Caregiver-associated physical activity patterns, dietary behaviors and interventional beliefs in individuals with down syndrome: Insights from a large European survey.
Background: Lifestyle factors such as diet and physical activity
significantly impact on the risk of obesity in individuals with Down
syndrome (DS). However, in the absence of national nutritional
guidelines in individuals with DS, further work is needed to understand
their dietary and physical activity patterns. In this work we retrieved
caregivers’ responses on those aspects. Methods: We analyzed data from a
cross-sectional online survey of caregivers of individuals with DS
conducted as part of the GO-DS21 project and reported in the
accompanying paper (nutrients-4216283) (n = 764). We explored physical
activity patterns, dietary habits, beliefs around weight-loss
interventions and caregiver confidence that family members with DS would
engage in a healthier lifestyle. Associations were examined using
correlation analysis, and cumulative and binary logistic regression
models. Results: Caregivers reported that most individuals with DS
exercised 1–3 times per week, with frequency declining with age. Males
were more likely to exercise daily than females. Caregiver exercise
frequency was positively correlated with that of their DS family member
(ρ = 0.521, p < 0.001), suggesting
clustering of shared health behaviors within households. In adjusted
models, caregivers who exercised regularly had up to thirteen-fold
higher odds of having a physically active family member with DS (aOR =
13.02, 95% CI: 7.40–24.06, p <
0.001). Fried food consumption and higher snack frequency were
independently associated with perceived obesity status, while
sugar-sweetened beverage consumption was not. Caregivers favored
exercise as a weight-loss strategy, while anti-obesity drugs were
endorsed by only 11% of caregivers primarily and were more likely to be
endorsed when obesity was perceived (aOR = 4.21, 95% CI: 2.44–7.39, p
< 0.001). Finally, caregiver confidence that their family member
with DS would engage in healthier behaviors was associated with
perceived obesity status and strongly associated with higher physical
activity levels (aOR 14.68, 95% CI: 6.59–33.40, p
< 0.001). Conclusions: In this large European caregiver survey,
reported consumption of selected energy-dense foods was generally low,
although fried food intake and higher snack frequency were associated
with perceived obesity. Physical activity patterns were closely aligned
between caregivers and individuals with DS, suggesting shared household
health behaviors. These findings highlight the importance of involving
caregivers and family environments in lifestyle interventions aimed at
supporting physical activity and weight management in individuals with
DS.