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Ptomey LT, Washburn RA, Sherman JR, Mayo MS, Krebill R, Szabo-Reed AN, Honas JJ, Helsel BC, Bodde A, Donnelly JE. Remote delivery of a weight management intervention for adults with intellectual disabilities: Results from a randomized non-inferiority trial. Disabil Health J 2024; 17:101587. [PMID: 38272776 PMCID: PMC10999321 DOI: 10.1016/j.dhjo.2024.101587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Remote delivery of multi-component weight management interventions results in clinically meaningful weight loss in adults without intellectual disabilities (ID), but the effectiveness of remotely delivered weight management interventions in adults with ID has not previously been evaluated. OBJECTIVE To determine if a weight management intervention delivered remotely could achieve weight loss (kg) at 6 months that is non-inferior to in-person visits in adults with ID and overweight or obesity (BMI ≥25 kg/m2). METHODS Participants were randomized to a 24-mo. trial (6 mos weight loss,12 mos weight maintenance, 6 mos. no-contact follow up) to compare weight loss achieved with the same multicomponent intervention delivered to individual participants in their home either remotely (RD) or during face-to-face home visits (FTF). RESULTS One hundred twenty adults with ID (∼32 years of age, 53 % females) were randomized to the RD (n = 60) or the FTF arm (n = 60). Six-month weight loss in the RD arm (-4.9 ± 7.8 kg) was superior to 6-month weight loss achieved in the FTF arm (-2.1 ± 6.7 kg, p = 0.047). However, this may be partially attributed to the COVID-19 pandemic, since weight loss in the FTF arm was greater in participants who completed the intervention entirely pre-COVID (n = 33,-3.2 %) compared to post-COVID (n = 22, -0.61 %). Weight loss across did not differ significantly between intervention arms at 18 (p = 0.33) or 24 months (p = 0.34). CONCLUSION Our results suggest that remote delivery is a viable option for achieving clinically relevant weight loss and maintenance in adults with ID. NCT REGISTRATION NCT03291509.
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Affiliation(s)
- L T Ptomey
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA.
| | - R A Washburn
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - J R Sherman
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - M S Mayo
- Department of Biostatistics & Data Science, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - R Krebill
- Department of Biostatistics & Data Science, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - A N Szabo-Reed
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - J J Honas
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - B C Helsel
- Department of Neurology, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - A Bodde
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - J E Donnelly
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
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Matsushita Y, Takahashi T, Asahi K, Harashima E, Takahashi H, Tanaka H, Tsumuraya Y, Sarukura N, Furuta M, Tanaka H, Yokoyama T. Validation of improved 24-hour dietary recall using a portable camera among the Japanese population. Nutr J 2021; 20:68. [PMID: 34266425 PMCID: PMC8283912 DOI: 10.1186/s12937-021-00724-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The collection of weighed food records (WFR) is a gold standard for dietary assessment. We propose using the 24-h recall method combined with a portable camera and a food atlas (24hR-camera). This combination overcomes the disadvantages of the 24-h dietary recall method. Our study examined the validity of the 24hR-camera method against WFR by comparing the results. METHODS Study subjects were 30 Japanese males, aged 31-58 years, who rarely cook and reside in the Tokyo metropolitan area. For validation, we compared the estimated food intake (24hR-camera method) and weighed food intake (WFR method). The 24hR-camera method uses digital photographs of all food consumed during a day, taken by the subjects, and a 24-h recall questionnaire conducted by a registered dietitian, who estimates food intake by comparing the participant's photographs with food atlas photographs. The WFR method involves a registered dietitian weighing each food item prepared for the subject to consume and any leftovers. Food intake was calculated for each food group and nutrient using the 24hR-camera vs. weighed methods. RESULTS Correlation coefficients between the estimated vs. weighed food intake were 0.7 or higher in most food groups but were low in food groups, such as oils, fats, condiments, and spices. The estimated intake of vegetables was significantly lower for the 24hR-camera method compared to the WFR method. For other food groups, the percentages of the mean difference between estimated vs. weighed food intake were -22.1% to 5.5%, with no significant differences between the methods (except for algae, which had a very low estimated intake). The correlation coefficients between the two methods were 0.774 for energy, and 0.855, 0.769, and 0.763 for the macronutrients, proteins, lipids, and carbohydrates, respectively, demonstrating high correlation coefficients: greater than 0.75. The correlation coefficients between the estimated vs. weighed for salt equivalents and potassium intake were 0.583 and 0.560, respectively, but no significant differences in intake were observed. CONCLUSIONS The 24hR-camera method satisfactorily estimated the intake of energy and macronutrients (except salt equivalents and potassium) in Japanese males and was confirmed as a useful method for dietary assessment.
