Obesity & Down Syndrome

Obesity – How and why does it affect persons with Down syndrome? By Rosette Gatt

(Manager for Programme for Individuals with Intellectual Disabilities and Specific Learning Difficult at The Inspire Foundation)

Every year people with Down’s Syndrome, their families and, people who work with them, do their utmost to raise awareness about the genetic condition that affects 1 in every 800 live births. This year, the main focus around the world is promoting a healthier and active lifestyle, throughout the ages. In this article we will be looking at how the physiological and behavioural aspects of this syndrome, place these individuals at an increased risk for obesity and what we can do about it.

 

Down syndrome is a genetic condition that causes delays in physical and intellectual development. It
occurs in one in every 800 live births and is not related to race, nationality, religion or socio-economic
status. The most important fact to know about individuals with Down syndrome is that they are more
like others than they are different. This syndrome is usually identified at birth or shortly thereafter. The
diagnosis is based on physical characteristics that are seen in new born babies, accompanied by genetic
testing. Down syndrome also carries health complications that affect most individuals, however, with
appropriate medical care and an active life-style, most individuals can lead healthy lives. Nowadays the
average life expectancy of individuals with Down syndrome is 55 years, with many living into their sixties
and seventies.

Early childhood intervention, screening for medical problems, a sound and caring family environment,
proper individualized education programmes and a supportive community can all improve the quality of
life.

Recent research is showing that as much as 30 to 50 % of children with Down syndrome are obese.
Specific associated health and behavioural concerns in the individual with Down syndrome foster the
development of obesity. A prevention and management plan needs to be mapped for each individual to
avoid negative consequences.

Weight-gain is mostly due to the implications that Down Syndrome has on the individual. These are :

1. Physical characteristics – mainly short stature and hypotonic musculature also affecting
ligaments, joints, hips, knees, pelvis and the spine.

2. Health concerns such as cardiac defects, thyroid function disorders, a decreased basal metabolic
rate, gastro-intestinal tract anomalies, sleep apnea and sight defects.

3. An inadequate diet because of dental problems, poor oral musculature and oral sensitivity.

4. Behavioural difficulties such as oppositional behaviour, impulsivity, negativity and non-compliance

All of these factors affect:
– Exercise – A sedentary life style – Individuals with Down syndrome are less vigorous and attend
to less intensive exercise routines because of lack of coordination and efficiency that causes low
motivation for participation in physical activities and a tendency to stop when uncomfortable.
They also tend to lead an inactive life-style – not going out, not having friends, not having
hobbies and last but not least not having a job and not having a scope in life.

– The diet – Because of gastro-intestinal tract anomalies and poor oral musculature and difficulty
with chewing raw fruit and vegetables as well as difficulty with swallowing, children tend to eat
softer foods which are usually higher in carbohydrates, cholesterol, sugars and fats.

– Behaviour – Opposition to eating a more nutritious diet, attempting an exercise routine and
adopting a healthy life-style is reported in many children with Down syndrome.

Everyone benefits from exercise! Exercise improves general health. For individuals with Down
Syndrome, regular physical activity has a direct impact on health and well-being. The individual with
Down Syndrome can participate at most forms of physical activities, however prior to starting a
healthier life style, certain aspects have to be looked into.

The trainer must first seek the recommendations stated by a Medical Doctor. This needs to include the
effect and restrictions that the health implications mentioned above are having on the individual as well
as any medication that is being administered and any effects that this has on the person. A psychological
report must also offer recommendations as to any communication or behavioural techniques that the
individual will need during the training. One must also consider the need for more personalized support.
Initially activities need to be easy, enjoyable and pain free.

Recommended exercise regimes and nutrition-based interventions are crucial to prevent and reduce
excessive weight-gain. Exercise recommendations should include aerobic training and musclestrengthening programmes that start at the individual’s level and gradually increase in intensity.Nutritional recommendations include oral health follow-ups, decreasing caloric intake and attending behavior management programmes to also address parental control over feeding practices.

When an individual with Down Syndrome is working out as a part of a group, the instructor needs to
look at adapting to the needs of the individual by looking at the environment, the exercise itself, the
equipment to be used and at adapting the rules of the game and the scope of the competition [reaching
a target for oneself as opposed to winning]

Individuals with Down syndrome can be supported when parents / carers:

– Make healthy habits a priority and talk about the benefits of these. Encourage regular physical activities by going on active family outings.
– Control how much time family members spend in front of a television, computer or video game.
It is suggested that children spend no more than 2 hours a day in front of a television.
– Enroll their children at a sport that the child likes best or chooses.
– Attend any sport activities that the children are participating in.
– Advocate for more sports activities in their schools and communities
– Work together with their local council in campaigning for the setting up of inclusive recreational
areas, health and fitness facilities, sports’ clubs.
– Advocate for more sports activities in their schools and communities
– Work together with their local council in campaigning for the setting up of inclusive recreational
areas, health and fitness facilities, sports’ clubs.

Healthy Life styles for all!
Parents do not have to become athletes to be role models for their children. Individuals with Down
Syndrome can also participate and contribute to healthy choices at home. Benefits of leading a healthy
life-style can include gains in mental and physical well-being as well as improved self-esteem and better
social skills. Exercise can also reduce the risk of chronic and secondary conditions.

Having fun while being active is the key to success!
Parents know their children best. When starting working with your children gear the activities according
to their age and ability. When carried out regularly, you will see that you all build on your strength and
are doing more than thought possible.

Rosette Gatt can be contacted on rosette.gatt@inspire.org.mt