1. Healthy Eating Similarities and Differences
among People with an Intellectual Disability
and the General Irish Population
Carolyn M. Shivers, Philip McCallion, & Mary McCarron
Introduction: Though doctors and dieticians have expressed concern about the nutritional health of individuals with intellectual and developmental disabilities (IDD), and several studies have shown individuals with ID to be at increased risk for obesity, very little is known about the nutritional habits of these individuals.
The present analyses were conducted to compared the nutritional habits of ageing individuals with ID to the ideal recommendations for the Irish population. In addition to overall nutritional patterns, we also wanted to assess whether or not food intake differed by residential setting. Due to recent legislation in Ireland, people with ID may be moving from residential settings to community group homes or to live with their families. However, more independent settings may not have the same level of nutritional supervision present in residential settings, leading to poorer nutrition choices. Alternately, people with ID living independently may be able to introduce more variety into their diets, leading to better nutrition.
Sample: Data were taken from Wave 1 of the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS-TILDA).
IDS-TILDA consists of 753 participants with IDD over the age of 40. Participants were randomly selected from the National Intellectual Disability Database (NIDD), and represent 138 service providers throughout Ireland.
All levels of ID were represented. In the final sample, 23.9% had mild ID, 46.5% had moderate ID, and 29.6% had severe or profound ID. There were slightly more females (55%) than males (45%) participating.
Data collection took place over a period of several months, and consisted of pre-interview health questionnaires and in-person interviews conducted by trained research personnel.
Dependent Variable: As part of the in-person interview, participants and their proxies were asked how many times per week the individual with ID ate a variety of food. These foods were then grouped into categories according to Irish dietary guidelines.
Methods: The dependent variables were constructed based on Flynn et al.’s (2011) food-based dietary guidelines for Ireland. After categorizing individuals based on age (40-49 or 50+), gender, and level of activity (moderately active or sedentary), we calculated whether they (a) fell below, (b) met, or (c) exceeded the recommended intake of food for the following five categories: sweets*, meat, fruits/vegetables, dairy, and carbohydrates**.
We then ran crosstabs for each of these food categories by age, gender, level of ID (mild, moderate, or severe/profound), and living situation (independently or with family, in a community group home, or in a residential setting).
*Because less than one serving of sweets per day is recommended, the only categories created were “meets recommendations” and “exceeds recommendations.”
**Only consumption of carbohydrates was broken down by level of activity. All other categories were created solely by age and gender.
Figure 1 Percentage of individuals falling below, meeting, and exceeding nutrition recommendations
by residential setting
Independent/Family
Community Group Home
Residential Setting
Exceeds recommendations
Meets recommendations
Below recommendations
Sweets Dairy Carbohydrates
Results – Frequencies revealed a large proportion of adults currently not meeting the recommendations for intake of various nutritional groups. A full 90% of respondents ate fewer servings of fruits and vegetables than suggested, while over half (51.5%) exceeded the recommended intake of sweets.
In contrast, over 90% of respondents consumed the recommended number of servings of meat per week, and nearly two thirds ate the recommended amount of carbohydrates (65.3%).
Consumption of sweets, dairy, and carbohydrates differed significantly by living situation, as seen in Figure 1. Differences were also found by level of ID, with people with mild ID more likely to follow the recommendations.
Acknowledgements
Participants: People with an intellectual disability, careres, and families who are participating in the study.
Funders: Department of Children and Health and the Health Research Board
Reference: Flynn et al. (2011). Revision of food-based dietary guidelines for Ireland, Phase 2: Recommendations for healthy eating and affordability. Public Health Nutrition, 15(3),
Discussion: Results show that a majority of adults with IDD over the age of 40 in Ireland do not currently meet nutritional recommendations for all food categories, with the vast majority not eating enough fruits and vegetables, and over half eating too many sweets. In fact, so few individuals met or exceeded the number of recommended servings for fruits and vegetables that no differences were found by gender, living situation, or level of ID.
Though results differed by gender, with females less likely than males to at the recommended amount of each food group, this is likely because Flynn et al. proposed a wider range of appropriate servings for males than for females (e.g. it is recommended that males eat 3-5 daily servings of dairy, while it is recommended that females eat exactly 3 servings per day).
However, the differences by living situation were much more interesting. While there were no significant differences in meat or fruit/vegetable consumption, individuals living independently or with family showed different nutritional habits than those living in community or residential settings. However, these differences were not consistent. Though individuals living independently were less likely to meet or exceed the recommendations for dairy consumption, they were more likely to eat only the recommended number of servings of sweets and carbohydrates. In contrast, individuals living in residential settings were most likely to exceed the recommended number of servings of sweets, but were also less likely to consume too few dairy products.
These findings show that more work is needed to engender adequate nutrition habits among individuals with ID. In particular, the low consumption of fruits and vegetables is concerning. Additionally, work is needed, both on a personal and service level, to create more balance in overall dietary patterns.