1 00:00:09,600 --> 00:00:13,320 Speaker 1: Everybody, Welcome to another edition of Wisdom Wednesdays. Now, today 2 00:00:14,200 --> 00:00:18,120 Speaker 1: I want to talk about a study that I just 3 00:00:18,360 --> 00:00:23,320 Speaker 1: read that is really concerning and will be uncomfortable listening 4 00:00:23,360 --> 00:00:26,520 Speaker 1: for some people, but I think it is a hugely 5 00:00:26,880 --> 00:00:30,960 Speaker 1: important public health message. Now, unless you've been living under 6 00:00:30,960 --> 00:00:35,520 Speaker 1: a rock, you'll know that there are whopping increases in 7 00:00:35,640 --> 00:00:41,440 Speaker 1: both ADHD and autism spectrum disorder that's being observed amongst children. 8 00:00:41,880 --> 00:00:46,080 Speaker 1: And I'll just give you some statistics for Australia. Apologies 9 00:00:46,120 --> 00:00:48,520 Speaker 1: to my overseas listeners, but we know that in most 10 00:00:48,520 --> 00:00:52,919 Speaker 1: developed nations they're increasing. So and I estimated not zero 11 00:00:53,000 --> 00:00:58,240 Speaker 1: point zero eight percent of Australia's population is autistic, although 12 00:00:58,440 --> 00:01:05,120 Speaker 1: the rear of diagnosis has risen very significantly in recent years. 13 00:01:05,600 --> 00:01:09,360 Speaker 1: And ADHD is slightly more frequent, occurring at an estimated 14 00:01:09,480 --> 00:01:13,039 Speaker 1: eight percent of children age four to eleven and up 15 00:01:13,080 --> 00:01:16,360 Speaker 1: to six percent of adults. And that's according to the 16 00:01:16,360 --> 00:01:20,160 Speaker 1: Australian and New Zealand Journal of Psychiatry. And as I said, 17 00:01:20,840 --> 00:01:26,720 Speaker 1: both of those rates are increasing pretty significantly. Now, this 18 00:01:26,840 --> 00:01:32,760 Speaker 1: study was an Australian study that explored the links between 19 00:01:33,000 --> 00:01:37,920 Speaker 1: the weight of the mum are overweight and obese and 20 00:01:38,000 --> 00:01:43,600 Speaker 1: both preconception and during pregnancy and long term neuropsychiatric health 21 00:01:43,640 --> 00:01:47,760 Speaker 1: of their children. And they specifically looked at autism spectrum 22 00:01:47,800 --> 00:01:51,800 Speaker 1: disorder ADHD, and conduct disorders as well as some other 23 00:01:51,880 --> 00:01:55,360 Speaker 1: mood disorders. So the study was a what's called a 24 00:01:55,440 --> 00:01:58,560 Speaker 1: systematic review and meta analysis, which you'll have heard me 25 00:01:58,680 --> 00:02:03,040 Speaker 1: talk about before. And what they did is they looked 26 00:02:03,080 --> 00:02:06,560 Speaker 1: at forty two different studies that were published peer reviewed 27 00:02:06,600 --> 00:02:13,160 Speaker 1: studies that involved in total nearly three point seven million 28 00:02:13,840 --> 00:02:17,799 Speaker 1: mother child pers and making this a very robust bit 29 00:02:17,840 --> 00:02:23,720 Speaker 1: of research. And they also followed very strict publication guidelines 30 00:02:24,080 --> 00:02:28,360 Speaker 1: to ensure that the data or what was produced with 31 00:02:28,400 --> 00:02:32,639 Speaker 1: a high level of rigor. And they searched multiple databases 32 00:02:32,760 --> 00:02:37,160 Speaker 1: looking for these observational studies that were studying those and 33 00:02:37,200 --> 00:02:41,600 Speaker 1: then they use these fancy statistics to pull all of 34 00:02:41,639 --> 00:02:45,359 Speaker 1: the results from the different