Dataset Information

A randomized trial comparing diet and delivery strategies for weight management in adolescents with intellectual disabilities.

ABSTRACT:

Background

The literature evaluating multi-component interventions for long-term weight loss in adolescents with intellectual disabilities (ID) is extremely limited.

Objectives

To compare the effectiveness of two delivery strategies, face-to-face (FTF) or remote delivery (RD), and two diets, enhanced Stop Light diet (eSLD) or conventional diet (CD) on weight change across 12 and 18 months. in response to an 18 months. weight management intervention (6 months Weight loss/12 months. Weight maintenance) in adolescents with ID.

Methods

Adolescents with ID were randomized to one of three arms: FTF /CD, RD/CD, RD/eSLD and asked to attend individual education sessions with a health educator which were delivered during FTF home visits or remotely using video conferencing. The CD followed the US dietary guidelines. The eSLD utilized the Stop Light guide and was enhanced with portion-controlled meals. Participants were also asked to increase their physical activity (PA) and to self-monitor diet, PA and body weight across the 18-month.

Intervention

Results

Weight was obtained from 92(84%) and 89(81%) randomized adolescents at 12 and 18 months, respectively. Weight change across 12 months. Differed significantly by diet (RD/eSLD: -7.0% vs. RD/CD: -1.1%, p = 0.002) but not by delivery strategy (FTF/CD: +1.1% vs. RD/CD: -1.1%, p = 0.21). Weight change across 18 months. Was minimal in all intervention arms and did not differ by diet (RD/eSLD: -2.6% vs. RD/CD: -0.5%; p = 0.28) or delivery strategy (FTF/CD: +1.6% vs. RD/CD: -0.5%; p = 0.47).

Conclusions

Additional research is required to identify effective strategies to improve long-term weight loss in adolescents with ID.

SUBMITTER: Ptomey LT

PROVIDER: S-EPMC9940267 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

A randomized trial comparing diet and delivery strategies for weight management in adolescents with intellectual disabilities.

Ptomey Lauren T LT Washburn Richard A RA Goetz Jeannine R JR Sullivan Debra K DK Gibson Cheryl A CA Mayo Matthew S MS Krebill Ron R Gorczyca Anna M AM Honas Jeffery J JJ Rice Anna M AM Helsel Brian C BC Lee Robert H RH Donnelly Joseph E JE

Pediatric obesity 20220821 1

<h4>Background</h4>The literature evaluating multi-component interventions for long-term weight loss in adolescents with intellectual disabilities (ID) is extremely limited.<h4>Objectives</h4>To compare the effectiveness of two delivery strategies, face-to-face (FTF) or remote delivery (RD), and two diets, enhanced Stop Light diet (eSLD) or conventional diet (CD) on weight change across 12 and 18 months. in response to an 18 months. weight management intervention (6 months Weight loss/12 months. ...[more]

PMID: 36054481

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Project description: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.

Project description:BackgroundPrevious research indicates that individuals with intellectual and developmental disabilities (IDDs) are at risk for poor diet quality.ObjectiveThe purpose of this secondary analysis was to determine whether two different weight-loss diets affect energy intake, macronutrient intake, and diet quality as measured by the Healthy Eating Index-2010 (HEI-2010) during a 6-month weight-loss period and 12-month weight-management period, and to examine differences in energy intake, macronutrient intake, and HEI-2010 between groups.DesignOverweight/obese adults with IDDs took part in an 18-month randomized controlled trial and were assigned to either an enhanced Stop Light Diet utilizing portion-controlled meals or a conventional diet consisting of reducing energy intake and following the 2010 Dietary Guidelines for Americans. Proxy-assisted 3-day food records were collected at baseline, 6 months, and 18 months, and were analyzed using Nutrition Data System for Research software. HEI-2010 was calculated using the data from Nutrition Data System for Research.Participants/settingThe study took place from June 2011 through May 2014 in the greater Kansas City metropolitan area.Main outcome measuresThis was a secondary analysis of a weight-management intervention for adults with IDDs randomized to an enhanced Stop Light Diet or conventional diet, to examine differences in energy intake, macronutrient intake, and HEI-2010 across time and between groups.Statistical analyses performedIndependent- and paired-samples t tests and general mixed modeling for repeated measures were performed to examine group differences and changes at baseline, 6 months, and 18 months between the enhanced Stop Light Diet and conventional diet groups.ResultsOne hundred and forty six participants (57% female, mean±standard deviation age=36.2±12.0 years) were randomized to either the enhanced Stop Light Diet or conventional diet group (77 enhanced Stop Light Diet, 69 conventional diet) and provided data for analysis at baseline, 124 completed the 6-month weight-loss period, and 101 completed the 18-month study. Participants on the enhanced Stop Light Diet diet significantly reduced energy intake at 6 and 18 months (both P<0.001), but those on the conventional diet did not (both P=0.13). However, when accounting for age, sex, race, education level, and support level (mild vs moderate IDD), there was a significant decrease during the 18-month intervention in energy intake for the enhanced Stop Light Diet and conventional diet groups combined (P<0.01 for time effect), but no significant group difference in this change (P=0.39 for group-by-time interaction). There was no significant change in total HEI-2010 score at 6 and 18 months (P=0.05 and P=0.38 for the enhanced Stop Light Diet group; P=0.22 and P=0.17 for the conventional diet group), and no significant group difference at 6 and 18 months (P=0.08 and P=0.42). However, when participants' age, sex, race, education level, and support level were accounted for, mixed modeling indicated a significant increase in total HEI-2010 scores for the enhanced Stop Light Diet and conventional diet groups combined during the 18-month intervention (P=0.01 for time effect).ConclusionsThe results of this study found that after controlling for demographic factors, individuals with IDDs can decrease their energy intake and increase their diet quality, with no significant differences between the enhanced Stop Light Diet and conventional diet groups.

