Exploring the effectiveness of an 18‐month weight management intervention in adults with Down syndrome using propensity score matching

Ptomey, Lauren T.; Willis, Erik A.; Sherman, Joseph R.; White, David A.; Donnelly, Joseph E.

doi:10.1111/jir.12713

Cited by 11 publications

(9 citation statements)

References 49 publications

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“…= +2.2%). Our observation of similar weight change in adolescents/young adults with DS and those with other types of ID are in agreement with results from a previously published secondary analysis of data ( 39 ) from an 18-month multi-component weight management intervention (6 mos. weight loss, 12 mos.…”

Section: Discussionsupporting

confidence: 92%

Weight loss in adolescents with down syndrome compared to adolescents with other intellectual disabilities enrolled in an 18-month randomized weight management trial

Ptomey

Bodde²,

Hastert³

et al. 2022

Front. Pediatr.

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BackgroundThere is limited information on the efficacy of weight management interventions in adolescents with Down Syndrome (DS)ObjectiveTo compare weight change and intervention compliance between adolescents with DS compared to adolescents with non-DS related intellectual disabilities (ID) who were enrolled in an 18-month weight management trial.MethodsParticipants were adolescents (13–21 years) with mild to moderate ID and overweight or obesity. Participants were randomized in a 1:1:1 allocation to one of 3 intervention arms for an 18-month weight management trial: face-to-face/conventional diet (FTF/CD), remote delivery/conventional diet (RD/CD), or remote delivery/enhanced Stop Light Diet (RD/eSLD). Anthropometrics were assessed at baseline 6, 12, and 18 months by staff blinded to the intervention, and self-monitoring data was collected across the 18-month study. As an unpowered, post-hoc, secondary analysis, two-sample t-tests were used to compare the weight change across 6,12, and 18 mos. and compliance across 18 mos. between adolescents with and without DS randomized to each intervention arm.ResultsAdolescents with ID (n = 110) were randomized to one of three intervention arms: FTF/CD (n = 36, DS = 17, other ID = 19), RD/CD (n = 39, DS = 21, other ID = 18) or RD/eSLD (n = 35, DS = 15, other ID = 20). Body weight at 18 months was obtained from 82%, 76% and 73% of participants with DS and 84%, 83% and 75% of participants with other ID randomized to the FTF/CD, RD/CD, and RD/eSLD arms, respectively Weight change across 18 months was −0.2 ± 8.8 kg (−0.5%), −0.3 ± 5.3 kg (−0.7%), and −2.6 ± 5.0 kg (−4.0%) in adolescents with DS randomized to the FTF/CD, RD/CD and RD/eSLD arms, respectively. There were no significant differences in change in body weight or BMI across 18 months between adolescents with DS or those with other ID in any of the 3 intervention arms (all p > 0.05). Additionally, there were no significant differences in intervention compliance between adolescents with and without DS across 18 mos. (all p > 0.05).ConclusionsAdolescents with DS respond to a multi-component weight management intervention similar to those with others ID

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Section: Discussionsupporting

confidence: 92%

Weight loss in adolescents with down syndrome compared to adolescents with other intellectual disabilities enrolled in an 18-month randomized weight management trial

Ptomey

Bodde²,

Hastert³

et al. 2022

Front. Pediatr.

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“…Information concerning the impact of trisomy 21 on whole-body metabolism is also limited, with metabolic assessments largely focused on adiposity, food intake, physical activity level, and energy expenditure in adolescent or adult Individuals with DS [ [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] ]. One study, however, has used phosphorus magnetic resonance spectroscopy to demonstrate a functional deficit in the skeletal muscle mitochondria of adults with DS [ 46 ].…”

Section: Introductionmentioning

confidence: 99%

Dysregulated systemic metabolism in a Down syndrome mouse model

Sarver¹,

Xu²,

Veléz³

et al. 2023

Molecular Metabolism

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“…as core components (Rotatori et al 1980;Rotatori et al 1986;Mann et al 2006;Melville et al 2011;Saunders et al 2011;McDermott et al 2012;Bergström et al 2013;San Mauro-Martín et al 2016;Harris et al 2017;Ptomey et al 2018a,b;Ptomey et al 2020;Niemeier et al 2021;Lally et al 2022). Other core components combinations included diet advice (Jackson & Thorbecke 1982;Fisher 1986;Norvell & Ahern 1987;Chapman et al 2005;Chapman et al 2008;Bazzano et al 2009;Curtin et al 2013;Marks et al 2013;Neumeier et al 2021;Lally et al 2022) and resistance exercise (Marks et al 2013;Pett et al 2013;Martínez-Zaragoza et al 2016;Kovačič et al 2020).…”

