RESEARCH

Research and Practice Innovations

The Use of Technology for Delivering a Weight

Loss Program for Adolescents with Intellectual
and Developmental Disabilities
Lauren T. Ptomey, PhD, RD, LD; Debra K. Sullivan, PhD, RD; Jaehoon Lee, PhD; Jeannine R. Goetz, PhD, RD, LD; Cheryl Gibson, PhD;
Joseph E. Donnelly, EdD

ARTICLE INFORMATION ABSTRACT

Article history: Adolescents with intellectual and developmental disabilities (IDD) are at an increased
Accepted 29 July 2014 risk of obesity, with up to 55% considered overweight and 31% obese. However, there
Available online 5 November 2014 has been minimal research on weight management strategies for adolescents with IDD.
The purpose of this study was to compare the effectiveness of two weight loss diets, an
Keywords: enhanced Stop Light Diet (eSLD) and a conventional diet (CD), and to determine the
Intellectual and developmental disabilities
Adolescents feasibility of using tablet computers as a weight loss tool in overweight and obese
Obesity adolescents with IDD. A 2-month pilot intervention was conducted. All participants
Weight management were randomized to the eSLD or CD and were given a tablet computer that they used to
Technology track daily dietary intake and physical activity. Participants and parents met weekly
with a registered dietitian nutritionist via video chat on the tablet computer to receive
2212-2672/Copyright ª 2015 by the Academy of diet and physical activity feedback and education. Twenty participants (45% female,
Nutrition and Dietetics. aged 14.9
2.2 years) were randomized and completed the intervention. Participants in
http://dx.doi.org/10.1016/j.jand.2014.08.031
both diets were able to lose weight, and there were no significant differences between
the eSLD and CD (3.89
2.66 kg vs 2.22
1.37 kg). Participants were able to use the
tablet computer to track their dietary intake 83.4%
21.3% of possible days and to attend
80.0% of the video chat meetings. Both dietary interventions appear to promote weight
loss in adolescents with IDD, and the use of tablet computers appears to be a feasible
tool to deliver a weight loss intervention in adolescents with IDD.
J Acad Nutr Diet. 2015;115:112-118.

A
PPROXIMATELY 1% TO 3% OF THE US POPULATION IS
diagnosed with an intellectual or developmental
disability (IDD). IDD is defined as a disability origi-
nating before age 10 years, characterized by signif-
icant limitations in both intellectual functioning (intelligence
quotient <75) and limitations in two or more adaptive
behaviors.1 Several hundred causes have been discovered, but
for one-third of the population affected the cause remains
unknown.2 The most common cause of IDD is Down syn-
drome, which accounts for 15% to 20% of the population.3
The prevalence of obesity in adolescents with IDD is
approximately two times greater than in the general popu-
lation.4-8 Approximately 55% of adolescents with Down syn-
drome are overweight (body mass index [BMI] 85th
percentile), with 31% of these adolescents considered obese
(BMI 95th percentile).6 Healthy People 2020, The National
Institute on Disability and Rehabilitation Research, The
Academy of Nutrition and Dietetics, The World Health
Organization, and the Surgeon General’s Report on Health
and Wellness of People with Disabilities all recommend
additional efforts to decrease the high prevalence of obesity
among adolescents with IDD.9-11 However, there are limited
data on which to base effective weight management
interventions in any age group with IDD.12-16
A conventional reduced-energy diet (CD), with an energy
deficit of 500 to 1,000 kcal/day, is recommended for healthy
individuals by the Academy of Nutrition and Dietetics17 and
the National Heart, Lung, and Blood Institute Guidelines.18
However, implementation of the CD may be problematic for
individuals with IDD because it can require calorie counting
and an ability to read and comprehend educational materials
and nutrition labels.
Although the CD may not be the best strategy for in-
dividuals with IDD, there is minimal data on which to base
weight management strategies for adults with IDD12,15,16,19
and no published data for adolescents. Most interventions
in adults have shown minimal weight change, þ0.7 kg
to 3.4 kg (w1.5% to 2.8%), which is considerably less than
the long-term weight loss necessary to achieve health ben-
efits (5% to 10%) recommended by the National Heart, Lung,
and Blood Institute Guidelines18 or the minimum 3% weight
loss suggested as clinically relevant.20
To date, there has only been one clinically successful
weight loss study in individuals with IDD. Saunders and
colleagues14 introduced a simplified approach to energy re-
striction for adults with IDD using an enhanced Stop Light
Diet (eSLD). In this study, 73 adults with IDD who followed an
eSLD, delivered by monthly in-person health education

