Parent Support Improves Weight Loss in Adolescents and Young Adults with Down Syndrome

Abstract

Objective To assess whether parent training in behavioral intervention, combined with a 16-session nutrition and activity education program, would improve weight loss relative to nutrition and activity education alone in adolescents and young adults with Down syndrome. Study design 21 youth with Down syndrome aged 13-26 with a BMI ≥85th percentile were enrolled and randomized to a 6-month nutrition and activity education intervention (n=10) or to nutrition and activity education+behaviorial intervention (n=11), and followed for 6 months after the active intervention period (1-year follow-up). The primary outcome measure was body weight; secondary outcomes included percentage body fat (%fat) by bioelectric impedance; intake of fruits, vegetables, and energy-dense low-nutrient snack food (treats) by 3-day food record; and moderate/vigorous physical activity by accelerometry. Results At 6 months, mean body weight in the nutrition and activity education+behaviorial intervention group was 3.2kg lower than in the nutrition and activity education group (95%CI: 1.0, 5.5, p=0.005). Mean group differences were sustained at 1 year (3.6kg 95%CI: 1.4, 5.9, p=0.002). At 6 months, moderate/vigorous physical activity time averaged 18 minutes/day more in nutrition and activity education+behaviorial intervention than at baseline (p=0.01); in nutrition and activity education, moderate/vigorous physical activity declined by 7 minutes/day (p=0.30); these changes were largely maintained at 1 year, but were not statistically significant. Vegetable intake in nutrition and activity education+behaviorial intervention exceeded intake in nutrition and activity education by a mean of 1.6 servings at 1 year (p=0.009), but not at 6 months. No group differences were observed for %fat or consumption of fruits or treats. Conclusions Parent-supported behavioral intervention appears to be a successful adjunct to a 6-month nutrition education intervention in achieving weight loss in youth with Down syndrome.

Managing the care of adults with Down's syndrome

“…calorie limitations has been shown to be successful for weight loss in the Down's syndrome population. 71 Down's syndrome is an independent risk factor for osteoporosis. 77 85 Incidence of fracture is reported to be as high as 55% (long bones) or 30% (vertebral bodies) in adults with Down's syndrome over 50 years old.…”

Obesity Prevention for Children with Developmental Disabilities

“…Although studies of these factors among children with DD are few, they appear to be equally or more susceptible to consuming poor quality diets. For example, several studies have found that children with ASD do not meet recommendations for fruit and vegetable intake [43–45], and some research has documented that children with ID consume fewer daily servings of dairy, fruits, and vegetables than recommended [46] and at lower amounts than their typically developing peers [47]. …”

A Novel Weight-Loss Tool Designed for Adolescents with Intellectual Disabilities

“…Weight loss and weight maintenance were greater in the condition in which parents received training on behavioral strategies compared with a group that received education only. 11 Given that today’s adolescents with ID are far more likely to live at home with family or in semi-independent settings than in institutions, they face the same everchanging food landscape filled with endless varieties of snacks, convenience foods, and sugar-sweetened beverages as the general population. Consequently, adolescents with ID need to learn how to make healthy food choices independently in a variety of situations such as choosing an afterschool snack at home, preparing food for themselves, or going out to eat with their friends.…”

“…11 The purpose of this article is to describe in detail the HEP and companion Food Guide used originally in the Health U. research study and slightly modified for use in an ongoing study with adolescents with ID. The HEP is a unique weight-loss tool created specifically for adolescents with ID.…”