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High prevalence of cardio-metabolic risk factors among adolescents with intellectual disability
Mälardalen University, School of Health, Care and Social Welfare. Karolinska Institutet, Stockholm, Sweden.
Mälardalen University, School of Health, Care and Social Welfare.ORCID iD: 0000-0002-0510-2458
Mälardalen University, School of Health, Care and Social Welfare. Karolinska Institutet, Stockholm, Sweden.
Karolinska Institutet, Stockholm, Sweden.
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2009 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 98, no 5, p. 853-859Article in journal (Refereed) Published
Abstract [en]

Abstract Adults with intellectual disabilities (IDs) have poor lifestyle-related health compared with the general population. Our aim was to study whether such differences are present already in adolescents. Aim: To compare the prevalence and severity of cardio-metabolic risk factors and cardio-vascular fitness in adolescents with and without IDs. Methods: Intellectual disability (ID) students (n = 66) and non-intellectual disability (non-ID) students from practical (non-ID-p) (n = 34) and theoretical (non-ID-t) (n = 56) programmes were recruited from three upper secondary schools. Anthropometric data, blood pressure, body composition, fasting-insulin, fasting-glucose, fasting-lipids and cardio-vascular fitness were measured. Results: Participants with and without ID differed significantly in the prevalence of cardio-metabolic risk factors with participants with ID having a higher percentage of total fat mass, wider waist circumferences (WCs), lower levels of fat-free mass (FFM), lower bone mineral density (BMD) and higher insulin and homeostasis model assessment of insulin resistance (HOMA) levels and poorer cardio-vascular fitness. The healthiest levels were found in the non-ID-t group compared to the group with ID and the group with non-ID-p in between. Conclusion: The prevalence of cardio-metabolic risk factors and poor cardio-vascular fitness was found to be high in this young population with intellectual disabilities. Measures should be taken to improve the health messages directed towards children and adolescents with intellectual disabilities.

Place, publisher, year, edition, pages
2009. Vol. 98, no 5, p. 853-859
Keywords [en]
Cardiorespiratory fitness; Cross-sectional study; Learning disability; Metabolic Risk factors; Youth
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-5000DOI: 10.1111/j.1651-2227.2008.01197.xISI: 000264878100019PubMedID: 19183118Scopus ID: 2-s2.0-64149115562OAI: oai:DiVA.org:mdh-5000DiVA, id: diva2:159815
Available from: 2009-02-10 Created: 2009-02-10 Last updated: 2017-12-14Bibliographically 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)
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Available from: 2013-04-15 Created: 2013-04-15 Last updated: 2015-11-13Bibliographically approved

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