Section: Multiple Behaviours (Low Physical Activity Sedentary Behavio...mentioning

confidence: 99%

“…Interventions were developed and adapted for people with IDs. Studies consulted existing literature and manual published by the authors (Rotatori et al 1980;Jackson & Thorbecke 1982;Harris & Bloom 1984;Fisher 1986;Rotatori et al 1986; Norvell & Ahern 1987; Melville et al 2011;Saunders et al 2011;Marks et al 2013;San Mauro-Martín et al 2016;Spanos et al 2016;Harris et al 2017;Ptomey et al 2018a,b;Ptomey et al 2020;Niemeier et al 2021), such as the Glasgow and Clyde Weight Management Service (GCWMS) (Melville et al 2011), the original SHAPE UP weight management programme (Lally et al 2022) and Stoplight diet guides (Saunders et al 2011;Ptomey et al 2018a,b). Health curriculum was specially tailored using information such as Health Education Learning Program (HELP) (Ewing et al 2004;Mann et al 2006;McDermott et al 2012), HealthMatters collaborative community empowerment (Marks et al 2013;Marks et al 2019), and the materials by the Health Promotion Agency in Northern Ireland (Croot et al 2018).…”

Section: Multiple Behaviours (Low Physical Activity Sedentary Behavio...mentioning

confidence: 99%

Lifestyle modification interventions for adults with intellectual disabilities: systematic review and meta‐analysis at intervention and component levels

Rana,

Westrop,

Jaiswal

et al. 2024

J intellect Disabil Res

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BackgroundAdults with intellectual disabilities (IDs) are susceptible to multiple health risk behaviours such as alcohol consumption, smoking, low physical activity, sedentary behaviour and poor diet. Lifestyle modification interventions can prevent or reduce negative health consequences caused by these behaviours. We aim to determine the effectiveness of lifestyle modification interventions and their components in targeting health risk behaviours in adults with IDs.MethodsA systematic review and meta‐analysis were conducted. Electronic databases, clinical trial registries, grey literature and citations of systematic reviews and included studies were searched in January 2021 (updated February 2022). Randomised controlled trials and non‐randomised controlled trials targeting alcohol consumption, smoking, low physical activity, sedentary behaviours and poor diet in adults (aged ≥ 18 years) with ID were included. Meta‐analysis was conducted at the intervention level (pairwise and network meta‐analysis) and the component‐level (component network meta‐analysis). Studies were coded using Michie's 19‐item theory coding scheme and 94‐item behaviour change taxonomies. Risk of bias was assessed using the Cochrane Risk of Bias (ROB) Version 2 and Risk of Bias in Non‐randomised Studies of Interventions (ROBINS‐I). The study involved a patient and public involvement (PPI) group, including people with lived experience, who contributed extensively by shaping the methodology, providing valuable insights in interpreting results and organising of dissemination events.ResultsOur literature search identified 12 180 articles, of which 80 studies with 4805 participants were included in the review. The complexity of lifestyle modification intervention was dismantled by identifying six core components that influenced outcomes. Interventions targeting single or multiple health risk behaviours could have a single or combination of multiple core‐components. Interventions (2 RCTS; 4 non‐RCTs; 228 participants) targeting alcohol consumption and smoking behaviour were effective but based on limited evidence. Similarly, interventions targeting low physical activity only (16 RCTs; 17 non‐RCTs; 1413 participants) or multiple behaviours (low physical activity only, sedentary behaviours and poor diet) (17 RCTs; 24 non‐RCTs; 3164 participants) yielded mixed effectiveness in outcomes. Most interventions targeting low physical activity only or multiple behaviours generated positive effects on various outcomes while some interventions led to no change or worsened outcomes, which could be attributed to the presence of a single core‐component or a combination of similar core components in interventions. The intervention‐level meta‐analysis for weight management outcomes showed that none of the interventions were associated with a statistically significant change in outcomes when compared with treatment‐as‐usual and each other. Interventions with core‐components combination of energy deficit diet, aerobic exercise and behaviour change techniques showed the highest weight loss [mean difference (MD) = −3.61, 95% credible interval (CrI) −9.68 to 1.95] and those with core‐components combination dietary advice and aerobic exercise showed a weight gain (MD 0.94, 95% CrI −3.93 to 4.91). Similar findings were found with the component network meta‐analysis for which additional components were identified. Most studies had a high and moderate risk of bias. Various theories and behaviour change techniques were used in intervention development and adaptation.ConclusionOur systematic review is the first to comprehensively explore lifestyle modification interventions targeting a range of single and multiple health risk behaviours in adults with ID, co‐produced with people with lived experience. It has practical implications for future research as it highlights the importance of mixed‐methods research in understanding lifestyle modification interventions and the need for population‐specific improvements in the field (e.g., tailored interventions, development of evaluation instruments or tools, use of rigorous research methodologies and comprehensive reporting frameworks). Wide dissemination of related knowledge and the involvement of PPI groups, including people with lived experience, will help future researchers design interventions that consider the unique needs, desires and abilities of people with ID.

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Exploring the effectiveness of an 18‐month weight management intervention in adults with Down syndrome using propensity score matching

Cited by 11 publications

References 49 publications

Weight loss in adolescents with down syndrome compared to adolescents with other intellectual disabilities enrolled in an 18-month randomized weight management trial

Weight loss in adolescents with down syndrome compared to adolescents with other intellectual disabilities enrolled in an 18-month randomized weight management trial

Dysregulated systemic metabolism in a Down syndrome mouse model

Lifestyle modification interventions for adults with intellectual disabilities: systematic review and meta‐analysis at intervention and component levels

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