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Autism rates declining among wealthy, while escalating among poor, minorities

Wealthy people – once considered the hotbeds for autism spectrum disorder (ASD) – have seen prevalence flatten or fall in the last two decades, while rates among the poor and minorities keep ticking up.

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Wealthy people – once considered the hotbeds for autism spectrum disorder (ASD) – have seen prevalence flatten or fall in the last two decades, while rates among the poor and minorities keep ticking up, new CU Boulder research has found.

The study, published in the Journal of Autism and Developmental Disorders, raises the possibility that parents in wealthier locations are successfully reducing environmental exposures that may contribute to autism risk, or taking other steps to curb its severity early on.

While that’s a hopeful possibility, the authors say, the findings also illuminate a disturbing economic and racial divide.

“While autism was once considered a condition that occurs mainly among (those from) high socioeconomic status, these data suggest that the brunt of severe autism is now increasingly being borne by low-income families and ethnic minorities,” said lead author Cynthia Nevison, PhD, an atmospheric research scientist with the Institute of Arctic and Alpine Research, who also studies environmental health.

Adds co-author Willam Parker, PhD, an autism researcher at Duke University Medical Center: “There is potentially good news here, but, unfortunately, not everyone is a beneficiary of this good news.”

For the study, the researchers analyzed 20 years’ worth of autism caseload counts from the California Department of Developmental Services, comparing data from 36 of the state’s most populous counties.

Between birth years 1993 and 2000, autism prevalence increased steadily among all racial groups.

But around 2000, the trajectories started to diverge: Prevalence among whites in wealthy counties like Santa Clara (home to Silicon Valley) and from Monterey to the San Francisco coast started to decline.

In middle-income counties like Sacramento, Los Angeles and San Diego, prevalence among whites continued to increase, but at a slower rate.

Meanwhile, in lower income areas like Riverside and the South Central Valley, rates among whites climbed steeply.

By birth year 2013, prevalence among whites in the lowest income counties was at least double that of whites in the highest income counties. Generally speaking, the higher the county income, the lower the rate of autism among white children.

Notably, Santa Clara County had a surge in the rate of autism spectrum disorders between 1993 and 2000, with rates doubling among whites and Asians in just seven years. As Nevison and Parker recall in the new paper, that surge gave rise to controversial theories that men with poor social skills but strong math and engineering skills were increasingly able to find partners in the tech-age and were fathering “genetically autistic” children.

“Our data contradict that argument,” said Nevison, noting that today Santa Clara County has one of the lowest prevalence rates of severe autism in the state among whites. Growth in prevalence among Asians has also flattened in the county.

Meanwhile, the study found, incidence among blacks has increased rapidly across California, marking the highest rates among any ethnic or racial group at 1.8%. That finding is in line with previous research finding that autism prevalence is rising rapidly nationwide among African Americans.

Some health experts have attributed such increases among minorities to better screening and diagnosis, but the authors believe environmental factors also play a role.

Just which factors may be at play is unclear, but Parker notes that many of the same things that fuel disease-causing inflammation–toxins, unhealthy food and emotional stress–are also associated with autism. And lower-income and minority families tend to have a harder time accessing or affording healthier lifestyle options.

Established risk factors associated with autism include: advanced parental age, challenges to the immune system during pregnancy, genetic mutations, premature birth and being a twin or multiple.

Since the study was done in the US, the authors cannot say if their findings would translate to other locations or to milder forms of autism. They also cannot rule out that wealthy families are opting out of state services in favor of private services. More research is underway.

“There is an urgent need to understand what wealthy… parents are doing or have access to that may be lowering their children’s risk,” they conclude.

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Eating late increases hunger, decreases calories burned, and changes fat tissue

Eating later had profound effects on hunger and appetite-regulating hormones leptin and ghrelin, which influence our drive to eat. Specifically, levels of the hormone leptin, which signals satiety, were decreased across the 24 hours in the late eating condition compared to the early eating conditions.

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Obesity afflicts approximately 42 percent of the adult population and contributes to the onset of chronic diseases, including diabetes, cancer, and other conditions. While popular healthy diet mantras advise against midnight snacking, few studies have comprehensively investigated the simultaneous effects of late eating on the three main players in body weight regulation and thus obesity risk: regulation of calorie intake, the number of calories you burn, and molecular changes in fat tissue. A new study by investigators from Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, found that when we eat significantly impacts our energy expenditure, appetite, and molecular pathways in adipose tissue. Their results are published in Cell Metabolism.