112 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS ª 2015 by the Academy of Nutrition and Dietetics.

meetings, for 6 months lost an average of 6.1 kg (6.3%), and
the average weight loss after 12 months was 8.6 kg (9.1%).
Although the eSLD appears to be successful in adults with
IDD, it has not been reported in adolescents with IDD. As
adolescents with IDD have some different barriers to weight
loss than adults, such as school lunches and parent involve-
ment, it is unknown whether the eSLD can promote signifi-
cant weight loss in that population.
Adolescents with IDD frequently use computer technology
for education and training.21-25 Technology in the form of
tablet computers may be an effective educational tool in
weight management of adolescents with IDD. The use of
tablet computers could allow for instant feedback, serve as a
visual aid, and allow for frequent health educator feedback,
which may reduce some of the limitations in conducting a
weight loss program in individuals with IDD. However, there
are currently no published reports that have explored the
feasibility of using tablet computers as a weight loss tool in
adolescents with IDD.
The purpose of this study was to determine the feasibility
of using tablet computers as a weight loss tool and to
compare the effectiveness of two weight loss diets, an eSLD
and a CD, in overweight and obese adolescents with IDD.
METHODS
Participants and Enrollment
An 8-week pilot investigation for adolescents with mild to
moderate IDD was conducted. To participate, individuals had
to be aged 11 to 18 years with an intelligence quotient 50 to
69 (mild) or 35 to 49 (moderate),1 overweight or obese (BMI
>85th percentile on Centers for Disease Control and Pre-
vention growth charts), living at home with a parent, and
have access to a wireless Internet connection. Individuals
were excluded from the study if they had insulin-dependent
diabetes, had participated in a weight reduction program
during the past 6 months, were being treated for major
depression or eating disorders, were consuming special diets,
had a diagnosis of Prader-Willi syndrome, or were pregnant
or became pregnant during the study. Participants were
recruited through local community programs and advertise-
ments in the target area using flyers and e-mail. All recruit-
ment materials included investigators’ contact information
(toll-free telephone, e-mail). Questions from interested par-
ents were addressed, and initial eligibility screenings were
completed via telephone or e-mail. Home visits were
scheduled with interested parents and potential participants
to explain the project, answer questions, and obtain parental
consent and adolescent assent. All parents or legal guardians
signed a university-approved consent form, and all partici-
pants gave oral assent to participant in the study.
Intervention Components
Overview. All participants were randomized to either the
eSLD or CD, and participants were given a tablet computer
(iPad2, Apple Inc) that they used to track dietary intake and
physical activity and that was returned at the end of the
study. At baseline, the participant and a parent attended a
90-minute, at-home diet orientation session conducted by a
registered dietitian nutritionist (RDN), and subsequently
participated in weekly at-home education sessions that were
conducted over video chat (FaceTime, Apple, Inc) on the iPad.
January 2015 Volume 115 Number 1
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One parent was identified as a study helper, and was asked to
be present at the orientation; attend all weekly education
sessions; help track diet intake and physical activity on the
tablet computer, if needed; and provide encouragement for
the program by helping with meal preparation and encour-
aging physical activity. All participants completed outcome
assessments at baseline and at the end of Month 2.
eSLD. The original Stop Light Diet developed by Epstein26 for
use in children was enhanced with the addition of fruits and
vegetables (5 servings/day) and high-volume, low-energy
portion controlled meals (PCMs) consisting of two entrées
and two shakes per day. The original Stop Light Diet is easy
for children and individuals with IDD to understand, espe-
cially with added assistance from parents,14,26 and was given
a Grade 1 for its effectiveness in weight management for
children by the Academy of Nutrition and Dietetics Evidence
Analysis Library.27 PCMs designed for weight loss are any