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Affiliation(s)
- Yumi Matsushita
- Department of Clinical Research, National Cen, ter for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
| | - Tosei Takahashi
- Department of Nutritional and Health Sciences, Faculty of Food and Nutritional Sciences, Toyo University, 1-1-1 Izumino, Itakura-machi, Ora-gun, Gunma, 374-0193, Japan
| | - Kumiko Asahi
- Department of Clinical Nutrition, Faculty of Health and Wellness Sciences, Hiroshima International University, 5-1-1 Hirokoshinkai, , Kure city, Hiroshima, 737-0112, Japan
| | - Emiko Harashima
- Department of Nutrition and Life Science, Faculty of Health and Medical, Sciences, Kanagawa Institute of Technology, 1030 Shimo-ogino, Atsugi-shi, Kanagawa, 243-0292, Japan
| | - Hiroko Takahashi
- The Japanese Society of Nutrition and Dietetics, 3-4-18-904 Mita Minato-ku, Tokyo, 108-0073, Japan
| | - Hiroyuki Tanaka
- Department of Human Nutrition Faculty of Human Nutrition, Tokyo Kasei Gakuin University, 22 Sanbant-cho Chiyoda-ku, Tokyo, 102-8341, Japan
| | - Yoshiko Tsumuraya
- Department of Nutritional Management, Faculty of Nutritional Science, Sagami Women's University, 2-1-1 Bunkyo, Minami-ku, Sagamihara-shi, Kanagawa, 252-0383, Japan
| | - Nobuko Sarukura
- Department of Nutrition and Health, Faculty of Nutritional Science, Sagami Women's University, 2-1-1 Bunkyo, Minami-ku, Sagamihara-shi, Kanagawa, 252-0383, Japan
| | - Masashi Furuta
- Department of Nutrition, Toho University Omori Medical Center, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Heizo Tanaka
- Professor Emeritus, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Tetsuji Yokoyama
- Department of Health Promotion, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
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Ptomey LT, Szabo-Reed AN, Martin LE, Mayo MS, Washburn RA, Gorczyca AM, Lepping RJ, Lee P, Forsha DE, Sherman JR, Danon JC, Donnelly JE. The promotion of physical activity for the prevention of Alzheimer's disease in adults with Down Syndrome: Rationale and design for a 12 Month randomized trial. Contemp Clin Trials Commun 2020; 19:100607. [PMID: 32642594 PMCID: PMC7334572 DOI: 10.1016/j.conctc.2020.100607] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/16/2020] [Accepted: 06/28/2020] [Indexed: 11/23/2022] Open
Abstract
Nearly all individuals with Down Syndrome (DS) display pathology associated with Alzheimer's disease (AD) beginning as early as age 30. Previous research in typically developed adults suggests that increased moderate-to-vigorous physical activity (MVPA) may improve cognitive function and protect against age-related structural and functional changes in the brain; however, the potential impact of increased MVPA on the development of AD in adults with DS has not been evaluated. Despite the potential positive impact of MVPA on cognition and AD risk, participation in MVPA among young adults with DS is low. The limited research evaluating strategies for increasing MVPA in adults with DS has been unsuccessful in increasing MVPA. Results from our preliminary investigation where we remotely delivered real-time MVPA, led by a trained health educator, to groups of adults with DS in their homes via video conferencing on a tablet computer demonstrated high attendance, increased MVPA during group sessions, and improvements in cognitive function. However, the sustainability, impact on total daily MVPA, optimal session frequency, and potential impacts on cognitive function and brain health of remotely delivered group MVPA sessions in adults with DS are unknown. Therefore, we will conduct a trial in 80 non-demented adults with DS to determine the feasibility and potential efficacy of remotely delivered group MVPA sessions to increase daily MVPA, relative to a usual care control. Secondarily we will assess the impact of MVPA on cardiovascular fitness, quality of life, cognitive function and brain parameters related to AD. NCT REGISTRATION NCT04048759.