studies and then calculate the 35 00:02:45,840 --> 00:02:50,440 Speaker 1: odds ratio or the hazard ratio of the outcomes so 36 00:02:50,480 --> 00:02:54,720 Speaker 1: that gives us a good statistical number, right, And so 37 00:02:54,800 --> 00:02:58,560 Speaker 1: what the results were, they were pretty significant. Children who 38 00:02:58,600 --> 00:03:05,440 Speaker 1: were born to mothers who were obese during preconception had 39 00:03:05,480 --> 00:03:10,639 Speaker 1: a fifty seven percent higher risk of developing ADHD than 40 00:03:10,760 --> 00:03:14,440 Speaker 1: children who were born to mothers who were normal preconception, 41 00:03:15,160 --> 00:03:18,880 Speaker 1: and then when the mother was obased during pregnancy, there 42 00:03:18,919 --> 00:03:21,080 Speaker 1: was a thirty two percent increased risk. So what they 43 00:03:21,120 --> 00:03:25,240 Speaker 1: did is they separated out when the mother was overweight 44 00:03:25,400 --> 00:03:28,520 Speaker 1: or obese preconception and then when they were overweight or 45 00:03:28,600 --> 00:03:34,320 Speaker 1: obasee during pregnancy. So slightly higher risk or slightly higher 46 00:03:34,320 --> 00:03:38,600 Speaker 1: increase risk with the mother and being overweight or obese 47 00:03:38,680 --> 00:03:43,080 Speaker 1: during preconception than there was during pregnancy, but they were 48 00:03:43,160 --> 00:03:47,880 Speaker 1: both very significant increases. And then for autism spectrum disorder, 49 00:03:48,440 --> 00:03:54,000 Speaker 1: when the mother was obase preconception, that child was had 50 00:03:54,040 --> 00:03:57,760 Speaker 1: a forty two percent increased risk of being born or 51 00:03:57,880 --> 00:04:02,400 Speaker 1: developing autism spectum disorder compared the children of mothers who 52 00:04:02,480 --> 00:04:05,800 Speaker 1: were a normal weight preconception, and then when the mother 53 00:04:06,000 --> 00:04:09,640 Speaker 1: was a base during pregnancy, the risk of the child 54 00:04:09,760 --> 00:04:13,600 Speaker 1: being born with autism specting disorder increased by whopping one 55 00:04:13,760 --> 00:04:17,880 Speaker 1: hundred and thirty three percent compared to children whose mothers 56 00:04:17,920 --> 00:04:21,840 Speaker 1: were of normal weight during pregnancy. And then these risks 57 00:04:21,880 --> 00:04:25,640 Speaker 1: also extended to conduct disorders. There was a sixteen percent 58 00:04:25,720 --> 00:04:29,279 Speaker 1: increased risk of developing conduct disorders and also a significant 59 00:04:29,360 --> 00:04:36,320 Speaker 1: increased risk of developing external behaviors with maternal obesity. In 60 00:04:36,360 --> 00:04:40,680 Speaker 1: those categories, However, there was no significant associations found between 61 00:04:40,880 --> 00:04:43,360 Speaker 1: the weight of the mother and other conditions like mood 62 00:04:43,800 --> 00:04:49,320 Speaker 1: or anxiety disorders, so it seemed to be those neuropsychiatric 63 00:04:49,600 --> 00:04:56,039 Speaker 1: conditions of ADHD, ASD and conduct disorders. Now, interestingly, the 64 00:04:56,080 --> 00:04:59,520 Speaker 1: findings applied not just to the mum being obese, but 65 00:04:59,640 --> 00:05:04,440 Speaker 1: also so being overweight, although those risks were slightly lower 66 00:05:04,520 --> 00:05:10,560 Speaker 1: but still significant. So the discussion section that paper was 67 00:05:10,600 --> 00:05:13,839 Speaker 1: really quite interesting that shed some light