prepackaged, preportioned food product that is low in calo-
ries, high in nutritional content, and intended to take the
place of regular meals or snacks. PCMs are an effective weight
loss tool because they are decision-free, so there is no
guesswork or measuring of portion size, and they received a
Grade 1 rating for their effectiveness in weight management
from the Academy of Nutrition and Dietetics Evidence Anal-
ysis Library.28 Noncaloric beverages were allowed ad libitum.
All PCMs were provided to participants and were delivered to
the participants’ homes on a monthly basis. Participants were
instructed to consume two entrées and two shakes per day,
and if they were still hungry or were unable to consume an
entrée or shake, they could pick foods from the Stop Light
Diet picture guide, which was uploaded onto the tablet
computer. Participants were instructed to choose green or
yellow category foods and to avoid red category foods. PCMs
were selected by participants during the health education
session and shipped to participants’ homes weekly.
CD. Participants in the CD group were educated to consume
a nutritionally balanced, high-volume, lower fat (20% to 30%
energy) diet as recommended by the US Department of
Agriculture MyPlate approach.29 Participants’ energy needs
were estimated using the Dietary Reference Intake total
energy equation for overweight boys/girls.30 A deficit of 500
to 700 kcal/day was prescribed; however, prescriptions never
recommended <1,200 kcal/day. Consumption of five servings
of fruits and vegetables per day was recommended. Partici-
pants were provided examples of meal plans consisting of
suggested servings of grains, proteins, fruits and vegetables,
dairy, and fats based on their energy needs, and they were
counseled on appropriate portion sizes using 3-dimensional
food models.
Physical Activity. All participants were instructed to engage
in moderate intensity physical activity to gradually accumu-
late a total of 60 minutes per day at least 5 days per week as
recommended by the American College of Sports Medicine.31
During the first week of the intervention, participants were
instructed to engage in 10 minutes per day of physical ac-
tivity, and every week another 10 minutes were added until a
total of 60 minutes per day was obtained. Participants were
encouraged to try a variety of different activities, such as
walking, bike riding, and dancing. Because adolescents with
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS 113
RESEARCH
IDD have difficulty with estimating time spent doing physical
activity, participants were asked to wear a wireless activity
monitor (Fitbit Ultra, Fitbit Inc) so that the health educator
could monitor their progress and provide weekly feedback.
Tablet Computer. The tablet computer was given to each
participant for the duration of the study. The application Lose
It! (FitNow, Inc) was used to track all foods and beverages
consumed. Food and beverages were logged in Lose It! by
entering in the food name then selecting the portion size or
by scanning the bar code of the food item using the tablet
computer. Fitbit wireless activity trackers captured all activ-
ity, steps taken, stairs climbed, and intensity of activities and
wirelessly synced all data collected to the tablet computer. All
information entered into the application was stored on a
secure online server that was only accessible by the health
educators and study staff.
Weekly Monitoring. Participants and a parent met with an
RDN for 30 minutes once a week over video chat using
FaceTime on the tablet computer. These sessions took place
during a weekday evening, with the time and date set by the
parent and participant during the diet orientation. During
these meetings, participants took part in a brief lifestyle
modification session covering social support, self-monitoring,
physical activity, environmental control, and self-efficacy.
Copies of all eight lessons were loaded into the tablet com-
puter. During each meeting, diet and physical activity data
was reviewed, and the RDN answered questions, problem-
solved, helped to foster goal setting, and provided support.
Data Collection and Assessment
Anthropometrics. Weight was assessed with a calibrated
digital scale accurate to
0.1 kg (model no. PS6600, Befour).
All participants were weighed with the participant clothed
and without shoes. Weight was taken at baseline and the end
of Months 1 and 2. Height was measured at baseline and the
end of Month 2 using a portable stadiometer (model no.
