Physical Activity and Nutritional Behaviors in Adults with
Intellectual Disabilities
Carolyn Apfelbach, Emily Behrens, Devin Schoen, Kimberly Schumacher, Kelsey Sparks
Faculty Mentors: Dr. Saori Braun, and Dr. Marquell Johnson
Department of Kinesiology, University of Wisconsin- Eau Claire
ABSTRACT
Background: Current research suggests this population has a high rate of
obesity, physical inactivity, and poor fruit and vegetable intake; yet, no
study has examined the interaction of these three components. Purpose:
This study examines the physical activity (PA) and fruit and vegetable
intake of adults with intellectual disabilities to determine if they meet the
current recommendations and their impact on obesity. Methods: A total
of 6 adults with intellectual disability ages 18+ years residing in Western
Wisconsin have been recruited. Anthropometric information (body mass
index and waist circumference) was recorded for measures of obesity,
and a demographic questionnaire was completed by each participant.
Subjective accounts of fruit and vegetable intake and PA was taken twice
(pre- and post-activity monitoring) via questionnaires. PA was
objectively measured using an accelerometer (Actical) for 7 consecutive
days. The Actical device was exchanged on day 3 and day 5 of the
monitoring period and collected on day 8. Results: It was observed that
50% of participants do not meet the PA recommendations 83.3% do not
meet recommended steps per day, 100% do not consume at least 5 cups
of fruits and vegetables per day, and the majority over report their
participation in PA.
METHODS
STATISTICAL ANALYSIS
Subjects
Data analyzed using IBM SPSS version 19.0
Descriptive statistics was used to determine the mean and standard deviation of
the baseline characteristics of the subjects including age, height, weight, BMI and
waist circumference.
An intraclass correlation coefficient was calculated to ensure consistency
between pre- and post- PA and nutrition questionnaire responses
6 adults with intellectual disability, age 18 and older
Participants recruited via PA and Recreation for Individuals with
Disabilities in the Eau Claire area for Adults Program (PRIDE4Adults),
county Offices of Developmental Disabilities Services, area Arc offices in
Western Wisconsin, and private and state operated assisted living
programs.
Exclusion criteria: Not capable of remembering to properly wear the
Actical for 7 consecutive days.
Informed consent gathered according to IRB guidelines at UW-Eau Claire.
Instrumentation
Objective PA data was measured via and Actical accelerometer device. It
was worn aligned with the right hip and when worn properly the word
“Actical” was upright and facing out.
RESULTS
Table 1 presents the participant characteristics including their BMI classification
and risk classification from waist circumference.
Table 2 presents the mean responses and measurements of PA (minutes per week
and steps per day) and fruit and vegetable intake.
Table 2: Mean Physical Activity and Nutrition
Self-Report PA* (min/week)
Actical PA* (min/week)
Actical PA* (steps/day)
Fruit and Vegetables (cups/day)
267.50 ± 150.26
147.42 ±119.28
7055.00 ±3409.72
3.17±0.98
*PA= Physical Activity
Table 3 reports the percentage of participants who met the current guidelines
for PA and consumption of fruits and vegetables.
INTRODUCTION
Table 3: Percentage of Sample Size Meeting Recommendations
A high prevalence of obesity is present among this population as
compared to the general population.
Obesity in this population has the potential to reduce or limit
opportunities for various types of community participation,
including employment and leisure, and can also require greater
effort on the part of the caregiver in assisting the individual with ID
with various activities and instrumental activities of daily living.
The current trend of leisure time activities for this population
consists of sedentary behaviors leading them to not meet the
recommended duration for PA.
Adults with intellectual disability often do not meet the
recommended intake of 5 cups of fruit and vegetables per day.
PURPOSE AND HYPOTHESIS
The purpose of this study is to examine the PA behaviors and
nutritional intake of adults with ID to determine if they meet the
current recommendations and their impact on obesity. We hypothesize
that a majority of adults with ID living in the community will not meet
the recommendations for daily PA and/or nutritional intake of fruits
and vegetables, will present a higher BMI.
Table 1: Participant Characteristics
Gender
Age (years)
BMI** (kg/m2)
Normal (n =2)
Overweight (n =3)
Obese (n =1)
Waist Circumference (cm)
High Risk (n =4 )
Low Risk (n =2)
n= 5 male (83.3%); n= 1 female (16.7%)
20.00 ±.98
28.11 ±3.77
33.3%
50.0%
16.7%
99.25 ±15.99
66.7%
33.3%
**BMI= Body Mass Index
Note: continuous variables are expressed as mean ± standard deviation and categorical variables as percentages
PA was subjectively measured by administration of the PA portion of the
CDC’s Behavioral Risk Factor Surveillance Survey (2013), Completed at
both the baseline and final pick-up meetings. The utilization of a
secondary source in completing the questionnaire was encouraged.
Fruit and vegetable intake was subjectively measured by completion of the
National Institute of Health’s “All Day Fruit and Vegetable Screener” at
both baseline and final pick-up meetings. The assistance of a secondary
source in completing the questionnaire was encouraged.
Anthropometric measurements (height, weight, waist circumference) were
taken using a stadiometer, an electronic scale, and a flexible tape measure.
Based on the calculated BMI and waist circumference, each participant
was categorized into two difference classification:
Normal/overweight/obese, and low/high risk.
Data Collection Procedure
At the initial visit investigators gathered demographic and anthropometric
measurements from the participants. The participants then completed two
questionnaires regarding their PA and fruit and vegetable intake habits
over the past month.
The Actical was given to the participants who then demonstrated they
could successfully put it on a take it off. Data collection would begin that
following morning at 12:00am and continue for 7 consecutive days with a
30-sec epoch length.
Participants were instructed to wear the device during all
waking hours with the exception of water activities.
Investigators exchanged devices with the participants on day 3
and 5 of monitoring to ensure prospering device functioning.
On the day following the final day of monitoring the device was picked up
from participants and the PA and fruit and vegetable questionnaire were
administered and completed with the help of a secondary source
ACKNOWLEDGMENTS
We would like to thank Dr. Marquell Johnson and Dr. Saori Braun, for their guidance and
assistance in making this a successful research project. We would also like to thank the
Department of Kinesiology for allowing us the use of the equipment needed for this study.
Mean Steps/Day
Actical PA* (min)
Self-Reported PA* (min)
Self-Reported Fruits and Vegetables (cups/day)
16.7%
50.0%
83.3%
0%
*PA= Physical Activity
SUMMARY AND CONCLUSIONS
Our hypothesis- a majority of adults with ID living in the community will not
meet the recommendations for daily PA and/or nutritional intake of fruits and
vegetables, will present a higher BMI- was supported by results.
With a high percentage of participants not meeting the current PA
recommendation and even higher not meeting steps per day, it can be seen that
there is a need for an increase of PA opportunity and intervention for this
population.
All participants reported engaging in more PA than was recorded, which
means they are unaware of how intense they should be exercising and thus
the extent of their sedentarism.
With no participants consuming recommended fruit and vegetables per day it is
obvious that this population can benefit from increased education on nutritional
needs specifically regarding fruit and vegetable consumption.
Limitations: 1)Small sample size, 2)Actical cannot collect data for aquatic
activities or stationary cycling, and 3) All participants are from the Eau Claire
area, participate in PRIDE4Adults and Special Olympics.
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