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The KU Diet Program: Making Choices and Losing Weight

The KU Diet Program: Making Choices and Losing Weight. All information from this presentation, including teaching materials, can be obtained at www.diet.ku.edu. Funded by: Kansas Council on DD US Administration on DD University of Kansas.

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The KU Diet Program: Making Choices and Losing Weight

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  1. The KU Diet Program:Making Choices and Losing Weight

  2. All information from this presentation, including teaching materials, can be obtained at www.diet.ku.edu

  3. Funded by:Kansas Council on DDUS Administration on DDUniversity of Kansas

  4. Our Team:Richard and Muriel SaundersJoe DonnellyDebra SullivanBryan SmithBrian EricksonBrianne Guilford Mary Rondon

  5. Did You Know?

  6. Overweight or Obese

  7. Previous Research • Published weight loss interventions with adults with IDD have shown poor results • Previous approaches have generally been in the form of weekly presentations about healthy food choices, cooking methods, and the benefits of exercise • Previous interventions have been of relatively short duration

  8. Health Care Costs • Medical care for obese people cost $1,429 more per person each year than persons of normal weight • Extra costs are due primarily to treatment of diabetes, hypertension, and cholesterol Newsweek, August 17, 2009

  9. Our Participants • Enrollment in 6 counties • 79 Participants following initial meeting • 75 Completed 6-month diet phase • 20% have Down syndrome • 96% have mild or moderate ID

  10. Living Arrangement • Alone with some supports 25% • With a family member 24% • Home/apartment of 2-3 23% • Home/apartment of >3 21% • With spouse with IDD 7%

  11. Baseline; N=77

  12. Intervention Type • Home-based; caregiver present 43 • Office-based; participant only 32

  13. Methods

  14. Food Preference AssessmentandStoplight Chart

  15. Our Diet Plan • Teach a HIGHER VOLUME, LOWER CALORIE diet (1-hour initial training). • Daily: • 5 or MORE servings of fruits and vegetables • 3 meal replacement shakes/smoothies • 2 frozen entrees of <300 calories each

  16. Self-Recording of Food and Beverage Energy Intake

  17. Self-Recorded Weight

  18. Monthly Meetings: Diet • Re-take weight and waist measurements • Obtain recollections of foods eaten in the past 24 hours (analyze later for nutritional content) • Count vegetables, fruits, smoothies and entrees eaten • Discuss progress and problems • Review last month’s calories from 24-hr recall

  19. Our Exercise Plan • Provide pedometers and encourage increased walking • Encourage other forms of exercise

  20. Monthly Meetings: Exercise • Total steps taken • Count periods of other exercise

  21. Monthly Meetings: Incentives • $5.00 per 100,000 steps, tracked on a game board • $0.05 per healthy item consumed and $0.05 to savings account • Pay savings balance for 1 BMI pt lost. • Award certificates, stickers, bragging cards • High-fives all around for trying/success

  22. Results at 6 Months Average weight loss for the 75 completing the diet phase was about 13 lbs, or more than 6% of their average baseline weight.

  23. Average at 6 Months; N=75

  24. Comparisons • Weight loss by males was no different than weight loss by females • Weight loss by those we saw at Kansas Elks was no different than those seen in their homes in NE Kansas • Individuals with Down syndrome lost a few pounds less than the average

  25. Residence Comparisons • Individuals in all types of residence lost weight • Those in homes or apartments of 2-3 lost the most weight: ~18 lbs • Those living with a spouse with IDD or in large group homes lost the least weight, but the samples are too small for firm conclusions

  26. Results at 12 Months Average weight loss for the 46 completing the maintenance phase was about 19 lbs, or more than 9% of their average baseline weight.

  27. Average at 12 Months; N=46

  28. Average at 18 Months; N=12

  29. The Most Successful

  30. Characteristics of Big Losers • Personally invested and often someone in circle of supports was also invested • Assisted in buying/cooking • Kept timely, thorough weekly records • Rarely snacked on red light foods • Weighed self frequently • Enjoyed the monthly positive feedback

  31. What is Important?

  32. Choice, Independence, Control • Participants had more choices - in the grocery store - in food selection at mealtime - in when to eat - in how much to weigh

  33. Supported Routines • The diet became a consistent routine, supported by others • Consistent routines are essential to any long term behavior change

  34. Projection • Our average participant would need 3 years to reach a weight in the normal range. • Thus, real success is about permanently changing how you eat, rather than dieting for a short period of time.

  35. Conclusions • The caregiver must be made aware when the diet(er) is not supported • Ultimately, the adult with IDD “drives” the effort, not someone else • The interventionist must have status, but not be judgmental

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