According to data from the National Health and Examination Survey, ∼40% of adults and 19% of youth in the United States were obese in 2015 and 2016, with a disproportionate burden seen in non-Hispanic Black and Hispanic youth when compared with non-Hispanic White and non-Hispanic Asian youth.1 The etiology of the obesity epidemic is complex and multifaceted, spanning physiologic, behavioral, genetic, social–emotional, political, and economic factors. As the epidemiology of morbidity and mortality has shifted from infectious to chronic and, most often, preventable diseases, the importance of healthy lifestyle behaviors for all families, including autistic individuals, could not be more pressing.
Autistic children and adolescents are at disproportionate risk for unhealthy weight status and represent just one of many communities with unique considerations when it comes to tailoring interventions designed to improve nutrition and physical activity.2,3 Restrictive eating behaviors, sensory issues, specialized diets, social and behavioral impairments, motor impairments, and family factors are key considerations in addressing barriers to optimal nutrition and physical activity in autistic children.4–6 For American Black and Hispanic/Latinx families with autistic children, a history of structural racism and the generation of limiting social structures further complicate efforts at healthier living via the disproportionate burden of food insecurity, food deserts, and safe built environments they share. Multifaceted interventions offering touchpoints in multiple social arenas (ie school, church, home, community center) that are tailored to the needs and strengths of diverse communities will be required for meaningful and effective change for families with autistic individuals.7
Lifestyle medicine focuses on 6 key tenets of health: (1) whole food, plant-based diet, (2) regular physical activity, (3) restorative sleep, (4) stress management, (5) social connectedness, and (6) avoiding risky substance use. When optimized, these 6 tenets can prevent and even help reverse chronic diseases such as cardiovascular disease, diabetes, and cancer. Our goal is to pursue interventions that, first and foremost, use the local autistic community’s input to guide the development and implementation of interventions aimed at improving the lifestyle of autistic individuals and their families. By prioritizing creative educational delivery methods such as a virtual teaching kitchen that promotes social engagement, sensory exposure to a variety of foods, and meal preparation skills that promote self-care and independent living skills, we aim to promote whole-person growth and wellness.
The coronavirus disease 2019 pandemic has undoubtedly altered every family’s life in deep and meaningful ways. It has also spurred and required innovative solutions, including the explosive growth of virtual meeting platforms, whose use will require continued input from autistic youth and their families for the development of best practices. Virtual platforms provide expansive virtual reach to autistic youth and families in a variety of historically underserved settings such as rural and urban underserved areas. By funding small-scale pilots, enabling researchers to engage with a network of collaborating research entities, and providing a centralized data infrastructure, the lifestyle node of the Autism Intervention Research Network on Physical Health is poised to scale and more robustly evaluate novel interventions.
Drs Fernandes and Gragnani conceptualized, drafted, reviewed, and revised the manuscript and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
FUNDING: This project is supported by the Health Resources and Services Administration of the US Department of Health and Human Services under the Autism Intervention Research Network on Physical Health, grant UT2MC39440. The information, content, and/or conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by Health Resources and Services Administration, US Department of Health and Human Services, or the US Government. The funder/sponsor did not participate in the work for this article.
CONFLICT OF INTEREST DISCLOSURE: The authors have indicated they have no potential conflicts of interests to disclose.