IP0955, Invicta Plastics Limited). BMI was calculated as
weight (in kilograms)/height (in meters2).
Accelerometry. To assess physical activity levels, all par-
ticipants wore an ActiGraph Model GT3þ (ActiGraph LLC) for
4 consecutive days (2 weekdays and 2 weekend days) at
baseline and at the end of Month 2. The outcome variables
were the average accelerometer counts per minute over
the 4-day period and time spent sedentary and in light-,
moderate-, and vigorous-intensity physical activity. To iden-
tify intensity levels, the cut points laid out in the National
Health and Nutrition Examination Survey as described by
Troiano and colleagues32 were used. A valid monitoring day
was defined as 10 hours of valid data.
Energy/Macronutrient Intake. Dietary intake was assessed
using 3-day photo-assisted diet records at baseline and at the
end of Month 2, a technique that has been demonstrated to
improve dietary assessment of individuals with IDD.33,34
Participants (with the help of a parent) were asked to write
down all food and beverages consumed over 3 days
(2 weekdays and 1 weekend day) and to use the tablet
computer to take pictures of all meals consumed at home
during those days. The RDN reviewed the food records with
114 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
the participant and parent, and collected additional details
from the photographs. All dietary records were entered by
the same RDN into Nutrition Data System for Research
(version 2011, Nutrition Coordinating Center, University of
Minnesota) for dietary analysis.
Diet Quality. The Healthy Eating Index-2010 (HEI-2010) was
used to calculate diet quality from data obtained from the
3-day photo-assisted diet records at baseline and at the end
of Month 2. The HEI-2010 was calculated using Nutrition Data
System for Research output and followed the method
developed by the National Cancer Institute.35 Point values for
each category were summed to give the final HEI score, with
100 points as the maximum score.
Tablet Use. To determine the feasibility of using tablet
computers to track dietary intake and daily physical activity,
participants’ use of Lose It! and Fitbit was reviewed by the
RDN to determine how many days out of the 2-month
intervention participants were able to track at least one
meal and to wear the Fitbit to get physical activity data.
Tablet Questionnaire. At the end of Month 2, participants
completed a questionnaire assessing their comfort using the
tablet computer, tracking their food and steps, and using the
video chat. All questions had responses given in a 5-point
Likert scale ranging from “very easy” to “very hard.” Parents
were asked how often they helped their dependent use the
tablet computer to track their food and steps.
Statistical Analysis
Sample demographics and all outcome measures were sum-
marized using descriptive statistics. Bivariate tests compared
groups at baseline and the end of Month 2 as well as changes
from baseline to Month 2. General mixed modeling was used
to examine group, time, and group-by-time interaction
effects on accelerometry variables, and general linear
modeling was used to examine group effects on the change in
other outcomes. The models included covariates, such as
participants’ ages, sex, races, and levels of IDD severity (mild
or moderate), that are potentially associated with the out-
comes. Statistical significance was determined at .05 alpha
level, and all analyses were conducted using SAS (version 9.2,
2012, SAS Institute Inc).
RESULTS
Recruitment
Of 21 participants who enrolled in the pilot study, 1 partici-
pant dropped after baseline testing. Of 20 participants who
completed the study (age¼14.9
2.2 years; 45% female),
10 were randomized to the eSLD, and 10 were randomized to
the CD. Table 1 provides demographic data for the partici-
pants who completed the study. Although the groups were
different in terms of sex, race, and level of IDD severity, the
only significant difference between diet groups was age
(P¼0.04), possibly due to the small sample size.
Anthropometrics
Participants in the eSLD had a weight loss of 3.89
2.66 kg
(P¼0.001), compared with participants in the CD who had a
loss of 2.22
1.37 kg (P¼0.001). This resulted in a loss of 4.6%
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Table 1. Demographic data of adolescents with intellectual and developmental disabilities (IDD) and their support parent
enrolled in a weight loss program utilizing either the enhanced Stop Light Diet (eSLD) or a conventional diet (CD)

