Overweight and obesity in children and adolescents with Down syndrome—prevalence, determinants, consequences, and interventions: A literature review

Bertapelli, Fábio; Pitetti, Kenneth H.; Agiovlasitis, Stamatis; Guerra, Gil

doi:10.1016/j.ridd.2016.06.018

Cited by 240 publications

(297 citation statements)

References 77 publications

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“…Thus, the health promotion through initiatives that encourage greater participation in physical activities can be an essential pillar when working with this population (Bertapelli et al . ; Rimmer et al . ; Ulrich et al .…”

Section: Discussionmentioning

confidence: 99%

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Physical therapy in Down syndrome: systematic review and meta‐analysis

Ruiz-González

Lucena-Antón

Salazar

et al. 2019

J intellect Disabil Res

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Background Down syndrome is the most common chromosomal abnormality, with a worldwide incidence of around 0.1% in live births. It is related to several conditions in which the physical therapy could take action‐preventing co‐morbidities. This study aims to evaluate the effectiveness of physical therapy in Down syndrome, to know and compare the effectiveness of different physical therapy interventions in this population. Methods A systematic review and a meta‐analysis of randomised controlled trials were conducted. The search was performed during June 2018 in the following databases: PubMed, Web of Science, Physiotherapy Evidence Database and Scopus. The studies were selected using predefined inclusion and exclusion criteria. The Physiotherapy Evidence Database scale evaluated the quality of the methods used in the studies. Subsequently, the data were extracted, and statistical analysis was performed when possible. Results A total of 27 articles were included, of which nine contributed information to the meta‐analysis. Statistical analysis showed favourable results for the strength of upper and lower limbs [standardised mean difference (SMD) = 1.46; 95% confidence interval (CI): (0.77–2.15); and SMD = 2.04; 95% CI: (1.07–3.01)] and mediolateral oscillations of balance [SMD = −3.30; 95% CI: (−5.34 to −1.26)]. Conclusions The results show the potential benefit of certain types of physical therapy interventions, specifically in strength and balance, in people with Down syndrome. There are still many aspects to clarify and new lines of research.

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Section: Discussionmentioning

confidence: 99%

“…; Hardee & Fetters ; Bertapelli et al . ; Sugimoto et al . ) in this population focus on a specific type of intervention.…”

Section: Introductionmentioning

confidence: 99%

Physical therapy in Down syndrome: systematic review and meta‐analysis

Ruiz-González

Lucena-Antón

Salazar

et al. 2019

J intellect Disabil Res

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“…Additionally, DS is associated with an increased risk for obesity (7, 12), with an estimated prevalence of 47–48% in adults (13) and 30–50% in children (14–16). Highlighting the potential implications for youth with DS, research in typically developing youth has found QOL among obese children to be lower than non-obese peers (17, 18).…”

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confidence: 99%

Caregiver-Reported Quality of Life in Youth with Down Syndrome

Xanthopoulos

Walega

Xiao

et al. 2017

The Journal of Pediatrics

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Objectives To describe caregiver-reported QOL in youth with DS and to examine the role of obesity on QOL. Study design Caregivers of youth with and without DS aged 10 through 20 years completed questionnaires examining QOL (PedsQL) and weight-related QOL (Impact of Weight on Quality of Life-Kids: IWQOL-Kids). Age- and sex-specific Z-scores were generated for body mass index (BMI). Obesity was defined as a BMI≥95th percentile for age and sex. Results Caregiver-reported Total QOL, Physical Health, and Psychosocial Health summary scores were all lower in the DS group compared with the non-DS controls (p<0.001). Social and School Functioning were also lower (p<0.001), but Emotional Functioning did not differ between DS and non-DS groups (p=0.31). Physical Functioning (p=0.003) and Total scores (p=0.03) differed between obese and non-obese non-DS youth, but no differences were reported between obese and non-obese youth with DS. On the IWQOL-Kids, caregivers of youth with DS reported higher Body Esteem (p=0.020) and Social Life scores (p=0.03) than caregivers of non-DS youth. Caregivers of youth with obesity, regardless of DS status, reported significantly lower weight-specific QOL scores than caregivers for non-obese youth. Conclusion Caregivers reported lower QOL in youth with DS compared with youth without DS with the exception of emotional functioning. Obesity influences most domains of weight-related QOL in youth with and without DS; therefore, providers should address weight concerns in youth with obesity even in the presence of DS.

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“…A recent systematic review from Bertapelli et al (2016) provided a thorough overview of potential determinants of obesity in children and adolescents with Down syndrome, including physical activity levels, dietary intake and feeding behaviours, resting energy expenditure and thyroid function. A recent systematic review from Bertapelli et al (2016) provided a thorough overview of potential determinants of obesity in children and adolescents with Down syndrome, including physical activity levels, dietary intake and feeding behaviours, resting energy expenditure and thyroid function.…”

Section: Introductionmentioning

confidence: 99%

Diurnal cortisol and obesity in adolescents with and without Down syndrome

Pitchford

Hasson

Hornyak

et al. 2019

J intellect Disabil Res

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Background The prevalence of obesity in adolescents with Down syndrome (DS) far exceeds that in the general population. Cortisol, an adrenal hormone, can be obesogenic when dysregulated. However, the diurnal patterns of this hormone have not been examined among individuals with DS. Variations in adiposity may also mediate cortisol regulation. This study sought to examine diurnal cortisol patterns in adolescents with DS as well as associations between cortisol function and obesity. Method A total of 32 adolescents, including 16 with DS and 16 controls with typical development (TD) of similar sex, age and Tanner pubertal stage (P > 0.05), participated in this preliminary study. Participants completed a dual‐energy X‐ray absorptiometry scan to measure body composition and collected saliva samples for cortisol measurements in the morning, afternoon and night. Linear mixed models with random intercepts and repeated measures were used to examine the daily trajectory of log‐transformed cortisol concentrations between adolescents with and without DS. A second model examined the interaction between DS and presence of elevated body fatness. Results Adolescents with DS had higher morning cortisol concentrations (intercept = 0.37 μg/dL), but this was not significantly different than in TD (0.35 μg/dL, P = 0.16). Cortisol significantly declined across hours (b = −0.026 μg/dL/h, P < 0.001), but this decline also did not differ from that observed in TD (b = −0.024 μg/dL/h, P = 0.43). While cortisol levels were slightly higher among adolescents with elevated body fatness, this difference was not statistically significant (P > 0.05; d = 0.30). Conclusions This study is the first to examine diurnal cortisol in DS but is limited in sample size. These preliminary findings suggest that diurnal cortisol patterns are not significantly different between adolescents with DS and TD and that cortisol levels are not associated with adiposity in this population. Despite these non‐significant differences, youth with DS continue to be an ‘at‐risk' population for paediatric obesity in need of clinical intervention.

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Overweight and obesity in children and adolescents with Down syndrome—prevalence, determinants, consequences, and interventions: A literature review

Cited by 240 publications

References 77 publications

Physical therapy in Down syndrome: systematic review and meta‐analysis

Physical therapy in Down syndrome: systematic review and meta‐analysis

Caregiver-Reported Quality of Life in Youth with Down Syndrome

Diurnal cortisol and obesity in adolescents with and without Down syndrome

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