Biosci. Biotech. Res. Comm. Special Issue No 1:1-6 (2017)

The prevalence of overweight and obesity among adults

with intellectual and developmental disabilities in

Ahvaz, Iran

Sajed Salehi

, Gholamhossein Nassadj

, Kamal Shakhi

, Mohammad Hossein

Haghighizade

and Sheyda Javadipour

Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences,

Ahvaz, Iran

Department of Statistics, School of Public Health, Ahvaz Jundishapur University of Medical Sciences,

Ahvaz, Iran

ABSTRACT

The prevalence of overweight and obesity among people with intellectual and developmental disabilities (IDD) is 4

times more than any other people in the community, but a little research have been examined the prevalence of over-

weight and obesity among people with intellectual disabilities (ID) recently, So the present study aimed in order to

estimate the prevalence of overweight and obesity in ID people in Ahvaz, Iran.205 adults with IDD who had referred

to  ve rehabilitation centers to receive rehabilitation services participated in this cross-sectional study. In addition

to demographic information of ID people, data on their height and weight were collected to measure the body mass

index (BMI). 69 percent of participants are male and 97 individuals had Down syndrome. The results of the present

study Demonstrated that the prevalence of overweight and obesity among people with ID is high and about 57

percent. The results showed that there is a statistically signi cant difference between gender, IQ level, family size;

and disability type with the prevalence of overweight and obesity.Implementation of intervention programs such as

physical activities over the week in supportive institutions, as well as increasing parent awareness of IDD people

about overweight and obesity could help to reduce the prevalence of overweight and obesity among people with IDD.

KEY WORDS: OVERWEIGHT, OBESITY, PREVALENCE, PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES

ARTICLE INFORMATION:

*Corresponding Author: heyda.javadi@gmail.com

Received 27

Nov, 2016

Accepted after revision 21

March, 2017

BBRC Print ISSN: 0974-6455

Online ISSN: 2321-4007

Thomson Reuters ISI ESC and Crossref Indexed Journal

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reserved.

Online Contents Available at: http//www.bbrc.in/

2 THE PREVALENCE OF OVERWEIGHT AND OBESITY AMONG ADULTS BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS

Sajed Salehi et al.

INTRODUCTION

One of the most important health problems in many

countries is overweight or obesity of adults (Wille

et al. 2008; James et al. 2004). The prevalence of over-

weight and obesity in adults are estimated 6 billion

and 400 million respectively which have doubled in

the last 20 and it seems to increase as an epidemic and

common problem in communities in addition (World

Health Organization, 2008; World Health Organization,

2007). They cause many other diseases such as diabe-

tes, hypertension, gallbladder and osteoarthritis disor-

ders (James, 2001). Overweight and obesity is considered

as an epidemic and common problem in communities

it is increasing; moreover obesity and its related com-

plications impose signi cant costs on society (Obesity,

2000).

The prevalence of overweight and obesity among peo-

ple with IDD in United States is 4 times more than any

other people in the community (Rimmer and Yamaki,

2006; Mikulovic et al. 2011), but very few studies are

conducted regarding the prevalence of overweight and

obesity among people with IDD newly and the major-

ity of studies have addressed the prevalence of over-

weight and obesity in different age groups and among

adolescents and young people (Barzin et al. 2009). Hsieh

et al. in the United States showed that over 38% of peo-

ple with mental disabilities had a BMI more than 30 and

women are more obese than men in this study. In addi-

tion, people with Down syndrome have highest preva-

lence of obesity among different groups with IDD and

they plus had more health problems than other commu-

nity members (Hsieh et al. 2012).

The result of another study by Bhaumik et al.(2008)

in the UK showed that only 34.6% of people with IDD

had normal BMI and most of them had overweight

and obesity problem. Beside, in the study it is found

that people with IDD had higher blood pressure, poorer

nutritional status and more high-risk behaviors than

healthy people,(Bhaumik et al. 2008). People with ID

often have a mortality rate greater than the general

population, their health status is less than others and

the prevalence of obesity in them is higher than other

members of society due to immobility, lack of exer-

cise and poor nutritional status (Koritsas and Iacono,

2015).

According to our research, Iranian scienti c resources

show that no study has been conducted on the preva-

lence of overweight and obesity in individuals with IDD,

so this study was aimed to investigate the prevalence of

overweight and obesity among adults with IDD in Ahvaz

and its results could contribute in developing health care

programs to support these people.

MATERIAL AND METHODS

STUDY DESIGN AND DATA COLLECTION

This study has been designed and conducted to inves-

tigate the prevalence of overweight and obesity among

people with IDD in Ahvaz. 205 adults with IDD (like:

Down syndrome, cerebral palsy, autism spectrum disor-

ders and intellectual disability) who had referred to eight

rehabilitation centers (medical and vocational rehabili-

tation centers) to receive rehabilitation services par-

ticipated in this cross-sectional study. The demographic

information of the people with IDD have been obtained

from existing records in centers and this information

includes items such as: age, gender, language, IQ, race,

ethnicity, disability type, place of residence, educational

status and employment status. Data on their height and

weight has been collected over a period of two months

from May to July 2016 by two professionals.

