Physical Activity and Autism

As a mental health provider and competitive athlete you might guess that I pay close attention to where these fields of interest overlap…

Physical Activity and Autism

As a mental health provider and competitive athlete you might guess that I pay close attention to where these fields of interest overlap (nutrition, mental health, physical fitness, etc.). If you did, you’d be right! There is even a journal titled Mental Health and Physical Activity.

I will be re-publishing an article about autism and nutrition in the the future. Additionally, I had been planning a follow up article (about mental health and physical activity) when I saw that the above journal’s March 2021 volume published an article titled “Association between engagement in physical activity and adaptive behavior in young children with Autism Spectrum Disorder”( 1). A couple weeks later a publication from the volume crawled across my feed titled “Exercise training effects on sleep quality and symptoms of anxiety and depression in post-traumatic stress disorder: A systematic review and meta-analysis of randomized control trial” ( 2).

The highlights from the first article read:

  • Novel study on phsyical activity (PA) in children with Autism Spectrum Disorder.
  • More frequent engagement in PA is associated with higher levels of adaptive functioning.
  • PA independently associated with adaptive behaviors, controlling for cofounders.
  • Positive assocaitions between PA and three of four subdomains of adaptive behaviors.
  • Association with socialization, daily living, and motors skills, not communication.
  • emphasis added

It’s worth noting that the p-values for these associations were a bit weak (p < 0.05). More rigorous associations have p-values < 0.001 or at least < 0.01 (99% outcomes did not happen at random). At any rate, 95% confidence is still worth considering, especially when coupled with other factors (like nutrition!).

When we look at their conclusions, this is congruent with other developmental association and benefits of PA with cognitive and motor development in the general population. That is, there seems to a specific benefit (to ASD children) to general improvements in neuro-development (e.g. building and reinforcing neural connections, which physical activity does a great job of).

It seems obvious that PA would aid in the development of motor and daily living skills (which require motor movement and cognitive processing). Interestingly though, this general development did not carry over to the specific development of socialization, but not communication skills. It would be useful to know if they PA specified was engagement in team sports or not.

The authors conclude that:

“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.”

Shifting gears to the second study then;

  • A limited number of exercise training studies of patients with Post-Traumatic Stress Disorder (PTSD) include sleep quality.
  • Exercise training was accompanied by small to moderate improvements in sleep quality.
  • Exercise training was associated with small to moderate improvements for symptoms of PTSD, anxiety, and depression.
  • Future studies examining the effects of exercise training on sleep quality among individuals with PTSD are warranted.

The meta-analysis observed that exercise interventions ranging from 3–12 weeks “supported a favorable effect of exercise training” and that “Exercise training was consistently associated with small or moderate improvements in PTSD, anxiety, and depression symptoms.”*

Again, we’re looking at p-values < 0.05. Now, as a mental health provider, I fully believe in the power of nutritional and physical activity interventions not only for the neurological component (your brain-emotion connection), but from a psycho-social perspective as well (your perception of yourself and others and your lived experience). But, these effect sizes show us that nutrition and exercise, while powerful interventions, are only a piece of the puzzle and are not a magical panacea.

Ironically, that comment has gotten me into some arguments with other nutrition professionals that swear up and down that nutrition can cure everything. I’m sorry, it does not. Whilst my nutritional peers may have more broad experience than I in nutritional interventions, they are lacking in the depth and breadth of their understanding of mental health. These interventions are more potent than “the icing in the cake”, but aren’t bedrock components either.

I’m not suggesting complete reliance on pharmaceuticals (anything but!), but some “holistic” providers have simply swapped drugs for nutrition and either underestimate, ignore, or overlook the relational component of these disorders. Full disclosure, I — carnivore Austin — have a candy jar full of Snicker’s and Reese’s in my office. It’s not for me. But if you’re my patient and seeking help for a prolific history of sexual abuse, or one of your children is literally trying to murder the other, we can worry about your diabetes later.

On the other hand, there have most definitely been patients where the suggestion to stop eating grains and seed oils, and add a little more (animal) protein and fat was a catalyst for dramatic improvement in how they felt and looked at themselves (literally in the mirror and in conception of their identity).

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