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Affiliation(s)
- Lauren T. Ptomey
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Amanda N. Szabo-Reed
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Laura E. Martin
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Matthew S. Mayo
- Department of Biostatistics & Data Science, University of Kansas Medical Center, USA
| | - Richard A. Washburn
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Anna M. Gorczyca
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Rebecca J. Lepping
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Phill Lee
- Department of Radiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Daniel E. Forsha
- Ward Family Heart Center, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Joseph R. Sherman
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Jessica C. Danon
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Joseph E. Donnelly
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
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Ptomey LT, Washburn RA, Mayo MS, Greene JL, Lee RH, Szabo-Reed AN, Honas JJ, Sherman JR, Donnelly JE. Remote delivery of weight management for adults with intellectual and developmental disabilities: Rationale and design for a 24 month randomized trial. Contemp Clin Trials 2018; 73:16-26. [PMID: 30145269 PMCID: PMC6176482 DOI: 10.1016/j.cct.2018.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/22/2018] [Accepted: 08/23/2018] [Indexed: 01/28/2023]
Abstract
Adults with intellectual and developmental disabilities (IDD) represent an underserved segment of the US population with a high prevalence of obesity and limited options for weight management. Previous research has demonstrated clinically meaningful weight loss of 7% of total body weight in in adults with IDD using an enhanced Stop Light Diet (eSLD) in combination with monthly at-home face-to-face (FTF) behavioral sessions, and a recommendation for increased physical activity. However, the time and cost associated with FTF delivery (travel + sessions) limits the potential for scaling and implementation and suggests the need for the evaluation of less costly and burdensome strategies for intervention delivery. Therefore, we will conduct a 24-mo. randomized trial to compare a weight management intervention (6 mos. weight loss, 12 mos. maintenance, 6 mos. no-contact follow-up) delivered to 120 overweight/obese adults with IDD in their home, either remotely (RD) using video conferencing on a tablet computer, or during FTF visits. Our primary aim is whether RD is non-inferior to FTF for weight loss (0-6 mos.). Secondarily, we will compare the RD and FTF groups on mean weight loss, the proportion of participants who achieve clinically meaningful weight loss, and changes in quality of life across 24 months. We will also conduct cost analysis, cost-effectiveness, and contingent valuation analyses to compare the RD and FTF groups.
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Affiliation(s)
- Lauren T Ptomey
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - Richard A Washburn
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - Matthew S Mayo
- Department of Biostatistics, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - J Leon Greene
- Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, KS 66045, USA.
