sleep, BMI, and health outcomes of autistic adults. Molecular Autism 12, 31 (2021). DOI: 10.1186/s13229-021-00441-x

Funding
Funding for this project was generously provided by the Autism Research Trust, the Rosetrees Trust, and the Cambridge and Peterborough NHS Foundation Trust, the Corbin Charitable Trust, the MRC, the Wellcome Trust and the Innovative Medicines Initiative.