STATISTICAL ANALYSIS

For calculating the overweight or obesity the body mass

index (BMI) was used such that  rst the height is meas-

ured by the wall by stadiometer with accuracy of 0.5 and

then their weight was obtained by minimum clothing

and no shoes on a scale with an accuracy of 100 grams.

BMI was achieved by dividing weight (in kilograms) by

the square of height (in meters) and someone with a BMI

of less than 18.5 is underweight, between 18.6 and 25

is normal, between 25.1 and 30is overweight and the

one with the BMI higher than 30 is obese (International

Obesity Task Force, 2007). Data has been analyzed using

SPSS version 16 software. Descriptive statistics such as

mean, SD and frequency percentage are used to report

BMI, age and gender. As well, the Chi Square and ANOVA

tests have been applied used to evaluate the prevalence

of overweight and obesity in terms of gender, ethnicity,

location and different age groups.

Parents of all people with IDD were announced of the

purpose of the study and they signed the informed con-

sent. This research ethics code IR.AJUMS.REC 263.1395

has been con rmed by Jundishapour University of Med-

ical Sciences Ethics Committee.

RESULTS

The results showed that133 of participants (69%) were male

and 73 participants were female. 97 people with had Down

syndrome, 81 with intellectual disability (ID), 13 individuals

had autism, and 14 of participants had cerebral palsy (CP)

that 53% (108 cases) had IQ within the range of 51-70 and

BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS THE PREVALENCE OF OVERWEIGHT AND OBESITY AMONG ADULTS 3

Sajed Salehi et al.

Table 1. demographic information of people

with ID

Variables Categories

Frequency

n (%)

Gender Male 133(65)

Female 72(35)

Age (year) 15-25 132(64)

26-35 59(29)

36-44 14(7)

IQ <50 58(28)

51-70 109(53)

>70 38(19)

Race Persians 84(41)

Arabs 121(59)

Residential Area Urban 175(85)

Rural 30(15)

Education Diploma 16(8)

Under Diploma 189(92)

Occupation Supportive

Employment

70(34)

Sheltered

Employment

38(19)

Unemployed 97(47)

parent’s Education Illiterate 99(48)

Diploma 76(37)

Academic 30(15)

Family Size <7 76(37)

≥7 129(63)

Disability Type Down

Syndrome

97(47.3)

Intellectual

Disability only

81(39.5)

Autism 13(6.4)

Cerebral Palsy 14(6.8)

58 cases had the IQ range less than 50. Fifty nine percent

of respondents were Arabic speakers and 41% of them were

Farsi speakers; and about 73% of them lived in large fami-

lies (more than 7 members). Most people with intellectual

and developmental disabilities were urban dwellers and had

under diploma education. Only 15% of parents of persons

of these people had academic degree and about 88% of

them were covered by social security insurance. The demo-

graphic features of the participants have been reported in

Table 1. As  gure 1 suggests, 57% of the people with IDD

suffer from overweight and obesity, 13.7% are underweight

and only 29% have normal BMI. Among the various IDD,

prevalence of obesity is higher in people with Down syn-

drome than other types of disability (Figure 2). Based on

the results presented in Figure 3, the prevalence of over-

weight and obesity among women is higher than men.

The results presented in table 2 show there is a signif-

icant difference between gender of participants and the

prevalence of overweight and obesity (P=0.001), but sta-

tistically there is no difference between participants eth-

nicity and the prevalence of overweight and obesity (P=

0.32). ANOVA test results has demonstrated that there is

no signi cant difference between different age groups

and the prevalence of overweight and obesity (P=0.502).

The results also has depicted that the prevalence of over-

weight and obesity of people with an IQ less than 50 is

higher than the other groups (P=0.02). The prevalence of

obesity among large families (more than 7 members) has

a signi cant difference with smaller families (less than

7 members) (P=0.031). Table 2 shows the results of the

relationship between the prevalence of overweight and

obesity and demographic data of individuals with IDD.

DISCUSSION

The current research has been designed and performed

in order to estimate the prevalence of overweight and

FIGURE 1. BMI status for adults with Developmental and

Intellectual Disabilities

Sajed Salehi et al.