| | - Robert H Lee
- Department of Health Policy and Management, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - Amanda N Szabo-Reed
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - Jeffery J Honas
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - Joseph R Sherman
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - Joseph E Donnelly
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
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Ptomey LT, Saunders RR, Saunders M, Washburn RA, Mayo MS, Sullivan DK, Gibson CA, Goetz JR, Honas JJ, Willis EA, Danon JC, Krebill R, Donnelly JE. Weight management in adults with intellectual and developmental disabilities: A randomized controlled trial of two dietary approaches. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31 Suppl 1:82-96. [DOI: 10.1111/jar.12348] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Lauren T Ptomey
- Cardiovascular Research Institute; Department of Internal Medicine; The University of Kansas Medical Center; Kansas City KS USA
| | - Richard R Saunders
- The Schiefelbusch Institute for Lifespan Studies; The University of Kansas-Lawrence; Lawrence KS USA
| | - Muriel Saunders
- The Schiefelbusch Institute for Lifespan Studies; The University of Kansas-Lawrence; Lawrence KS USA
| | - Richard A Washburn
- Cardiovascular Research Institute; Department of Internal Medicine; The University of Kansas Medical Center; Kansas City KS USA
| | - Matthew S Mayo
- Department of Biostatistics; The University of Kansas Medical Center; Kansas City KS USA
| | - Debra K Sullivan
- Department of Dietetics and Nutrition; The University of Kansas Medical Center; Kansas City KS USA
| | - Cheryl A Gibson
- Department of Internal Medicine; The University of Kansas Medical Center; Kansas City KS USA
| | - Jeannine R Goetz
- Department of Dietetics and Nutrition; The University of Kansas Medical Center; Kansas City KS USA
| | - Jeff J Honas
- Cardiovascular Research Institute; Department of Internal Medicine; The University of Kansas Medical Center; Kansas City KS USA
| | - Erik A Willis
- Cardiovascular Research Institute; Department of Internal Medicine; The University of Kansas Medical Center; Kansas City KS USA
| | - Jessica C Danon
- Cardiovascular Research Institute; Department of Internal Medicine; The University of Kansas Medical Center; Kansas City KS USA
| | - Ron Krebill
- Department of Biostatistics; The University of Kansas Medical Center; Kansas City KS USA
| | - Joseph E Donnelly
- Cardiovascular Research Institute; Department of Internal Medicine; The University of Kansas Medical Center; Kansas City KS USA
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Donnelly JE, Ptomey LT, Goetz JR, Sullivan DK, Gibson CA, Greene JL, Lee RH, Mayo MS, Honas JJ, Washburn RA. Weight management for adolescents with intellectual and developmental disabilities: Rationale and design for an 18month randomized trial. Contemp Clin Trials 2016; 51:88-95. [PMID: 27810602 DOI: 10.1016/j.cct.2016.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/24/2016] [Accepted: 10/29/2016] [Indexed: 11/29/2022]
Abstract
Adolescents with intellectual and developmental disabilities (IDD) are an underserved group in need of weight management. However, information regarding effective weight management for this group is limited, and is based primarily on results from small, non-powered, non-randomized trials that were not conducted in accordance with current weight management guidelines. Additionally, the comparative effectiveness of emerging dietary approaches, such as portion-controlled meals (PCMs) or program delivery strategies such as video chat using tablet computers have not been evaluated. Therefore, we will conduct an 18month trial to compare weight loss (6months) and maintenance (7-18months) in 123 overweight/obese adolescents with mild to moderate IDD, and a parent, randomized to a weight management intervention delivered remotely using FaceTime™ on an iPad using either a conventional meal plan diet (RD/CD) or a Stop Light diet enhanced with PCMs (RD/eSLD), or conventional diet delivered during face-to-face home visits (FTF/CD). This design will provide an adequately powered comparison of both diet (CD vs. eSLD) and delivery strategy (FTF vs. RD). Exploratory analyses will examine the influence of behavioral session attendance, compliance with recommendations for diet (energy intake), physical activity (min/day), self-monitoring of diet and physical activity, medications, and parental variables including diet quality, physical activity, baseline weight, weight change, and beliefs and attitudes regarding diet and physical activity on both weight loss and maintenance. We will also complete a cost and contingent valuation analysis to compare costs between RD and FTF delivery.