Project description:BackgroundAdolescents and young adults with intellectual and developmental disabilities (IDD) have high rates of obesity and low levels of physical activity. This analysis examined changes in light, moderate-to-vigorous physical activity (MVPA) and sedentary time, and the association between changes in MVPA and weight loss in adolescents and young adults with IDD and overweight and obesity participating in a 6-month multi-component weight loss intervention.MethodsAdolescents and young adults with IDD and overweight or obesity (body mass index ≥ 85 percentile, n = 110, age ~16 years, 52.7% female) and a parent were randomised to one of three intervention groups: face-to-face delivery/conventional reduced energy diet (n = 36), remote delivery (RD)/conventional reduced energy diet (n = 39), or RD/reduced energy enhanced stop light diet (eSLD) (n = 35.) Participants were asked to engage in 60 min/day of MVPA on 5 or more days/wk. Participants and a parent attended twice monthly education/behavioural counselling sessions with a health educator to assist participants in complying with dietary and MVPA recommendations. Education/counselling in the RD arms was delivered remotely using video conferencing, and self-monitoring of MVPA and daily steps was completed using a wireless activity tracker. Education/counselling in the face-to-face arm was delivered during home-visits and self-monitoring of MVPA and daily steps was completed by self-report using paper tracking forms designed for individuals with IDD. MVPA, light activity, and sedentary time were assessed over 7 days at baseline and 6 months using a portable accelerometer (ActiGraph wGT3x-BT).ResultsMixed modelling analysis completed using participants with valid accelerometer data (i.e. ≥4-10 h days) at baseline (n = 68) and 6 months (n = 30) revealed no significant changes in light, moderate- MVPA, or sedentary time across the 6-month intervention (all P > 0.05). Participants obtained 15.2 ± 21.5 min/day of MVPA at baseline and 19.7 ± 19.7 min/day at 6 months (P = 0.119). Mixed modelling indicated no significant effects of group (P = 0.79), time (P = 0.10), or group-by-time interaction (P = 0.21) on changes in MVPA from baseline to 6 months. Correlational analysis conducted on participants with valid accelerometer data at both baseline and 6 months (n = 24) revealed no significant associations between baseline sedentary time (r = 0.10, P = 0.40) and baseline MVPA (r = -0.22, P = 0.30) and change in MVPA across the 6-month intervention. Additionally, attendance at education/counselling sessions (r = 0.26, P = 0.22) and frequency of self-monitoring of MVPA were not significantly associated with change in MVPA from baseline to 6 months (r = 0.26, P = 0.44). Baseline MVPA (r = 0.02, P = 0.92) and change in MVPA from baseline to 6 months (r = 0.13, P = 0.30) were not associated with changes in body weight across the 6-month intervention.ConclusionWe observed a non-significant increase in MVPA (30%), which was not associated with the magnitude of weight loss in a sample of adolescents and young adults with IDD who participated in a 6-month multi-component weight loss intervention. Additional strategies to increase MVPA in adolescents and young adults with IDD participating in weight loss interventions need to be developed and evaluated.

Project description:BackgroundLittle is known about the relationship between disability and mode of delivery. Prior research has indicated elevated risk of cesarean delivery among women with certain disabilities, but has not examined patterns across multiple types of disability or by parity.ObjectiveThis study sought to determine whether physical, sensory, or intellectual and developmental disabilities are independently associated with primary cesarean delivery.MethodsWe conducted a retrospective cohort study of all deliveries in California from 2000 to 2010 using linked birth certificate and hospital discharge data. We identified physical, sensory, and intellectual and developmental disabilities using International Classification of Diseases, 9th revision, clinical modification codes. We used logistic regression to examine the association of these disabilities and primary cesarean delivery, controlling for sociodemographic characteristics and comorbidities, and stratified by parity.ResultsIn our sample, 0.45% of deliveries (20,894/4,610,955) were to women with disabilities. A greater proportion of women with disabilities were nulliparous, had public insurance, and had comorbidities (e.g., gestational diabetes) compared with women without disabilities (p < .001 for all). The proportion of primary cesarean in women with disabilities was twice that in women without disabilities (32.7% vs. 16.3%; p < .001; adjusted odds ratio, 2.05; 95% confidence interval, 1.94-2.17). The proportion of deliveries by cesarean was highest among women with physical disabilities due to injuries compared with women without disabilities (57.8% vs. 16.3%; p < .001; adjusted odds ratio, 6.83; 95% confidence interval, 5.46-8.53).ConclusionsWomen across disability subgroups have higher odds of cesarean delivery, and there is heterogeneity by disability type. More attention is needed to this population to ensure better understanding of care practices that may impact maternal and perinatal outcomes.

Dataset Information

A randomized trial comparing diet and delivery strategies for weight management in adolescents with intellectual disabilities.

Background

Objectives

Methods

Intervention

Results

Conclusions

Publications

A randomized trial comparing diet and delivery strategies for weight management in adolescents with intellectual disabilities.

Similar Datasets

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