“We wanted to test the mechanisms that may explain why late eating increases obesity risk,” explained senior author Frank A. J. L. Scheer, PhD, Director of the Medical Chronobiology Program in the Brigham’s Division of Sleep and Circadian Disorders. “Previous research by us and others had shown that late eating is associated with increased obesity risk, increased body fat, and impaired weight loss success. We wanted to understand why.”

“In this study, we asked, ‘Does the time that we eat matter when everything else is kept consistent?’” said first author Nina Vujović, PhD, a researcher in the Medical Chronobiology Program in the Brigham’s Division of Sleep and Circadian Disorders. “And we found that eating four hours later makes a significant difference for our hunger levels, the way we burn calories after we eat, and the way we store fat.”

Vujović, Scheer and their team studied 16 patients with a body mass index (BMI) in the overweight or obese range. Each participant completed two laboratory protocols: one with a strictly scheduled early meal schedule, and the other with the exact same meals, each scheduled about four hours later in the day. In the last two to three weeks before starting each of the in-laboratory protocols, participants maintained fixed sleep and wake schedules, and in the final three days before entering the laboratory, they strictly followed identical diets and meal schedules at home.

In the lab, participants regularly documented their hunger and appetite, provided frequent small blood samples throughout the day, and had their body temperature and energy expenditure measured. To measure how eating time affected molecular pathways involved in adipogenesis, or how the body stores fat, investigators collected biopsies of adipose tissue from a subset of participants during laboratory testing in both the early and late eating protocols, to enable comparison of gene expression patterns/levels between these two eating conditions.

Results revealed that eating later had profound effects on hunger and appetite-regulating hormones leptin and ghrelin, which influence our drive to eat. Specifically, levels of the hormone leptin, which signals satiety, were decreased across the 24 hours in the late eating condition compared to the early eating conditions. When participants ate later, they also burned calories at a slower rate and exhibited adipose tissue gene expression towards increased adipogenesis and decreased lipolysis, which promote fat growth. Notably, these findings convey converging physiological and molecular mechanisms underlying the correlation between late eating and increased obesity risk.

Vujović explains that these findings are not only consistent with a large body of research suggesting that eating later may increase one’s likelihood of developing obesity, but they shed new light on how this might occur. By using a randomized crossover study, and tightly controlling for behavioral and environmental factors such as physical activity, posture, sleep, and light exposure, investigators were able to detect changes the different control systems involved in energy balance, a marker of how our bodies use the food we consume.

In future studies, Scheer’s team aims to recruit more women to increase the generalizability of their findings to a broader population. While this study cohort included only five female participants, the study was set up to control for menstrual phase, reducing confounding but making recruiting women more difficult. Going forward, Scheer and Vujović are also interested in better understanding the effects of the relationship between meal time and bedtime on energy balance.

“This study shows the impact of late versus early eating. Here, we isolated these effects by controlling for confounding variables like caloric intake, physical activity, sleep, and light exposure, but in real life, many of these factors may themselves be influenced by meal timing,” said Scheer. “In larger scale studies, where tight control of all these factors is not feasible, we must at least consider how other behavioral and environmental variables alter these biological pathways underlying obesity risk. ”

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DKSH, LEO Pharma partner to deliver products, solutions to people with skin conditions, thrombosis

DKSH Business Unit Healthcare, a leading partner for healthcare companies seeking to grow their business in Asia and beyond, has partnered with LEO Pharma to bring high-quality therapeutic products for dermatology and thrombosis to patients across Asia.

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DKSH Business Unit Healthcare, a leading partner for healthcare companies seeking to grow their business in Asia and beyond, has partnered with LEO Pharma to bring high-quality therapeutic products for dermatology and thrombosis to patients across Asia.

Partnering in Hong Kong, Malaysia, Singapore, Taiwan, Thailand, Vietnam, and the Philippines, the two companies seek to solidify brand presence, grow market share, and ultimately improve patient health outcomes in the region. Skin diseases can cause serious physical and social discomfort for millions of patients around the world whereas thrombosis can affect anyone regardless of their age, race, gender, and ethnicity.

