EE values were 10% lower in Down syndrome patients compared with normal babies. Neonatal heartbeats were also found to be lower in Down syndrome babies (6 beats less per min on an average). The researchers found that REE was 14% lesser than healthy infants of comparable age. [Jacqueline et.al, 2003] more recent study aimed at understanding the differences in weight among normal people and the intellectually disabled population was conducted by the Leicestershire NHS Partnership Trust and the Department of health. This was an extensive study which included 1119 ID subjects registered in the Leicestershire database and comapred their BMI data with non-intellectualy disabled subjects in the region. The data obtained indicated that among those aged 20 and above, the prevelance rates for obesity, overweight, normal weight, and underweight were 20.7%, 28%, 32.7% and 18. 6% respectively. From the data that was gathered it was clear that obesity was positively associated with downs syndrome and being a female was a high risk factor. Also, the researchers found absence of Down's syndrome as a clear factor in the case of underweight conditions. This research further confirmed that having down's syndrome predisposes one to obesity. [Sabyasachi Bhaumik et.al, 2007]
Obesity Screening and Health promotion Impact recent study in northern ireland was undertaken to identify the effect of screening programs and other health intervention programs for intellectually disabled people. Screening programs were conducted by 2 disability nurses for around 464 people aged over 10 years and attending special services in the region. It was found that around 64% of adults and 26% of those between 10 and 19 were either overweight or obese.
However, a follow up survey after 3 months indicated that of the 122 people identified and recommended for weight reduction programs only 34% participated in the program and only 3 among them achieved weight reduction. This study pointed out that screening programs by themselves are ineffective without any followup. In case of people with intellectual disabilities like Down's syndrome, obesity presents a huge problem and a collaborative effort is required for effective health promotion. [Marshall D. et.al, 2003]
Outcome for fitness and health education programs were effective among Down syndrome patients in Heller et.al (2004). In a randomised trial of 53 subjects, (29 females and 24 males) 32 subjects were randomly assigned to the program group while 21 subjects were in the control group. After the completion of a 12-week at 3 days per week training program, the subjects showed significant improvement in self-efficacy, expressed increased interest in exercise programs, displayed cognitive improvements, decreased depression levels and an overall improvement in positive outcomes. [Heller, 2004]
Down's syndrome is a common chromosomal disorder and a debilitating one. Asides the cognitive impariments, the disorder also causes obesity, another major health concern. With majority of the down syndrome population falling into overweight or obese conditions, the consequent health issues assume great significance. Background obesity is thus a huge problem in patients with intellectual disabilities, and in particular, Down's syndrome. Some of the studies reviewed above also showed a greater predisposition among females than males in contracting obesity due to Down's sydnrome. Though there is considerable amount of research devoted to obesity or Down syndrome seperately there is a dearth of research when it comes to studying the association between them. Some studies have been more generalized discussing the whole spectrum of Intellectual disabilities and obesity. The few studies which have been specifically devoted to Down's syndrome and its relation to obesity have so far indicated a positive correlation between them. More research is required to identify the causes that result in the onset of obesity among such intellectually disabled patients. The recent research that identified Leptin resistance as the main cause for obesity among Down syndrome patients is a positive breakthrough in the research on down syndrome. Very soon, pharmacological interventions would be targetted at rectifying this leptin resistance and then obesity may cease to be a coexisting condition. However, that would necesitate a better understanding of the molecular mechanics behind leptin resistance.
In future, with the advancements in genomic science and stem cell therapy it would be possible to completely cure this genetic disorder but such a cure remains a distant dream at this moment. Until such time it is necessary to provide better interventions and support to the affected people. Weight management interventions constitute an important aspect in the management of down's syndrome and other related intellectual disabilities. Inorder to provide more effective treatment and better services to such patients there is a necessity for professionals representing these different fields to work together. Only such a coordinated effort from professionals from the fields of Obesity and intellectual disabilities would provide the necessary expertise and ensure quality care provision for the patients suffering from such debilitating health conditions.
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3) Sheela N. Magge, Kristen L. O'Neill, Justine Shults, Virginia a. Stallings, Nicolas Stettler, 2007, 'Leptin Levels among Prepubertal Children with Down Syndrome Compared with Their Siblings', the Journal of Pediatrics
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