by Ian Wishart
Something, however, must have happened to generate a rapidly rising autism rate over that time, and that ‘something’ must be common to our wider civilisation, like vaccination. Or maybe slip, slop, slap.
“The apparent increase in the prevalence of autism over the last 20 years corresponds with increasing medical advice to avoid the sun,” wrote California doctor and psychiatrist John Cannell in a 2008 study,[1] “advice that has probably lowered vitamin D levels and would theoretically greatly lower activated vitamin D (calcitriol) levels in developing brains.
“Animal data has repeatedly shown that severe vitamin D deficiency during gestation dysregulates dozens of proteins involved in brain development and leads to rat pups with increased brain size and enlarged ventricles, abnormalities similar to those found in autistic children.
“Children with vitamin D deficient rickets have several autistic markers that apparently disappear with high-dose vitamin D treatment.”
Like the Alzheimer’s study in the previous chapter, Cannell’s work shook up the autism world. Across the western world, sun avoidance has been one of if not the primary dominant public health messages of the past two decades. While correlation does not automatically prove causation, it is undeniable that the rapid take-up of the sun avoidance message, particularly by women of child-bearing age, coincides with the rapid rise of autism.
The hypothesis was simple: could a lack of vitamin D exposure in pregnancy deprive a baby’s developing brain of crucial input into its VDR receptors? For researchers, there was growing circumstantial evidence that this might be exactly the case.
Firstly, they found autism levels were considerably lower in populations who consumed high levels of oily fish – a well recognised vitamin D source – in their usual diets. In Manhattan, London, Toronto, Sydney or Auckland, oily fish is not a regular menu item for families, but in many wilder parts of the world it is.
“Consumption of vitamin D-containing fish during pregnancy reduces autistic symptoms in offspring,” notes Cannell.
“Surprisingly, high maternal seafood consumption, of the type known to be contaminated with mercury, has been associated with fewer, not more, autistic markers in the offspring. Lower maternal seafood intake during pregnancy was associated with low verbal intelligence quotient, suboptimum outcomes for pro-social behaviour, fine motor, communication and social development scores.
“While the omega-3 and mercury content of fish is well known,” explains Cannell, “less well known is the fact that fish is one of the few foods with significant amounts of vitamin D, which…protects the genome from damage by toxins.”[2]
But there were more clues. Autism is more prevalent the further north or south of the tropics that you go. It’s more common in urban areas, or those with cloudier skies. In short, the distribution of autism across the planet seems to match the patterns of cancer alluded to in the first chapter and themselves now believed to be vitamin D related.
Vitamin D health problems are more common in dark-skinned people because their vitamin D levels are lower in the weaker sun of the temperate regions. Guess what? “Autism is more common in dark-skinned persons,” says Cannell, who reached a shocking conclusion about what’s causing autism:
“Widespread gestational and/or early childhood vitamin D deficiency may explain both the genetics and epidemiology [prevalence and spread] of autism. If so, much of the disease is iatrogenic [caused by the medical profession], brought on by medical advice to avoid the sun.”
Cannell theorises that autistic children probably have a genetic pre-disposition making them vulnerable to the disorder (a bit like the faulty gene allele recently located in Alzheimer’s), which is triggered by environmental events, including a lack of vitamin D. Maybe vitamin D is the crucial brick in the brain’s wall that’s missing; an infant’s brain VDRs wait for an influx of vitamin D that never comes, and therefore the final chemical reaction, the key in the lock, to make their brains safe from the risk of autism never takes place.
This, he says, would explain the partially inherited side of autism.
Vitamin D deficiency, says Cannell, is a prime risk factor for neurodevelopmental disorders because vitamin D is a hormone that:
Functions as a neurosteroid
Is a potent up-regulator of nerve growth factor
Is found in a wide variety of brain tissue very early in embryogenesis
Offers neuroprotection, anti-epileptic effects, and immunomodulation [control of the immune system]
But what about the fact that many mothers worldwide take a daily pregnancy multi-vitamin that includes vitamin D? Surely that proves the mothers and babies should have been getting enough?