DKSH will support LEO Pharma by building dedicated sales and marketing teams on the ground in Asia and managing logistics and product distribution in these markets. The firm’s experienced teams and broad distribution network will ensure LEO Pharma products reach modern trade, traditional trade, hospitals, clinics, and other medical channels, as well as patients in need across the region.

LEO Pharma is a global company dedicated to advancing the standard of care for the benefit of people with skin conditions, their families and society. With decades of research and development to advance the science of dermatology, LEO Pharma now offers a wide range of innovative treatments and therapies for all skin disease severities as well as thrombosis.

Khalid Aouidat, Vice President, responsible for commercial activities in Southeast Asia at LEO Pharma commented: “At LEO Pharma, we are dedicated to changing the standards of care for people with skin diseases by bringing new innovative treatments forward and making them easily accessible. Supporting this ambition, we are delighted to be partnering with DKSH. Their experience and strong regional footprint in Asia, as well as their marketing and sales expertise will help to further strengthen LEO Pharma’s brand and its continued growth.”

Bijay Singh, Head of Business Unit Healthcare at DKSH, said: “We are committed to enriching people’s lives and improving healthcare for all. The partnership with LEO Pharma strengthens our ambition to become the preferred partner for clients to help patients in Asia to have better access to high-quality and innovative products and solutions. While we drive their growth across the region, LEO Pharma can focus on researching and developing products and solutions for people with skin conditions.”

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Epson partners with WWF, launches mangrove restoration project in Palawan

Epson, which has previously supported the development of WWF-Philippines’ virtual museum Museo Kalikasan, is now supporting the Mangrove Restoration Project in the municipalities of Balabac and Bataraza, Southern Palawan.

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Epson Philippines’ partnership with the World Wide Fund for Nature (WWF) Philippines for marine ecosystem restoration has officially kickstarted with a ceremonial launch in Balabac, Palawan. Supported by project stakeholders such as the European Union delegation to the Philippines and local government officials, the project launch highlights the importance of rehabilitating mangrove sites, recognizing their critical role in marine biodiversity and protecting coasts from erosion and storm surges.

Epson, which has previously supported the development of WWF-Philippines’ virtual museum Museo Kalikasan, is now supporting the Mangrove Restoration Project in the municipalities of Balabac and Bataraza, Southern Palawan. As part of the wider European Union-funded Ocean Governance Project—an initiative focused on strengthening habitat resilience through restoration in the Sulu Sulawesi Seascape that covers the Philippines, Indonesia, Malaysia—the joint mission in Palawan aims to boost local capacity in taking care of the mangroves, as well as address other critical issues such as plastic waste management. With Epson as a key partner, the Mangrove Restoration Project was able to expand beyond Balabac and into the neighboring municipality of Bataraza. In addition, the growing relationship between Epson Philippines and WWF-Philippines only further drives Epson Philippines’ commitment to support sustainable innovations and initiatives to solve the world’s greatest challenges.

“Corporations have a shared responsibility in sustainable development,” said Eduardo Bonoan, Epson Philippines’ General Manager for Marketing Division, who shared his remarks virtually during the project launch. “As Epson continues its commitment to sustainable innovation and environmental responsibility, we believe in forming critical partnerships with organizations that are aligned with our values—such as WWF-Philippines.”

To further the goals of the Mangrove Restoration Project, WWF-Philippines will continue to work with local government and key stakeholders such as Epson Philippines to establish a ‘Community Learning and Innovation Hub’ that aims to bridge knowledge gaps and strengthen coastal communities’ experience in resource management, thereby helping to build local capacity.

“It is important that we continue to protect and manage Balabac’s valued mangrove forests to boost our efforts in keeping a healthy environment and supporting local livelihoods,” said Balabac Mayor Shuiab J. Astami, who officially launched the project in Balabac Island.

“We are excited to be part of this multi-stakeholder effort that will restore critical mangroves in Balabac, Palawan and improve the way their coastal resources are managed for the long haul. We strongly hope that this project will succeed and serve as an example for many other communities,” said Executive Director of WWF-Philippines, Katherine Custodio.

Moving forward, Epson aims to continue setting a more sustainable example for corporations across the region.

“Working alongside governments, local champions and conservation organizations, we are proud to be part of this public-private partnership that is aligned with our renewed Epson 25 Corporate Vision—which aims to enrich communities and help realize a sustainable society,” concludes Bonoan. ”We hope that this opens up a path for more sustainable partnerships in the future.”

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