on the potential 68 00:05:13,960 --> 00:05:18,799 Speaker 1: mechanisms that were driving these associations. And this is obviously 69 00:05:18,920 --> 00:05:24,080 Speaker 1: speculation from the researchers because it was observational data, and 70 00:05:24,880 --> 00:05:29,000 Speaker 1: whilst it's not entirely clear because of the observational data, 71 00:05:29,040 --> 00:05:34,960 Speaker 1: while whether the maternal adipacity or weight it was directly 72 00:05:35,080 --> 00:05:38,920 Speaker 1: causing the new event developmental outcomes, or if there was 73 00:05:38,960 --> 00:05:42,880 Speaker 1: some sure genetic and environmental factors that played a role 74 00:05:43,000 --> 00:05:49,080 Speaker 1: such as socioeconomic status, the researchers actually suggested that it 75 00:05:49,320 --> 00:05:53,960 Speaker 1: could be due to some of the metabolic consequences of obesity, 76 00:05:54,120 --> 00:05:58,000 Speaker 1: such as having high blood pressure, having high blood sugar 77 00:05:58,320 --> 00:06:01,279 Speaker 1: and then also the inflat eimiation that we know that 78 00:06:01,400 --> 00:06:06,760 Speaker 1: goes hand in hand with obesity, and that then can 79 00:06:07,720 --> 00:06:12,120 Speaker 1: hamper the development of the vetus's brain in utero, and 80 00:06:12,160 --> 00:06:15,520 Speaker 1: that could well explain the findings, and that seems pretty 81 00:06:15,600 --> 00:06:19,800 Speaker 1: damn plausible to be honest, but again, with observational studies, 82 00:06:19,839 --> 00:06:24,599 Speaker 1: you can't infer direct cause and effect, although it is 83 00:06:24,640 --> 00:06:28,719 Speaker 1: a bit of a smoking gun, and it also follows 84 00:06:28,760 --> 00:06:31,719 Speaker 1: a host of other research that has shown over the 85 00:06:31,800 --> 00:06:35,560 Speaker 1: years that the health and fitness status of both mom 86 00:06:35,600 --> 00:06:39,960 Speaker 1: and dad at the time of conception has a significant 87 00:06:40,000 --> 00:06:44,040 Speaker 1: impact on the future health of the child through epigenetic mechanisms. 88 00:06:44,279 --> 00:06:47,800 Speaker 1: So for those just a little reminder. Genes are obviously 89 00:06:47,839 --> 00:06:52,360 Speaker 1: the genes. Think of them as the hardware. Epigenetics sits 90 00:06:52,400 --> 00:06:56,359 Speaker 1: on top of that, and that's the software that kind 91 00:06:56,360 --> 00:06:58,760 Speaker 1: of tells the genes how to express and how to 92 00:06:58,800 --> 00:07:03,640 Speaker 1: behave so that if you're unfit and an unhealthy at 93 00:07:03,640 --> 00:07:06,080 Speaker 1: the time of conception, it doesn't change the genes that 94 00:07:06,120 --> 00:07:09,520 Speaker 1: your child gets, but it changes how those genes can 95 00:07:09,560 --> 00:07:13,320 Speaker 1: be expressed. And it's been well established by other studies 96 00:07:13,320 --> 00:07:16,120 Speaker 1: that on the healthy parents at the time of conception 97 00:07:16,560 --> 00:07:21,800 Speaker 1: and poor health of the mother during pregnancy significantly increases 98 00:07:21,840 --> 00:07:26,000 Speaker 1: the risk of that child being born or developing overweight 99 00:07:26,560 --> 00:07:30,840 Speaker 1: and suffering from metabolic disorders or increased risk of metabolic 100 00:07:30,880 --> 00:07:35,080 Speaker 1: disorders such as type two diabetes and also cardiovascular disease. Now, 101 00:07:35,120 --> 00:07:38,800 Speaker 1: what this study adds is that the mum's weight, both 102 