For much of the past three decades, the official recommended daily intake of vitamin D has been only 200 IU (international units) a day. In fact, this is still the current RDI recommendation for children in New Zealand today. This figure is described as “adequate” by the Cancer Society and the Ministry of Health.[3]
Yet in a controlled randomised double blind trial involving autistic children, a daily dose of 300IU still didn’t get their blood serum levels anywhere close to adequate, leaving the study authors to comment: “It appears that much higher levels of vitamin D are needed to affect blood levels of vitamin D.”[4]
At the risk of labouring the point, if health authorities are so far behind the eight ball in understanding vitamin D deficiency and don’t even realise how much vitamin D the public actually need, can the public rely on their assurances? And to answer the question a moment ago, if pregnancy supplements for most of the past two decades have only included a few hundred units of vitamin D, mothers may as well have been ‘peeing in the wind’ for all the good it was doing.
John Cannell makes the same point, contrasting the tiny amounts of vitamin D in pregnancy supplements (the artificial option) with the amounts generated when a pregnant woman sunbathes (the natural option throughout history):
“Large populations of pregnant women putting small amounts of vitamin D in their mouths – in the form of prenatal vitamins – instead of generating large amounts in their skins, is novel to human brain development.”
In other words, it’s an experiment that’s never been tried before.
“The skin’s production of vitamin D is remarkably rapid and extraordinarily robust, easily exceeding recognised dietary sources by an order of magnitude. When fair-skinned adults sunbathe in the summer for 20 minutes, they input about 20,000 IU of vitamin D to their systemic circulation within 24 hours.”
Even when the D supplement in pregnancy multivitamins was boosted to 400IU, Cannell was scornful:[5]
“A 2008 review detailed the devastating effect gestational vitamin D deficiency has on developing mammalian brains. Unfortunately the tiny 10 μg (400IU) dose in prenatal vitamins is virtually irrelevant in preventing the current epidemic of gestational vitamin D deficiency.[6] For this reason, in 2007, the Canadian Paediatric Society cautioned pregnant women they may require not 400IU/day but 2000IU/day, or more, to prevent gestational vitamin D deficiency.”[7]
Since Cannell first published his suspicions that the slip, slop, slap campaign may be directly responsible for autism, the evidence has poured in to back up those suspicions.
A study in California found pregnant women whose first trimester fell in the winter months were at a higher risk of having an autistic child.[8]
In Sweden, immigrant mothers from Somalia have been the subjects of two major studies recently. One found that black Somalian mothers are 630% more likely than white Swedes to give birth in Sweden to an autistic child, and dark-skinned mothers from East Asia were the next highest risk group at 240%,[9] while the second study found black African mothers were five times more likely to have autistic children. In all cases, the Somali mothers had much lower vitamin D levels, and 80% of their affected children had some kind of attention-deficit hyperactivity disorder.[10]
That hyperactivity link alerted the researchers, who found that rats dep
rived of vitamin D during brain development become hyperactive.[11]
That news alone raises questions about whether ADHD’s explosion over the past twenty years is also slip, slop, slap related.
A third study, examining the rates of autism in dark-skinned immigrant mothers, found a “highly significant” link between black ethnicity and autism. “The risk was also very significant for autism associated with mental retardation. These results are consistent with the maternal vitamin D insufficiency hypothesis.”[12]
The study called for urgent randomised, controlled trials to document “the effect of maternal vitamin D insufficiency during pregnancy on the foetal brain and the window of vulnerability. This review stresses the importance of monitoring vitamin D levels in pregnant women, especially those who are immigrant, dark-skinned or veiled.”
However, Somali migrants in Europe are not the only ones suddenly giving birth to autistic children.