Variable All participants (n[20) eSLD participants (n[10) CD participants (n[10)

ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒmean
standard deviationƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ!
Age (y) 14.9
2.2 15.9
1.8 13.9
2.2
Body mass index Percentile (%) 91.6
6.1 92.7
6.0 90.4
7.0
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ%ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ!
Female 45 50 40
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
ƒ n (%)ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
ƒ!
Race
Asian 1 (5) 0 (0) 1 (10)
Black 4 (20) 4 (40) 0 (0)
White 14 (70) 6 (60) 8 (80)
Mixed 1 (5) 0 (0) 1 (10)
Ethnicity
Not Hispanic/Latino 20 (100) 10 (100) 10 (100)
Level of IDD severity
Mild 12 (60) 4 (40) 8 (80)
Moderate 8 (40) 6 (60) 2 (20)
Secondary diagnosis
Autism 9 (45) 4 (40) 5 (50)
Down syndrome 8 (40) 5 (50) 3 (30)
Other 3 (15) 1 (10) 2 (20)
All parents (n¼20) Parents with children Parents with children
following eSLD (n¼10) following a CD (n¼10)
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒmean
standard deviationƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ!
Age (y) 48.1
5.6 49.1
7.2 48.0.
4.8
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
ƒ %ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ
ƒ!
Female 95 100 90
ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒn (%)ƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒƒ!
Race
Black 4 (20) 4 (40) 0 (0)
White 16 (80) 6 (60) 10 (100)
Other 0 (0) 0 (0) 0 (0)
Ethnicity
Not Hispanic/Latino 20 (100) 10 (100) 10 (100)
Highest level of education
High school/general equivalency diploma 0 (0) 0 (0) 0 (0)
Associate’s degree 1 (5) 0 (0) 1 (10)
Bachelor’s degree 13 (65) 6 (60) 7 (70)
Graduate degree 6 (30) 4 (40) 2 (20)
Employment status
No job 3 (15 ) 0 (0) 3 (30)
Part-Time 4 (20) 3 (30) 1 (10)
Full Time 13 (65) 7 (70) 6 (60)

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RESEARCH

Table 2. Change in body weight and body mass index (BMI) across an 8-week weight loss intervention in adolescents with
intellectual and developmental disabilities following either an enhanced Stop Light Diet (eSLD) or a conventional diet (CD)

Variable eSLD (n[10) CD (n[10) P valuea

ƒƒƒƒƒraw mean
standard deviationƒƒƒƒƒ!

Weight (kg)
Baseline 82.3
29.8 65.1
25.3 0.180
2 mo 78.4
27.7 62.8
24.1 0.197
Weight change (kg) 3.9
2.7 2.2
1.4 0.094
% Weight change 4.6
2.1 3.3
1.2 0.131
BMI
Baseline 30.7
7.3 26.9
5.3 0.192
2 mo 29.2
6.7 25.9
5.1 0.231
BMI change 1.6
0.9 1.0
0.4 0.078
BMI percentile
Baseline 92.7
6.0 88.4
10.6 0.279
2 mo 89.6
9.7 83.9
15.3 0.333
BMI percentile change 3.1
4.0 4.5
5.2 0.512
Waist circumference (cm)
Baseline 89.8
17.0 80.6
12.6 0.185
2 mo 87.0
15.3 77.4
10.9 0.125
Waist circumference change 2.8
2.9 3.2
3.3 0.807
a
For t test that compares eSLD and CD.

