Posted on Autism, Mental health

A new study reveals harrowing experiences of misdiagnosis of borderline personality disorder in autistic adults

In an innovative phenomenological study, researchers at Brighton and Sussex Medical School (BSMS) have explored the lived experiences of autistic adults who were previously diagnosed with Borderline Personality Disorder (BPD)
In an innovative phenomenological study, researchers at Brighton and Sussex Medical School (BSMS) explored the lived experiences of autistic adults previously diagnosed with Borderline Personality Disorder (BPD).

The study used interpretive phenomenological analysis and involved conducting one-to-one, semi-structured interviews with 10 participants. Each participant shared overlooked autistic traits from childhood and explained how being misdiagnosed with borderline personality disorder (BPD) had a significant impact on them. This research sheds light on the difficulties of differentiating between autism and BPD, particularly among autistic women who are frequently misdiagnosed.

In recent years, numerous studies have delved into the links between autism and BPD, revealing significant overlaps and challenges in differentiating between these two conditions. Notably, many individuals on the autism spectrum, especially women, have reported being misdiagnosed with BPD.

Stigma and diagnostic overshadowing

Many participants believed that being diagnosed with BPD (borderline personality disorder) led to significant stigma and diagnostic overshadowing, resulting in harmful experiences. They felt that healthcare professionals often neglected their true condition and imposed treatments that were not only unhelpful but also detrimental.

Harmful treatments and masking

“Treating BPD by encouraging the ‘masking’ of behaviours was found to be harmful. Masking, or hiding true autistic traits, has been linked to an increased risk of suicide among autistic individuals. Participants felt powerless, unable to challenge the BPD diagnosis even when they believed it was inaccurate.”

The transformative impact of correct diagnosis

Getting diagnosed with autism was described as “life-changing,” providing profound validation and enabling individuals to embrace their authentic selves. The autism diagnosis shifted the emphasis from attempting to alter their identity to recognizing and encouraging their unique qualities, leading to a considerable improvement in their mental health and overall well-being.

Barriers to autism diagnosis

Participants encountered significant obstacles in obtaining autism assessments after being diagnosed with BPD, leading to delayed access to appropriate support and prolonged struggles.

Comparing stigma

While autism is stigmatized in society, it is distinctly different from the severe stigma associated with BPD. Autism stigma often questions competence, whereas BPD stigma implies individuals are broken and potentially harmful.

Dr. Bruce Tamilson, the primary author of the study and a Psychiatry MSc student currently working as a consultant Neuropsychiatrist and Liaison Psychiatrist in London, added, “This research is crucial in understanding the issue of misdiagnosis and its significant impact on autistic individuals. By sharing these stories, the study aims to humanize and improve mental health services, nurturing a more inclusive and empathetic healthcare system. The experiences of the participants serve as a strong call to action for clinicians and researchers, highlighting the necessity for accurate diagnoses and appropriate support for all individuals.”

Posted on Diabetes, Diet

Is a low-carb diet a nutritious diet? Yes it is!

A small clinical trial led by Stanford Medicine found that the metabolic effects of a ketogenic diet may help stabilize the brain.

Over the last decade, low-carbohydrate (i.e., low-carb) eating patterns have doubled in popularity.1 Substantial research also suggests a low-carb lifestyle is an effective way to support overall health, including managing or reversing type 2 diabetes. Yet, scepticism remains around the nutritional quality of low-carb diets, with some arguing that reducing carb intake leads to over-consuming protein or fat and under-consuming essential nutrients.

A new study in Frontiers in Nutrition has dispelled that misconception. It demonstrated that well-constructed low-carb eating patterns can meet, and sometimes even safely exceed, people’s nutrient needs.

The study assessed the nutrient adequacy of three different 7-day low-carb meal plans: two ketogenic diets – one that averaged approximately 20 grams of net carbs per day, one that provided an average of about 40 grams of net carbs per day – and one more liberalized plan that contained an average of around 100 grams of net carbs per day. (Net carbs equate to total grams of carbohydrates minus total grams of fibre consumed.)  All three plans met the consensus definition of a low-carb diet, which includes less than 130 grams of carbs per day.

All three low-carb meal plans safely exceeded nutrient needs for vitamins A, C, D, E, K, thiamin, riboflavin, niacin, folate and vitamins B6 and B12 for men and women aged 31-70.

“Many Americans struggle to get the nutrients they need from typical food choices,” notes study co-author Beth Bradley, PhD, Department of Nutrition and Food Sciences, University of Vermont. “Our findings suggest that, in addition to their well-established ability to support weight management, low-carb eating patterns can help promote better diet quality and close critical nutrient gaps.”

Only for specific sub-populations with higher needs did a few nutrients fall slightly short in the low-carb meal plans (e.g., iron for younger women and calcium for older adults).