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Affiliation(s)
- J E Donnelly
- Cardiovascular Research Institute, Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - L T Ptomey
- Cardiovascular Research Institute, Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - J R Goetz
- Department of Dietetics and Nutrition, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - D K Sullivan
- Department of Dietetics and Nutrition, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - C A Gibson
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - J L Greene
- Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, KS 66045, USA.
| | - R H Lee
- Department of Health Policy and Management, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - M S Mayo
- Department of Biostatistics, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - J J Honas
- Cardiovascular Research Institute, Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - R A Washburn
- Cardiovascular Research Institute, Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
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Spanos D, Hankey CR, Melville CA. The Effectiveness of a Weight Maintenance Intervention for Adults with Intellectual Disabilities and Obesity: A Single Stranded Study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 29:317-29. [PMID: 25916495 DOI: 10.1111/jar.12181] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND The evidence base for weight management programmes incorporating a weight loss and a weight maintenance phase for adults with intellectual disabilities (ID) is limited. This study describes the weight maintenance phase of a multicomponent weight management programme for adults with intellectual disability and obesity (TAKE 5). MATERIALS AND METHODS Thirty-one participants who had completed the 16 week TAKE five weight loss intervention (Phase I) were invited to participate in a 12 month weight maintenance intervention (Phase II). Content included recommendations of the National Weight Control Registry. RESULTS Twenty-eight participants completed Phase II with 50.4% maintaining their weight (mean weight change -0.5 kg, SD 2.2), 28.7% gaining weight (mean weight gain 5.4 kg, SD 2.2) and 21.6% losing weight (mean weight loss -8.0 kg, SD 3.0) at 12 months. CONCLUSION Further research is justified to investigate the efficacy of weight loss maintenance interventions in adults with intellectual disability and obesity, using controlled study designs.
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Affiliation(s)
- Dimitrios Spanos
- Institute of Mental Health & Wellbeing, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Catherine R Hankey
- College of Medical, Veterinary and Medical and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Craig A Melville
- Institute of Mental Health & Wellbeing, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Nordstrøm M, Paus B, Andersen LF, Kolset SO. Dietary aspects related to health and obesity in Williams syndrome, Down syndrome, and Prader-Willi syndrome. Food Nutr Res 2015; 59:25487. [PMID: 25653019 PMCID: PMC4317472 DOI: 10.3402/fnr.v59.25487] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 11/05/2014] [Accepted: 12/22/2014] [Indexed: 12/30/2022] Open
Abstract
Background Dietary aspects that might contribute to development of obesity and secondary conditions are not well documented in genetic subgroups associated with intellectual disability. Objective To describe the intake frequencies of selected foods in participants with Prader–Willi syndrome (PWS), Down syndrome (DS), and Williams syndrome (WS), and investigate the association with body mass index (BMI). To explore food-related autonomy and intake frequencies among persons with DS in different living arrangements. Methods Self-reported intake frequencies and measurement of plasma carotenoids and erythrocyte content of omega-3 fatty acids (FAs) were investigated in persons aged 16–42 years, with WS (n=21), DS (n=40), and PWS (n=20). Results A larger proportion of participants with PWS showed high-frequency intake of fruits (p=0.012) and vegetables (p=0.004), and had higher plasma carotenoids (p<0.001) compared to participants with DS and WS. Furthermore, a larger proportion of participants with WS were low-frequency consumers of fish (p=0.005), less likely to use omega-3 FA supplements (p=0.023), and had reduced erythrocyte concentrations of long-chain omega-3 FAs (p<0.001), compared to participants with PWS and DS. In DS, BMI was negatively associated with plasma carotenoids. Increased proportions of participants living in communities showed high-frequency intake of precooked meals (p=0.030), and a tendency toward high-frequency consumption of soft drinks (p=0.079), when compared to peers living with relatives. Participants in community residences were also more likely to participate frequently in food-related decisions and preparations. Conclusions Persons with WS had a less-favorable dietary pattern when compared to persons with PWS. A larger proportion of persons living in communities frequently consumed precooked meals and showed a tendency of high-frequency soft drink consumption. Otherwise, their intake frequencies of the investigated foods were similar to those living with relatives, but they participated more frequently in decisions and preparations of foods.