“Three of four recent US studies found a higher incidence of autism in black children, sometimes appreciably higher,” John Cannell revealed. “As Fernell et al report, the Somali immigrants in Sweden call autism ‘the Swedish disease’, and Somali immigrants in Minnesota call it ‘the American disease’, but in equatorial Somalia, autism has no name.”[13]
The Somali community’s autism webpage in the United States carries a poignant front page support message from down under:
“I just saw your website and wanted to thank you. I am a Somali social worker in New Zealand and see lots of Somali kids born here that also have autism. Thanks for being brave in the eyes of so many.”[14]
Remember, the central premise is simple: dark-skinned people are designed to live under tropical sun, and their skins are too dark to process enough vitamin D in colder climates, especially when religious or cultural veils are added to the mix.[15]
Adding weight to the vitamin D theory, a study of the prevalence of autism in sunny Oman, in Arabia, found 1 case per 7,000 children. Not one in 60.[16] In sunny Israel, the incidence is reportedly 1 in 5,000.[17] Interestingly, before the sun avoidance campaigns took hold from the eighties onwards, Israel’s diagnosed autism cases were as low as one in half a million. In cold, northern Japan on the other hand, one in 62 children in Yokohama were found to be suffering from autistic spectrum disorder.[18]
“Another of the mysteries of autism,” says Cannell, “is the apparent increased incidence of autism in the children of richer, college-educated parents, especially women.
“If the vitamin D theory is true, autism should be more common in richer, well-educated mothers, who are more likely than other mothers to practice sun-avoidance and use sunblock.”
Sure enough, that’s exactly what researchers have found.[19]
Study after study is now drawing a direct link between mothers who follow sunsmart advice, and a much higher risk of having autistic babies, such as this one from 2012:
“Vitamin D deficiency – either during pregnancy or early childhood – may be an environmental trigger for ASD (autistic spectrum disorder) in individuals genetically predisposed for the broad phenotype of autism. On the basis of the results of the present review, we argue for the recognition of this possibly important role of vitamin D in ASD, and for urgent research in the field.”[20]
Or:
“The increasing incidence of vitamin D insufficiency is likely also associated with the increased risk of autism spectrum disorders as reported in this cohort, thus supporting the hypothesis that gestational vitamin D deficiency is autism’s environmental trigger.”[21]
What about the age-old childhood disease of rickets, known to be caused by serious vitamin D deficiency?
“If adequate amounts of vitamin D prevent autism,” speculates Cannell, “one would expect children with rickets to have an increased risk of autism.”
While modern science has not yet run that comparison, Cannell found two old scientific papers predating 1943, when autism was first recognised and defined, that describe autism-like symptoms in children with rickets:
“Both papers describe ‘weak mindedness’, ‘feeble minds’, ‘mental dullness’, unresponsiveness and developmental delays. Even more intriguing, both papers report that the mental condition in rickets improved with vitamin D.”[22]
In 2010, Cannell threw down the gauntlet to health authorities: “Prove me wrong.” To date, no conflicting evidence has emerged.
“Vitamin D induces more than 3,000 genes, many of which have a role in fetal development,[23]” wrote two Harvard University doctors to the New England Journal of Medicine.[24] “Vitamin D may be particularly relevant to the ‘developmental origins hypothesis’ described by Barker et al, in which environmental factors such as vitamin D may influence the genomic programming of fetal development and hence subsequent disease risk in both childhood and adult life.”
In 1989, the American Medical Association issued an advisory to mothers about the high risk of letting sunlight fall on their children: “Keep infants out of the sun as much as possible”. The years that followed have seen a huge increase in children diagnosed with autistic spectrum disorder and attention deficit hyperactivity disorder. Behavioural problems have soared. Could it all be linked?
“If this theory is true,” Cannell said, “the path towards effective prevention – and perhaps [even] a treatment effect if adequate physiological doses of vitamin D are given – is so simple, so safe, so inexpensive, so readily available and so easy, that it defies imagination.
“Seventeen vitamin D experts recently stated, ‘In our opinion, children with chronic illnesses such as autism, diabetes and/or frequent infections should be supplemented with higher doses of sunshine or vitamin D3, doses adequate to maintain their 25(OH)D levels in the mid-normal of the reference range (65 ng/ml or 162 nmol/L) – and should be so supplemented year round’.
“Finally, if true, a darker side of the theory emerges. To some real but unknown extent, autism is an iatrogenic disease, caused by governments, organisations, committees, newspapers and physicians who promulgated the current warnings about sun exposure for pregnant women and young children without any understanding of the tragedy they engendered.”