and 3.3% body weight, respectively. Table 2 provides full
weight loss results. Covariates that significantly affected
weight change were race (weight change in kilograms,
P¼0.015; BMI change, P¼0.036) and level of IDD severity
(weight change in kilograms, P¼0.005; percent weight
change, P¼0.015; and BMI change, P¼0.007). After controlling
for covariates, no significant group difference was observed
in weight change (weight change in kilograms, P¼0.485;
percent weight change, P¼0.988; BMI change, P¼0.892; and
BMI percentile change, P¼0.781).
Accelerometry
Valid accelerometer data was collected from 16 subjects
(seven eSLD and nine CD) at baseline and 15 subjects (nine
eSLD and six CD) at the end of Month 2. Mixed modeling
results indicated there was a significant decrease in seden-
tary activity time in both groups combined (P¼0.028); how-
ever, there was no significant difference between groups
(P¼0.855). No significant difference in moderate (P¼0.176) or
vigorous (P¼0.136) activity time was detected.
group. Linear modeling results showed participants in the
eSLD had a significantly greater reduction of energy intake
compared with participants in the CD group (P¼0.048).
Table 3 provides an energy and macronutrient comparison of
the CD vs the eSLD.
Diet Quality
Total HEI-2010 increased in both diet groups: from 50.5
10.9
to 56.3
13.2 in the eSLD group and from 53.1
13.7 to
57.6
12.9 in the CD group. However, the increase did not
significantly differ between groups (P¼0.379). A significant
improvement across the intervention in both groups was a
decrease in empty calories (P¼0.015).
Tablet Use
Participants in both groups entered their food intake into the
tablet computer 83.4%
21.3% of total days and had physical
activity data for 60.0%
34.3% of total days in the study. In
addition, participants and parents attended an average of 80%
(range¼50% to 100%) of weekly video chat meetings.

Energy/Macronutrient Intake Tablet Questionnaire

Three-day photo-assisted food records were collected from
20 participants (60 records at baseline and 60 at the end of
Month 2). Fifty-two records were deemed to be reliable and
representing a typical day at baseline and 51 at the end of
Month 2. Dietary data revealed a 844.9
641.0 kcal deficit
between baseline and the end of Month 2 in the eSLD
(P¼0.002) and a 674.9
769.4 kcal (P¼0.030) deficit in the CD
Ninety-five percent of adolescents reported that they enjoyed
using the tablet computer and that it was “easy” to use.
Eighty-five percent of participants reported that it was “easy”
to enter their food into the Lose It! application. When asked
about their involvement in helping to enter food into the Lose
It! application, 42% of parents reported that the participants
entered everything on their own, 26% reported that they

116 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS January 2015 Volume 115 Number 1
 RESEARCH