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Affiliation(s)
- Marianne Nordstrøm
- Frambu Resource Centre for Rare Disorders, Siggerud, Norway.,Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway;
| | - Benedicte Paus
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Lene F Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Svein Olav Kolset
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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10
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Ptomey LT, Willis EA, Goetz JR, Lee J, Sullivan DK, Donnelly JE. Digital photography improves estimates of dietary intake in adolescents with intellectual and developmental disabilities. Disabil Health J 2015; 8:146-50. [DOI: 10.1016/j.dhjo.2014.08.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 08/05/2014] [Accepted: 08/23/2014] [Indexed: 11/25/2022]
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Edwards M, Holder M, Baum N, Brown R. Targeting Health Improvement via a Nutritional Intervention Program for Adults With Developmental Disabilities and Challenging Behaviors. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2014. [DOI: 10.1111/jppi.12067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Nehama Baum
- MukiBaum Accessibility Foundation; Toronto ON Canada
| | - Roy Brown
- University of Calgary; Calgary AB Canada
- Flinders University; Adelaide SA Australia
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Photo-assisted recall increases estimates of energy and macronutrient intake in adults with intellectual and developmental disabilities. J Acad Nutr Diet 2013; 113:1704-9. [PMID: 24095784 DOI: 10.1016/j.jand.2013.07.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 07/12/2013] [Indexed: 11/21/2022]
Abstract
Diet assessment of adults with intellectual and developmental disabilities is challenging because of their limited cognitive abilities. The objective of this study was to examine the feasibility and outcomes of combining photos with 24-hour dietary recalls for the assessment of energy and macronutrient intakes in adults with intellectual and developmental disabilities. Participants used an iPad 2 tablet computer (Apple) to take photos of all food and beverages consumed before a standard, multiple-pass, 24-hour dietary recall. After the standard 24-hour diet recall, the photos were reviewed with the participant for clarification details (eg, portion size) and differences were recorded. The standard 24-hour recall and photo-assisted recall were entered separately into the Nutrition Data System for Research for computerized dietary analysis. Sixty-four eating occasions were entered from 23 participants (48% female; mean age 26.4±9.7 years). Participants captured photos for 66.5%±30.4% of all recorded eating occasions. Greater energy intake per eating occasion was reported with the photo-assisted recalls than the standard recalls (625.6±85.7 kcal vs 497.2±86.6 kcal; P=0.002) and a greater intake of grams of fat (P=0.006), protein (P=0.029), and carbohydrates (P=0.003). Photo-assisted 24-hour recalls provided a significant increase in total calories and macronutrient content compared with a standard 24-hour recall and may be a feasible method to enhance dietary assessment in adults with intellectual and developmental disabilities.
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Hinckson EA, Dickinson A, Water T, Sands M, Penman L. Physical activity, dietary habits and overall health in overweight and obese children and youth with intellectual disability or autism. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:1170-1178. [PMID: 23400004 DOI: 10.1016/j.ridd.2012.12.006] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Revised: 12/10/2012] [Accepted: 12/12/2012] [Indexed: 06/01/2023]
Abstract
In children and youth with disability, the risk of obesity is higher and is associated with lower levels of physical activity, inappropriate eating behaviors, and chronic health conditions. We determined the effectiveness of a program in managing weight, through changes in physical activity and nutrition behaviors in overweight and obese New Zealand children and youth with intellectual disability or autism. Twenty-two children and youth 14±4 y (mean±SD) and their families participated in a 10-week school-based program. The program consisted of 18 sessions focusing on physical activity and nutrition. Changes were measured immediately after completion of the program (post 1) and at 24 weeks (follow up). Fitness was assessed with the six-minute walk-test (6MWT) and body fatness via waist circumference and BMI. Physical activity and nutrition changes were measured by means of proxy reporting and interviews with parents. Individual interviews were conducted with school teachers and program leaders at 24 weeks to gain feedback regarding the program. Most quantitative outcomes were either unclear or trivial. The only possible change was observed in the six-minute walk-test where 24 weeks post program where participants walked 51 m further. There was however, a substantial reduction in the consumption of confectionery and chocolate at the two measurement points. Parents commented that during the program there were less hospital visits and absences from school related to illness. The program assisted in the development of a supportive community network and participants' abilities to partake in family and community activities. This the first study to report on the results of a physical activity and nutrition program targeted in children and youth with intellectual disability and autism. The results of this study may support and inform future developments of an integrated weight management and prevention program to enhance the health and well being in children and youth with disabilities.