4 THE PREVALENCE OF OVERWEIGHT AND OBESITY AMONG ADULTS BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS

FIGURE 2. Prevalence of overweight and obesity by gender

of ID people

FIGURE 3. Overweight and obesity prevalence by disbility type of ID people

Table 2. BMI status and its relation with participant variables

Variables Categories

BMI Status BMI Status

overweight p-value Obesity p-value

Gender

Male 26.75

0.001

32.06

0.001

Female 29.23 36.47

Age groups (year)

15-25 27.74

0.502

33.25

0.67226-35 28.83 34.16

36-44 28.39 33.92

<50 28.63

0.02

36.54

0.00151-70 26.18 32.37

>70 26.35 33.74

Residential Area

Urban 29.32

0.012

35.24

0.001

Rural 26.07 31.15

Family Size

<7 27.14

0.03

31.78

0.02

≥7 29.59 35.41

Disability Type

Down Syndrome 29.34

0.01

36.32

0.001

Intellectual Disability only 27.88 32.63

Autism 27.31 30.82

Cerebral Palsy 26.8 30.01

Sajed Salehi et al.

BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS THE PREVALENCE OF OVERWEIGHT AND OBESITY AMONG ADULTS 5

obesity among adults with IDD in Ahvaz. The results

showed that the prevalence of overweight and obesity in

adults with IDD is about 36% which indicates the high

rate of obesity in this group. Hsieh et al.(Hsieh et al.

2012) in their research on adults with ID living in the

American community have noted that the prevalence of

obesity in the population was about 38% which in keep-

ing with the results of the present research. A study by

Mikulovic et al.(Mikulovic et al. 2011) on people with ID

showed that 19% of 535 cases have overweight which

in consistent with the results of the current. In Miku-

lovic study the prevalence of obesity among people with

ID is reported about 4% which is inconsistent with the

present results. The reason for this high difference in

the prevalence is perhaps due to the individuals that in

Mikulovic study only persons with ID are studied while

in our study, most individuals have Down syndrome that

usually the prevalence is high in this population com-

pared to other people.

The  ndings of various studies indicate that the prev-

alence of overweight among men is less than women;

the results also show that women are more obese than

men (Hsieh et al. 2012). The results of these studies are

consistent with the present study, the present study

showed that the prevalence of overweight (22.6% Vs

28.7%, P=0.001) and obesity (32.5% Vs 48.4%, P=0.001)

in women is higher than men. Yamaki and Rimmer

research’s results on obesity consideredthat the preva-

lence of obesity in people with Down syndrome is higher

than other disabilities and it is about 71%, as well peo-

ple with ID have the second place in the prevalence of

obesity among people with IDD (9). The present study

considered that people with Down syndrome have the

highest prevalence of obesity among other disabilities.

In the present research, people with CP had the lowest

prevalence of obesity which is consistent with Rimmer

and Yamaki research.

El Raghi et al.in Sudan stated that there is no signi -

cant correlation between age and the prevalence over-

weight and obesity (P =0.4) (El Raghi et al. 2016). Emer-

son in his research on adults with ID showed that there is

no signi cant difference between the prevalence of obe-

sity and different age groups (Emerson, 2005) which is

consistent with the present research  ndings. The results

revealed that the prevalence of obesity among families

with more than 7 members and people with the IQ less

than 50 is more than other groups. El Raghi indicates

that there is no signi cant difference between the prev-

alence of obesity and IQ which is not consistent with

the results of the present study (El Raghi et al. 2016).

The reason might be due to the fact that people with

50> IQ due to the cultural issues and they may cause

harm to others are kept at home and have low mobil-

ity and this lifestyle has led to gain extra weight and

obesity compared to the other groups. Another inter-

esting result of this study is that there is a signi cant

difference between the prevalence of overweight and

obesity in terms of the place of residence such that the

prevalence of overweight and obesity in rural dwellers is

lower than urban dwellers. Hseih et al.in their study to

determine the factors in uencing obesity among people

with intellectual disabilities found that urban lifestyle

compared to rural lifestyle leads to higher prevalence

of obesity and overweight which is consistent with the

present study (Hsieh et al. 2012).

LIMITATIONS AND ADVANTAGES

The participants of this study were the ones who referred

to educational and supportive institutions and these peo-

ple might not be the representative of the entire people

with IDD in Ahvaz. Additionally, in this study the effect

of factors such as diet habits, movement restrictions and

drug usage are not studied on overweight and obesity.

One of the most important advantages of the present

study is that this is the  rst study conducted to estimate

the prevalence of overweight and obesity among people

with IDD in Iran.

CONCLUSION

The results of the present study showed that the preva-

lence of overweight and obesity among adults with IDD

is high (57%); and it is higher than other community

groups which necessitates the intervention. Implemen-

tation of intervention programs such as physical activi-

ties over the week in supportive institutions, as well as,

increasing parent awareness of intellectual and develop-

mental disabilities people about overweight and obesity

could help to reduce the prevalence of overweight and

obesity among people with intellectual and develop-

mental disabilities.

ACKNOWLEDGMENTS

This research was a part of MSc thesis of Mr .Sajed Salehi

and supported by the Research Affairs Deputy,Ahvaz

Jundishapur University of Medical Sciences, Ahvaz,

Iran. The authors of the current study warmly appreciate

all the people with IDD and their families due to take

part in our research.

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