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Randomized Controlled Trial
. 2023 Jan;18(1):e12972.
doi: 10.1111/ijpo.12972. Epub 2022 Aug 21.

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

Lauren T Ptomey  1 , Richard A Washburn  1 , Jeannine R Goetz  2 , Debra K Sullivan  2 , Cheryl A Gibson  1 , Matthew S Mayo  3 , Ron Krebill  3 , Anna M Gorczyca  1 , Jeffery J Honas  1 , Anna M Rice  1 , Brian C Helsel  1 , Robert H Lee  4 , Joseph E Donnelly  1
Affiliations
Randomized Controlled Trial

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

Lauren T Ptomey et al. Pediatr Obes. 2023 Jan.

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.

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.

Keywords: autism; body composition; down syndrome; physical activity; weight loss; youth.

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Figures

FIGURE 1
FIGURE 1
Consort diagram
FIGURE 2
FIGURE 2
Percent change in weight in adolescents with intellectual disabilities across 12 and 18-months. FTF/CD = Face-to-face Delivery/Conventional Diet, RD/CD = Remote Delivery/Conventional Diet, RD/eSLD = Remote Delivery/Enhanced Stop Light Diet
FIGURE 3
FIGURE 3
Individual data for percent weight change in adolescents with intellectual disabilities across 12 and 18-months. Panel A: 0–12 months, Panel B: 0–18 months. FTF/CD = Face-to-Face Delivery/Conventional Diet, RD/CD = Remote Delivery/Conventional Diet, RD/eSLD = Remote Delivery/Enhanced Stop Light Diet
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