20; therefore, the power of the study was very small. If the
Table 3. Mean daily energy and macronutrient intake as sample size had been larger, the power of the study and
determined by photo-assisted 3-day food records, at ability to detect significant differences between groups
baseline and 2 months, from adolescents with intellectual would have increased.
and developmental disabilities following either an
enhanced Stop Light Diet (eSLD) or conventional diet (CD)
CONCLUSIONS
Nutrient eSLD (n[10) CD (n[10) P valuea
Adolescents with IDD have an increased risk of obesity; how-
mean
standard deviation! ever, there is minimal research on weight management prac-
tices in this population. Although future research is needed,
Energy (kcal) our study shows that adolescents with IDD can lose significant
Baseline 2,519.5
734.5 2,243.3
747.9 0.393 weight following both a CD and eSLD diet in combination with
2 mo 1,674.6
519.2 1,584.6
277.3 0.905 direction from an RDN. Furthermore, tablet computers are a
feasible aid in promoting weight management in this popula-
Carbohydrate (g) tion. RDNs working with adolescents with IDD should be aware
Baseline 289.5
86.8 292.7
81.5 1.000 of the challenges this population may face following a standard
2 mo 229.2
72.2 207.9
42.8 0.497 weight loss program and should consider the use of technology
or the eSLD in their treatment plans.
Protein (g)
Baseline 112.4
36.8 81.4
38.7 0.180 References
2 mo 79.6
21.0 64.8
20.1 0.197 1. American Association on Intellectual and Developmental Disabilities.
Definition of Intellectual Disabilities. http://www.aaidd.org/
Fat (g) content_100.cfm?navID¼21. Accessed April 16th, 2012.
2. The Arc for People with Intellectual and Developmental Disabilities.
Baseline 104.4
37.1 87.7
41.2 0.393 Causes and prevention of intellectual disabilities. http://www.thearc.
2 mo 52.5
23.2 57.8
17.1 0.661 org/what-we-do/resources/fact-sheets/causes-and-prevention.
Accessed July 15, 2014.
a
For t test that compares eSLD and CD. 3. Oeseburg B, Dijkstra GJ, Groothoff JW, Reijneveld SA, Jansen DEC.
Prevalence of chronic health conditions in children with intellectual
disability: A systematic literature review. Intellect Develop Disabil.
2011;49(2):59-85.
helped the participants to enter the food, and 32% reported
4. Curtin C, Anderson SE, Must A, Bandini L. The prevalence of obesity
having to enter everything themselves. in children with autism: A secondary data analysis using nationally
representative data from the National Survey of Children’s Health.
BMC Pediatr. 2010;10:11.
DISCUSSION
5. Maiano C. Prevalence and risk factors of overweight and obesity
The current study was a feasibility investigation of an inno- among children and adolescents with intellectual disabilities. Obesity
vative diet for adolescents with IDD. This study determined Rev. 2011;12(3):189-197.
that it is feasible to use a tablet computer as a weight loss 6. Rimmer JH, Yamaki K, Lowry BM, Wang E, Vogel LC. Obesity
tracking tool and education delivery system in adolescents and obesity-related secondary conditions in adolescents with
intellectual/developmental disabilities. J Intellect Disabil Res.
with IDD. Participants were able to track their food intake 2010;54(9):787-794.
83.4% of the time, which is a greater rate than in the general
7. Mikulovic J, Marcellini A, Compte R, et al. Prevalence of overweight
public.36-38 The results also found that adolescents with IDD in adolescents with intellectual deficiency. Differences in socio-
are willing to follow a supervised diet program and can be educative context, physical activity and dietary habits. Appetite.
successful in reducing their weight. All of the participants lost 2011;56(2):403-407.
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AUTHOR INFORMATION
L. T. Ptomey is a postdoctoral fellow and J. E. Donnelly is director, Center for Physical Activity and Weight Management, Cardiovascular Research
Institute, Division of Internal Medicine; D. K. Sullivan is department chair and a professor, and J. R. Goetz is an assistant professor, Department of
Dietetics and Nutrition; and C. Gibson is an associate professor, Department of Internal Medicine; all at The University of Kansas Medical Center,
Kansas City. J. Lee is a research associate professor, Institute for Measurement, Methodology, Analysis, and Policy, Texas Tech University, Lubbock;
at the time of the study, he was a research associate, Center for Research Methods and Data Analysis, University of Kansas, Lawrence.
Address correspondence to: Lauren T. Ptomey, PhD, RD, LD, Division of Internal Medicine, Cardiovascular Research Institute, University of Kansas
Medical Center, 3901 Rainbow Blvd, Mail Stop 1053, Kansas City, KS 66160. E-mail: LPtomey@ku.edu
STATEMENT OF POTENTIAL CONFLICT OF INTEREST
No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT
Portion controlled meals were provided by Health Management Resources, Boston, MA.

118 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS January 2015 Volume 115 Number 1