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Affiliation(s)
- Erica A Hinckson
- Centre for Child Health Research, Institute of Public Health and Mental Health, Auckland University of Technology, New Zealand.
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Lazarte CE, Encinas ME, Alegre C, Granfeldt Y. Validation of digital photographs, as a tool in 24-h recall, for the improvement of dietary assessment among rural populations in developing countries. Nutr J 2012; 11:61. [PMID: 22931128 PMCID: PMC3547686 DOI: 10.1186/1475-2891-11-61] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 07/26/2012] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Improvement of traditional methods for dietary assessment is necessary, especially in rural areas where it is more difficult to succeed with self-reporting methods. This study presents and validates a method for improving accuracy when measuring food and nutrient intake of individuals in rural areas. It is called the "Food photography 24-h recall method" (FP 24-hR) and is a modified 24-h recall with the addition of a digital food photography record and a photo atlas. METHODS The study was carried out in a rural area in the tropical region of Bolivia; 45 women participated. Validation of the method was made by comparing it with a reference method, the Weighed Food Record (WFR). During the FP 24-hR, digital photographs were taken by the subjects of all food consumed during a day and a 24-h recall questionnaire was conducted by an interviewer. An estimate of the amount of food consumed was made using a photo atlas and the photographs taken by the subjects. For validation, comparison was made between the calculations, by both methods, of the levels of food, and nutrient, intake. RESULTS The comparison was made in 10 food categories; most of which were somewhat underestimated from -2.3% (cassava) to -6.8% (rice), except for beverages (+1.6%) and leafy vegetables (+8.7%), which were overestimated. Spearman's correlation coefficients were highly significant (r from 0.75 for eggs to 0.98 for potato and cassava). Nutrient intakes calculated with data from both methods showed small differences from -0.90% (vitamin C) to -5.98% (fat). Although all nutrients were somewhat underestimated, Pearson's coefficients are high (>0.93 for all) and statistically significant. Bland Altman analysis showed that differences between both methods were random and did not exhibit any systematic bias over levels of food and nutrient intake, with acceptable 95% limits of agreement. CONCLUSION The FP 24-hR exhibits acceptable differences when compared with a WFR, digital photos are useful as a memory aid for the subjects during 24-h recall and as an estimation tool. The method is suitable for assessing dietary intake among rural populations in developing countries.
