Comparing the effectiveness of a multi-component weight loss intervention in adults with and without intellectual disabilities.

BACKGROUND: The prevalence of obesity in adults with intellectual disabilities (ID) is rising, although the evidence base for its treatment in this population group is minimal. Weight management interventions that are accessible to adults with ID will reduce the inequalities that they frequently experience in health services. This short report compared the effectiveness of weight management in those with and without ID who completed nine sessions of a multi-component weight management programme. METHODS: TAKE 5 is a 16-week multi-component weight management intervention for adults with ID and obesity [body mass index (BMI) ≥30 kg m(-2) ]. This intervention is an adaption of the weight management programme provided by the Glasgow & Clyde Weight Management Service (GCWMS) for adults without ID and obesity (National Health Service based). Fifty-two participants of the TAKE 5 programme were individually matched by baseline characteristics (sex, age and BMI) with two participants without ID of the GCWMS programme. Comparisons in terms of weight and BMI change and rate of weight loss were made for those who attended all nine sessions. RESULTS: There were no significant differences between the groups in the amount of weight loss (median: -3.6 versus -3.8 kg, respectively, P = 0.4), change in BMI (median: -1.5 versus -1.4 kg m(-2) , P = 0.9), success of achieving 5% weight loss (41.3% versus 36.8%, P = 0.9) and rate of weight loss across the 16-week intervention. CONCLUSIONS: A multi-component weight loss intervention can be equally effective for adults with and without ID and obesity.

Carers' perspectives of a weight loss intervention for adults with intellectual disabilities and obesity: a qualitative study.

BACKGROUND: To date, no studies have explored the role of carers in supporting adults with intellectual disabilities (ID) and obesity during a weight loss intervention. The present study explored perceptions of carers supporting adults with ID, as they participated in a 6-month multi-component weight loss intervention (TAKE 5). METHODS: Semi-structured interviews were used to explore the experiences of 24 carers. The transcripts were analysed qualitatively using thematic analysis. RESULTS: Three themes emerged from the analysis: carers' perceptions of participants' health; barriers and facilitators to weight loss; and carers' perceptions of the weight loss intervention. Data analysis showed similarities between the experiences reported by the carers who supported participants who lost weight and participants who did not. Lack of sufficient support from people from the internal and external environment of individuals with ID and poor communication among carers, were identified as being barriers to change. The need for accessible resources tailored to aid weight loss among adults with ID was also highlighted. CONCLUSION: This study identified specific facilitators and barriers experienced by carers during the process of supporting obese adults with ID to lose weight. Future research could utilise these findings to inform appropriate and effective weight management interventions for individuals with ID.

The habitual meal and snacking patterns of university students in two countries and their use of vending machines.

BACKGROUND: Dietary patterns and food choices in western and northern European countries can differ from those in countries that surround the Mediterranean basin. However, irregular meal patterns and the consumption of high-energy snacks tend to become common in most countries and their association with the prevalence of obesity has been examined in many studies. The first aim of the present study was to describe the habitual meal and snack intakes, including the use of vending machines, for two groups of first-year university students in two countries of different cultural backgrounds. The second aim was to explore the relationships between body mass index (BMI) and snacking for these two groups. METHODS: One hundred and sixty first-year undergraduate university students from two defined universities in Greece (n = 80) and Scotland (n = 80) volunteered to complete a food frequency questionnaire (FFQ). The FFQ comprised 16 questions assessing their meal and snacking habits. Self-assessed height and weight data were collected. RESULTS: The majority of the 160 students reported a BMI in the healthy range (<25 kg m(-2)). Overall, 26% of the students reported never consuming breakfast. More Scottish students (74%) used vending machines (P < 0.05). More Scottish students consumed chocolate bars and crisps than Greek students (41% and 34% versus 37.5% and 20%, respectively). Only the choice of chocolate bars from vending machines and the consumption of crisps and low fat yogurts were related to BMI (P < 0.05) for both groups. CONCLUSIONS: University students living in different countries report similar dietary patterns but differ in their snacking habits. No relationships were found between BMI and snacking. There is a need to carry out research to further our understanding of this relationship.

The effectiveness of smoking cessation methods for smokers in public health maternity clinics: a randomized trial.

Little insight is available in the literature on how best to assist the pregnant smoker in public health maternity clinics to quit during pregnancy. A randomized pretest/posttest experiment was used to evaluate the effectiveness of two different self-help cessation methods. Three hundred and nine pregnant women from three public health maternity clinics were assigned randomly to one of three groups with one-third assigned to each: a control group; a group receiving the American Lung Association's Freedom From Smoking Manual; and those receiving A Pregnant Woman's Self-Help Guide to Quit Smoking. Using a saliva thiocyanate (SCN) and behavioral report at mid-pregnancy and end of pregnancy to confirm cessation or reduction, 2 per cent in the control group quit and 7 per cent reduced their SCN levels substantially. Of the women assigned to the ALA method, 6 per cent quit and 14 per cent reduced their SCN levels substantially. Of the women who used the Guide, 14 per cent quit and 17 per cent reduced their SCN levels substantially. Results of this trial indicate that health education methods tailored to the pregnant smoker are more effective in changing smoking behavior than the standard clinic information and advice to quit and/or the use of smoking cessation methods not tailored to the needs of the pregnant smoker.