Exploring the effectiveness of an 18-month weight management intervention in adults with Down syndrome using propensity score matching.
L T Ptomey, E A Willis, J R Sherman and 2 others
PMID 31944472WHAT IT FOUND
Adults with Down syndrome lost similar weight to those with other intellectual disabilities during an 18-month diet and activity program.
Both groups achieved clinically significant weight loss, but physical activity did not increase, especially in those with Down syndrome.
Key findings
01Participants with Down syndrome lost 4.7 kg (5.2%) at 18 months, which was not significantly different from the 7.1 kg (6.8%) lost by the comparison group.
02Moderate-to-vigorous physical activity did not increase over the study; it was significantly lower in the Down syndrome group at 6, 12, and 18 months compared to controls.
03The weight loss achieved exceeded the 3-5% threshold associated with health benefits like reduced risk of type 2 diabetes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was small (n=40 after matching), and the original trial was not powered to detect differences between the Down syndrome and non-Down syndrome groups. Energy intake was measured using 3-day food records, which are prone to underreporting and may not accurately reflect long-term intake. Physical activity was self-monitored with pedometers during the intervention but measured by accelerometer only at specific time points; the lack of increase in activity suggests the intervention's strategy for promoting exercise was ineffective. Propensity score matching could not control for all potential confounding variables, such as specific living situations or unobserved health factors.
Declared interests
The authors declared no conflicts of interest. The study was supported by the National Institutes of Health.
The easy way to misread this
Do not assume that standard advice to 'walk more' will increase physical activity in adults with Down syndrome. The study found that moderate-to-vigorous activity did not increase and remained significantly lower than in the comparison group, likely due to gait and stability challenges inherent to the condition.