If true, the sun-safe slip, slop, slap campaign will go down as the deadliest and costliest public health mistake in history, having consigned millions to a needless life of autism and disability or, as we are about to discover, even worse.
[1] “Autism and vitamin D,” Cannell J, Med Hypotheses. 2008;70(4):750-9. Epub 2007 Oct 24.
[2] “On the aetiology of autism,” John Cannell, Acta Paediatrica 2010; 99, Issue 8:1128-1130, http://onlinelibrary.wiley.com/doi/10.1111/j.1651-2227.2010.01883.x/full
[3] See page 13 of the 2008 Cancer Society of NZ/MoH Position Statement
[4] “Effect of a vitamin/mineral supplement on children and adults with autism,” Adams et al, BMC Pediatrics 2011, 11:111, http://www.biomedcentral.com/1471-2431/11/111
[5] “On the aetiology of autism,” John Cannell, Acta Paediatrica 2010; 99, Issue 8:1128-1130, http://onlinelibrary.wiley.com/doi/10.1111/j.1651-2227.2010.01883.x/full
[6] “Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study,” Holmes et al, British Journal of Nutrition, 2009; 31:1-6
[7] “Vitamin D supplementation: recommendations for Canadian mothers and infants,” Canadian Paediatric Society, Journal of Paediatric Child Health, 2007; 12:583-98
[8] “Month of conception and risk of autism,” Zerbo et al, Epidemiology, July 2011, Vol 22, Issue 4:469-475
[9] “Risk factors for autism and Asperger syndrome,” Haglund, N, and Kallen, K, Autism, March 2011, vol 15 no. 2:163-183
[10] “Prevalence of autism in children of Somali origin living in Stockholm,” Barnevik-Olsson et al, Developmental Medicine & Child Neurology, Dec 2010, Vol 52, Issue 12:1167-1168
[11] “Hyperlocomotion associated with transient prenatal vitamin D deficiency etc,” Burne et al, Behav. Brain Res, 2006; 174:119-24
[12] “Prevalence
of autism according to maternal immigrant status and ethnic origin,” Dealberto, M J, Acta Psychiatrica Scandinavia, May 2011, Vol. 123, Issue 5:339-348
[13] “On the aetiology of autism,” John J Cannell, Acta Paediatrica, May 2010 “ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2913107/pdf/apa0099-1128.pdf
[14] Somali American Autism Support, http://saaswa.org/?page_id=94 accessed July 2012
[15] A study of Masai tribesmen in eastern Africa found their vitamin D levels were a staggering 47.6 ng/ml (119 nmol/L) on average, more than double the average of Africans living in America. See “Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/L,” Luxwolda et al. British Journal of Nutrition. 2012. doi:10.1017/S0007114511007161
[16] “Brief report: prevalence of autistic spectrum disorders in the Sultanate of Oman,” Yahya et al, Journal of Autism and Developmental Disorders, 2011, Vol. 41, Issue 6:821-825
[17] “Time trends in reported autistic spectrum disorders in Israel, 1972-2004,” Senecky et al, Israeli Medical Assn Journal, 2009 Jan;11(1):30-3 http://www.ima.org.il/imaj/ar09jan-05.pdf
[18] “No effect of MMR withdrawal on the incidence of autism: a total population study,” Honda et al, Journal of Child Psychology and Psychiatry, Volume 46, Issue 6, pages 572–579, June 2005
[19] “Sociodemographic risk factors for autism in a US metropolitan area,” Bhasin TK, Schendel D, Journal of Autism and Developmental Disorders, 2007; 37:667-77. See also “Geographic distribution of autism in California,” Van Meter et al, Autism Research, 2010; 3:19-29
[20] “Vitamin D and autism: Clinical review,” Kocovská et al, Research in Developmental Disabilities, Volume 33, Issue 5, September–October 2012, Pages 1541–1550
[21] “Autism Spectrum Disorders Following In Utero Exposure To Antiepileptic Drugs,” M. L. Evatt, Neurology, September 22, 2009 vol. 73 no. 12 997