Notably, the two meal plans containing 40 grams and 100 grams of net carbohydrates also provided more than enough fibre for women aged 31-70. Given low-carb diets are especially popular among middle-age women, meeting the nutrients needs of this population is especially relevant.1

“The idea that a low-carb diet must also be low in fibre is simply not supported by the data,” Dr Bradley explains. “High-fiber foods are an important part of a low-carb lifestyle, partly because fibre-rich food choices can help lower net carbohydrate intake. Non-starchy vegetables, nuts and seeds, and, in moderation, even higher-carb fruits, starchy vegetables and whole grains can contribute fibre to the diet while keeping overall net carb intake in check, especially in the more liberal low-carb approach.”

While all three low-carb meal plans were higher than the Recommended Dietary Allowance (RDA) for protein, protein levels still fell within the Acceptable Macronutrient Distribution Range of 10-35% of daily calories. In other words, the meal plans provided more protein than needed to prevent deficiency but did not deliver an excessive amount that would be considered unsafe.

Though lower in saturated fat and sodium than the average American diet, the meal plans also slightly exceeded recommendations for saturated fat and sodium. However, they also offered more beneficial omega-6 to omega-3 and sodium-to-potassium ratios.

“Nutrition is often more complex than simply tallying the totals you see on a menu or a food label,” says Dr Bradley. “Which foods your nutrients come from and how they fit within the broader context of your overall diet may play a more important role in determining health outcomes. For example, a better omega-6 to omega-3 ratio has been linked to a lower risk of cardiovascular disease and type 2 diabetes. And similarly, a more optimal sodium to potassium ratio may help lower the risk of high blood pressure and heart disease.”

The latest study findings add to the robust and growing evidence base demonstrating the role a lower-carb lifestyle can play in supporting good diet quality, overall well-being and managing or reversing diet-related disease. While some people (e.g., younger women and older adults) may benefit from dietary supplements to meet their individual needs, the low-carb diet provides a strong nutritional foundation for health.

Posted on Autism

Signs of Undiagnosed Autism in Adults

This won’t apply to all undiagnosed adults. Still, instead of doing the typical ‘Signs of Autism’ video, I wanted to talk to people who may be similar to me and may have a curiosity about whether they may or may not have Autism by using lifestyle examples.

Posted on Multiple Sclerosis, Sleep disorders

Managing Sleep Challenges with Multiple Sclerosis

“Many people with MS experience sleep issues, and this is also common among military veterans. This program will provide information on managing sleep problems in veterans with MS and introduce VA resources. Dr. Tiffany Braley, an associate professor of Neurology and section head of Multiple Sclerosis at the University of Michigan Health, will be featured in this program.”

Posted on Diet

Foods with low Nutri-Scores associated with an increased risk of cardiovascular diseases

Cardiovascular diseases are the top cause of death in Western Europe, accounting for one-third of all deaths in 2019. Diet is believed to be responsible for about 30% of these deaths. This makes nutrition-related prevention policies a significant public health challenge for addressing these diseases.

Researchers from the Nutritional Epidemiology Research Team (CRESS-EREN), along with members from Inserm, Inrae, Cnam, Université Sorbonne Paris Nord, Université Paris Cité, and in collaboration with researchers from the International Agency for Research on Cancer (WHO-IARC), will publish an article on 11 September 2024 in Lancet Regional Health – Europe. They found that the consumption of foods ranking lower on the Nutri-Score scale (new 2024 version) is linked to an increased risk of cardiovascular diseases in the European cohort EPIC. The study included 345,533 participants from 7 European countries who were followed for 12 years.

The Nutri-Score was officially adopted in France in 2017 and has been adopted in 6 other European countries since. Its aim is to provide quick and clear information on the nutritional quality of foods and drinks to help consumers compare and choose products with better nutritional quality. Additionally, it encourages manufacturers to improve the nutritional quality of their products.

The Nutri-Score consists of 5 categories, ranging from A (dark green, higher nutritional quality) to E (dark orange, lower nutritional quality). An algorithm assesses each product based on its levels per 100 g of energy, sugars, saturated fatty acids, and salt (to limit), as well as proteins, fruits, vegetables, and pulses (to favour).

Several studies published in international scientific journals have demonstrated the effectiveness of Nutri-Score in assessing the nutritional quality of foods and its ability to guide consumers toward healthier choices. Over 140 publications have supported these findings. Specifically, French studies like SU.VI.MAX and NutriNet-Santé cohorts have shown that consuming foods with a lower Nutri-Score (indicating lower nutritional quality) is associated with an increased risk of cardiovascular diseases. Similar associations have been observed in studies in France, the UK, Spain, and Italy, linking lower Nutri-Scores to increased risk of various chronic diseases and higher mortality.

In a recent study, researchers examined the updated 2024 version of the Nutri-Score algorithm, which is associated with the risk of cardiovascular diseases. The study involved a large population from 7 European countries and aimed to provide new scientific evidence to validate the Nutri-Score on a European scale. This study follows two previous ones from 2018 and 2020 that examined cancer risk and mortality within the same population.