00:07:38,840 --> 00:07:43,640 Speaker 1: preconception and during pregnancy also appear to significantly increase the 103 00:07:43,760 --> 00:07:48,119 Speaker 1: risk of a range of neuropsychatric outcomes in children as well. 104 00:07:48,840 --> 00:07:52,440 Speaker 1: And this actually reminds me of a conversation that I had. 105 00:07:52,760 --> 00:07:55,400 Speaker 1: It was probably more than a decade ago, or around 106 00:07:55,440 --> 00:07:59,440 Speaker 1: a decade ago. A good mate of mine, create Tours, 107 00:07:59,480 --> 00:08:03,480 Speaker 1: who was the director of Johnson and Johnson in New 108 00:08:03,560 --> 00:08:05,560 Speaker 1: Zealand at the time. He got the two of us 109 00:08:05,640 --> 00:08:09,760 Speaker 1: in audience with Sir Peter Gluckman, who at the time 110 00:08:10,120 --> 00:08:14,080 Speaker 1: was the chief scientist in New Zealand, and we were 111 00:08:14,080 --> 00:08:17,160 Speaker 1: talking to him about a program that I had run 112 00:08:17,320 --> 00:08:22,440 Speaker 1: that showed that we could significantly impact weight and blood 113 00:08:22,480 --> 00:08:25,000 Speaker 1: markers and health and blood pressure and stuff like that 114 00:08:25,920 --> 00:08:30,040 Speaker 1: of a bunch of people using an educational intervention. And 115 00:08:30,080 --> 00:08:33,360 Speaker 1: I'll never forget he said to me, Look, that's all 116 00:08:33,480 --> 00:08:37,560 Speaker 1: very interesting around adults. And you know, great study but 117 00:08:37,600 --> 00:08:42,240 Speaker 1: he said, I'm really only interested in stuff that is 118 00:08:42,320 --> 00:08:47,200 Speaker 1: going to influence the health of the parents who are 119 00:08:47,320 --> 00:08:50,480 Speaker 1: planning to have children. So ten years ago, Sir Peter 120 00:08:50,559 --> 00:08:54,400 Speaker 1: Gluckman was all over this like a spider monkey, and 121 00:08:54,440 --> 00:08:59,360 Speaker 1: he knew that the health of the parents before conception 122 00:08:59,600 --> 00:09:04,480 Speaker 1: and then the mother during pregnancy had a massive impact 123 00:09:04,679 --> 00:09:07,240 Speaker 1: on the long term health of that child. And this 124 00:09:07,320 --> 00:09:12,440 Speaker 1: is why we're seeing that progressively, generations are now starting 125 00:09:12,480 --> 00:09:15,520 Speaker 1: to get worse as we have more and more overweight 126 00:09:15,640 --> 00:09:22,320 Speaker 1: and obesity and unhealthy parents that then, through epigenetic mechanisms, 127 00:09:22,360 --> 00:09:27,200 Speaker 1: carries on and really significantly increases the health risks of 128 00:09:27,280 --> 00:09:31,200 Speaker 1: those future generations. So what is pretty clear from both 129 00:09:31,800 --> 00:09:35,720 Speaker 1: this study and other studies is and the researchers actually 130 00:09:35,760 --> 00:09:39,640 Speaker 1: called this out and said that there should be some 131 00:09:39,760 --> 00:09:46,760 Speaker 1: significant educational programs for partners who are planning to have 132 00:09:46,840 --> 00:09:51,679 Speaker 1: children because their health both at time of conception and 133 00:09:51,760 --> 00:09:55,720 Speaker 1: in the mum's health during pregnancy really does have a 134 00:09:55,760 --> 00:10:00,760 Speaker 1: significant impact. And now we're also seeing it on neuropsychia disorders. 135 00:10:01,240 --> 00:10:03,880 Speaker 1: So that is it for this week, folks, Catch you 136 00:10:03,920 --> 00:10:04,320 Speaker 1: next time.