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Eating patterns among students with intellectual disabilities after a multifactorial school intervention using the plate model
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0002-0510-2458
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
Karolinska Institutet.
2013 (English)In: Journal of Policy and Practice in Intellectual Disabilities, ISSN 1741-1122, E-ISSN 1741-1130, Vol. 10, no 1, p. 45-53Article in journal (Refereed) Published
Abstract [en]

Adolescents with intellectual disabilities (ID) have an increased prevalence of being overweight and having cardiometabolic diseases as adults, in part due to poor eating habits with an inadequate intake of vegetables. The aim of this study was to evaluate whether a multifactorial school intervention using the "Plate Model" results in improved healthy food choices with recommended ≥37.5% of vegetables. Participants with mild/moderate intellectual disabilities from an intervention school (n=27) were compared with controls (n=62) from two other upper secondary schools for students with ID. All were offered a test buffet lunch with meatballs, potatoes, sauce, and eight different vegetables presented in identical bowls. Their servings and food intake were evaluated from digital images and video films. The majority (88%) of the total group filled their plate with ≥37.5% of vegetables. The mean energy intake did not differ between the groups (576kcal (min 196-max 1444)). The intervention participants had a lower intake of fat (21% (SD 6) vs. 24% (SD 7), p=031), a higher intake of carbohydrates (57% (SD 7) vs. 53% (SD 8), p=035), less plate waste (5 (SD 10) grams vs. 25 (SD 43) grams, p=021), and more participants took only one portion (56% vs. 32%, p=039) compared with the control group. The participants from the intervention school made healthier food choices. In this setting, most adolescents with ID ate a sufficient amount of vegetables.

Place, publisher, year, edition, pages
2013. Vol. 10, no 1, p. 45-53
Keywords [en]
Food habits, Intellectual disabilities, Observation, School intervention, Vegetables
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-18733DOI: 10.1111/jppi.12020ISI: 000316968100004Scopus ID: 2-s2.0-84875551932OAI: oai:DiVA.org:mdh-18733DiVA, id: diva2:615883
Available from: 2013-04-12 Created: 2013-04-12 Last updated: 2018-02-26Bibliographically approved
In thesis
1. Cardiometabolic health in students and young adults with mild/moderate intellectual disabilities: Results from a longitudinal follow-up study and a school intervention
Open this publication in new window or tab >>Cardiometabolic health in students and young adults with mild/moderate intellectual disabilities: Results from a longitudinal follow-up study and a school intervention
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background

Adults with intellectual disabilities (ID) develop the metabolic syndrome and cardiovascular disease morefrequently than individuals without ID. The knowledge about cardiometabolic risk factors in adolescentswith mild/moderate ID is scarce.

Aims

The aims were 1) to examine cardiometabolic health among adolescents with ID 2) to study the progressof cardiometabolic risk factors from adolescence to young adulthood among young adults with andwithout ID 3) to evaluate whether a health-promoting program in an upper secondary school for studentswith ID could reduce cardiometabolic risk factors 4) to evaluate whether the plate model pattern, inlayedin a specially designed lunch plate, increases vegetable intake.

Material and Methods

Sixty-six adolescents with mild/moderate ID, mean age 18.6y recruited from one upper secondary schoolfor students with ID (year 1-4) were investigated in a cross sectional study (Paper I). Controls were 90students without ID, mean age 17.8y, recruited from practical and theoretical programs at schools nearby.In the follow-up study five years later 35% (n=23) of the now young adults with ID and 33% (n =30)from the control group were re-investigated (Paper II). Measures were anthropometrics, blood pressure,DXA, fasting blood samples and a submaximal cardiovascular fitness test. The multifactorial schoolintervention was evaluated on last year students after two years of intervention (n = 11) and comparedwith their base-line data (Paper I) and with last year students in Paper I (Paper III). The special plate withthe plate model inlayed was evaluated in an observational study. The intervention group (n = 27) hadeaten on the special plate during school lunches for at least six months. The control group (n=62) wasrecruited from two other upper secondary schools for students with ID. Food intake was estimated fromvideo recordings and digital photos (Paper IV).

Results

Adolescents with ID had a higher prevalence and severity of cardiometabolic risk factors together withlow cardiovascular fitness compared to the control group. At follow-up as young adults (mean age 24.3)35% were classified as obese and 22% had developed the metabolic syndrome. Those without ID frompractical educational programs also developed cardiometabolic risk factors but they did not reach thesame level as the group with ID. After two years of school intervention cardiometabolic risk factors haddecreased and no one were obese. Evaluation of the special plate showed no difference in vegetableintake between intervention and control group. Eighty-eight percent ate ≥ 37.5% vegetables. Theintervention group chose food with a lower fat content and with more carbohydrates, had less plate wasteand took fewer portions.

Conclusions

Already during adolescence individuals with ID have more cardiometabolic risk factors than thosewithout ID and as young adults individuals with ID in this study has a cardiometabolic health andcardiovascular fitness similar to the Swedish middle-age population. Actions to promote healthy livinghabits during school hours including the use of the special plate were promising. This indicates that it isnot the ID condition itself but the effects ID has on the living conditions that causes the highcardiometabolic risk. Thus, the results in this thesis show that initiatives especially designed forindividuals with ID to promote healthier living habits are required and are likely to be effective.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet, 2013. p. 79
Keywords
Intellectual disabilities; cardiometabolic health; school intervention; food habits; physical activity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mdh:diva-18739 (URN)978-91-7549-052-6 (ISBN)
Public defence
2013-02-22, Hörsal M 41, Karolinska Universitetssjukhuset, Huddinge, Stockholm, 13:24 (Swedish)
Opponent
Supervisors
Available from: 2013-04-15 Created: 2013-04-15 Last updated: 2015-11-13Bibliographically approved

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