Cooking skills to improve long-term weight loss in young adults with intellectual disabilities - ABSTRACT Young adults with ID (age 18-26 yrs.) especially those with Down syndrome, are an underserved population with a high prevalence of obesity (~45% by age 30), obesity related health conditions, and a reduced ability to complete instrumental/basic activities of daily living (I/ADLs). Young adults with ID no longer have the daily structure of attending public school with access to specialized medical services, may spend more time at home or residential day centers, begin to live independent of their parents, or to work outside the home which may all contribute to increased consumption of fast/processed higher calorie foods and decreased PA leading to accelerated weight gain. Thus, interventions to address long-term weight loss may have a significant impact on health in young adults with ID. Our research group has completed 2 NIH funded multi-component intervention trials which have demonstrated clinically relevant short and long-term weight loss (18 mos.) in adults with mild- to-moderate ID and overweight or obesity. However, we have been unable to achieve similar success for long- term weight loss using these intervention strategies in young adults with ID. A position paper from the Academy of Nutrition and Dietetics highlighted the importance of nutrition related services for individuals with ID across the lifespan; however, evidence based nutritional services for this group are essentially non-existent. Limited, data from other investigators and a pilot trial by our group, support the feasibility of delivering cooking skill interventions to individuals with ID. However, there are no adequately powered trails that have evaluated the effectiveness of a cooking skill intervention on long-term weight loss in young adults with ID. Thus, we propose to evaluate the impact of a cooking skills intervention in combination with a multicomponent weight management intervention on long-term weight loss (18 and 24 mos.) in 114 young adults with (50% with Down syndrome) and overweight/obesity. Participants-parent/caregiver dyads will be randomized (1:1) to a traditional weight loss (eSLD) or a weight loss plus cooking skills (eSLD+Chef-ID) arm for a 24-mo. trial (6 mos. loss/12 mos. maintenance/6 mos. no-contact follow-up). Our primary aim will compare weight loss across 18 mos. between intervention arms. Secondary aims will compare weight change across 24 mos. and change in cooking skills, body composition, cardiometabolic biomarkers, I/ADLs, and caregiver strain across 18 mos. between intervention arms. Additionally, we will explore potential mediators/moderators of weight change across 18 and 24 mos., and the association between changes in weight/body composition and cardiometabolic biomarkers across 18 mos. If the proposed project is successful, entities providing weight management services will have an evidence-based intervention for long-term weight loss for young adults with ID.