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Affiliation(s)
- Claudia E Lazarte
- Department of Food Technology, Lund University, P.O. Box 124, Lund 221 00, Sweden
- Food and Natural Products Center, San Simon University, Cochabamba, Bolivia
| | | | - Claudia Alegre
- Departament of Nutrition, San Simon University, Cochabamba, Bolivia
| | - Yvonne Granfeldt
- Department of Food Technology, Lund University, P.O. Box 124, Lund 221 00, Sweden
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Matthiessen TB, Steinberg FM, Kaiser LL. Convergent validity of a digital image-based food record to assess food group intake in youth. ACTA ACUST UNITED AC 2011; 111:756-61. [PMID: 21515125 DOI: 10.1016/j.jada.2011.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Accepted: 11/29/2010] [Indexed: 11/28/2022]
Abstract
Current methods to assess the dietary behavior of youth have many limitations that reduce accuracy. Previous research has examined use of food images to assess nutrient intake. The objectives for this study are to validate the use of a novel digital image-based food record (DIFR) method to assess food group intake in youth and examine inter-analyst reliability. In 2009, a convenience sample of youth aged 9 to 12 years were recruited in Davis, CA, and asked to take images of the food they ate between 5 pm and bedtime for 7 days. To examine convergent validity, 1-day and average weekly food group intakes assessed by DIFR were compared to food group estimates derived from 24-hour dietary recalls. To examine interanalyst reliability, estimates of food group intakes made by two independent nutrition students were compared, using Spearman correlation coefficients. Data from 26 youth showed that each participant's 1-day food group intakes assessed by the DIFR and recall methods were significantly correlated (P<0.001) for both analysts for all food groups. Estimated average daily intake amounts determined by the DIFR method and recall methods were also significantly correlated for all food groups except grains (n=28). Interanalyst reliability was very good; estimates of food group intakes, provided by the two students, were significantly correlated (n=28, P<0.001). These results show great potential for use of DIFR to assess 1 day's intake of food groups, but more research is needed to determine how well the method performs in capturing usual intake and changes in intake.
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Affiliation(s)
- Timothy B Matthiessen
- Department of Nutrition Services, University of Virginia Health System, Charlottesville, USA
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Jenkins CM, McKenzie K. The Application of the Theory of Planned Behaviour to Diet in Carers of People with an Intellectual Disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2011. [DOI: 10.1111/j.1468-3148.2010.00594.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Humphries K, Pepper A, Traci MA, Olson J, Seekins T. Nutritional intervention improves menu adequacy in group homes for adults with intellectual or developmental disabilities. Disabil Health J 2009; 2:136-44. [DOI: 10.1016/j.dhjo.2009.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 11/25/2008] [Accepted: 01/17/2009] [Indexed: 10/20/2022]
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Humphries K, Traci MA, Seekins T. Nutrition and adults with intellectual or developmental disabilities: systematic literature review results. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2009; 47:163-185. [PMID: 19489663 DOI: 10.1352/1934-9556-47.3.163] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Accepted: 10/08/2008] [Indexed: 05/27/2023]
Abstract
Approximately 4.5 million Americans have an intellectual or developmental disability. Concern is increasing about these individuals' nutrition-related behavior and its implications for their health. This article reports on a systematic search of the current literature listed in the PsycINFO and PubMed databases related to nutritional status of adults with intellectual or developmental disabilities. The authors used key terms for nutrition, secondary conditions, and intellectual and developmental disability and categorized literature pertaining to nutrition-related studies of adults with intellectual or developmental disabilities as follows: dietary intake studies, anthropometric assessments of nutritional risks, biochemical indexes, and clinical evaluations.
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Affiliation(s)
- Kathleen Humphries
- University of Montana Rural Institute on Disabilities, Research Unit, Missoula, MT, USA.
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Chapman MJ, Craven MJ, Chadwick DD. Following up fighting fit: the long-term impact of health practitioner input on obesity and BMI amongst adults with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2008; 12:309-323. [PMID: 19074936 DOI: 10.1177/1744629508100557] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This article presents findings on the long-term impact of health practitioner input to reduce obesity amongst adults with intellectual disabilities. Body mass index (BMI) was measured for an input group (N = 33) and a comparison group (N = 40) 6 years after the input group first received input. Data on BMI were collected at baseline, 6 months, 1 year and 6 years. Mean BMI for the input group reduced steadily over 6 years. Mean BMI in the non-input group rose initially, stabilized and then decreased (although remaining higher than at baseline). The input group demonstrated improvements in obesity levels and lost more weight than the non-input group. However, the differences between groups did not reach statistical significance. This and the improvements in BMI within the non-input group may be due to the relatively small sample size, effect size and the impact of other local initiatives.
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