Dual-Energy X-Ray Absorptiometry to Measure the Effects of a Thirteen-Week Moderate to Vigorous Aquatic Exercise and Nutritional Education Intervention on Percent Body Fat in Adults with Intellectual Disabilities from Group Home Settings

Abstract

People with intellectual disability are more likely to be obese and extremely obese than people without intellectual disability with rates remaining elevated among adults, women and individuals living in community settings. Dual-energy X-ray absorptiometry measured the effects of a 13-week aquatic exercise and nutrition intervention on percent body fat in eight adults with intellectual disabilities (aged 41.0 ± 13.7 yrs) of varying fat levels (15%–39%) from two group homes. A moderate to vigorous aquatic exercise program lasted for the duration of 13 weeks with three, one-hour sessions held at a 25m pool each week. Nutritional assistants educated participants as to the importance of food choice and portion size. A two-tailed Wilcoxon matched-pairs signed-ranks test determined the impact of the combined intervention on body fat percentage and BMI at pre and post test. Median body fat percentage (0.8 %) and BMI (0.3 kg/m2) decreased following the exercise intervention, but neither were statistically significant, p = .11 and p = .55, respectively. The combined intervention was ineffective at reducing percent body fat in adults with intellectual disability according to dual-energy X-ray absorptiometry. These results are in agreement with findings from exercise alone interventions and suggest that more stringent nutritional guidelines are needed for this population and especially for individuals living in group home settings. The study did show that adults with intellectual disability may participate in moderate to vigorous physical activity when given the opportunity.

Efecto del Ejercicio en el Medio Acuático sobre la Aptitud Física en Personas con Discapacidad Intelectual: Una Revisión Sistemática

“…Los estudios se desarrollaron en España, Canadá, Estados Unidos y Turquía. 2 estudios evaluaron a niños y adolescentes (edad = 13.1 ± 3.4 años; n = 24) (Casey et al, 2010;Yilmaz et al, 2009), mientras que 3 analizaron a adultos (edad = 38.5 ± 10.2 años; n = 44) (Ayán et al, 2018;Casey et al, 2012;Hakim et al, 2017). El nivel de discapacidad intelectual fue reportado en los estudios que examinaron adultos y se reporta como leve (n = 3), moderada (n = 12) y severa (n = 5).…”

Comorbid Conditions in Individuals with Intellectual Disabilities

“…As such, individuals with ID are likely to have eating dysfunctions (Hove 2004) and make unhealthy eating choices when unsupervised, including consuming insufficient micronutrients (Adolfsson et al 2008) and eating excessively throughout the day (Bertoli et al 2006;Starr and Mardsen 2008). Indeed, foods with higher energy density including many rich in fats, extracted sugars and refined starches are being eaten in large quantities on a reoccurring basis with such items often being used as a reward for good behavior (Casey et al 2012). The daily diet of individuals with ID who live in group home settings has also been shown to include nutrient-poor foods and dietary fats while staff supporting individuals with ID may not have the requisite knowledge or training with regards to food and nutrition (Humphries et al 2004).…”

“…Several studies have adopted healthy lifestyle components for adults and children with ID, that seek to promote health education through various educational techniques and different methods of physical activity (Bergstrom et al 2013;Bradley 2005;Casey et al 2012;Chapman et al 2005;Croce 1990). For example, combined physical activity sessions with health promotion class sessions centered on teaching children with ID about healthy eating in a motivational climate.…”

“…However, it is evident that not all multicomponent studies have provided a significant decrease in BMI, waist circumference or body fat (Bergstrom et al 2013;Casey et al 2012;Ewing et al 2004;. Certain interventions have also increased obsessive compulsive behavior (Descheemaeker et al 1994) and failed to reduce anxiety amongst youth with Prader-Willi syndrome (Messersmith et al 2008) …”

“…Some have emphasized a lack of stringent study design and follow-up (Wu 2010), small heterogeneous sample sizes (Bertoli et al 2006;Casey et al 2010Casey et al , 2012Messersmith et al 2008) as well as inconsistent methods of measurement (Ozmen et al 2008). Spanos et al (2013) suggest that clinical guidelines recommending exercise training interventions include 225-300 mins of moderate activity per week in order to treat obesity have seldom been met (National Institute for Health and Clinical Excellence 2006).…”