The CDC (Centers for Disease Control and Prevention) states that children with special needs are almost 40% more likely to be obese than their non-disabled peers.2 Further, the “obesity rate for adults with disabilities is 57% higher than for adults without disabilities.” In addition, “Adults with disabilities are physically active on a regular basis about half as often as adults without disabilities (12% vs. 22%).
Disability and Healthy Nutrition
The CDC has information on food insecurity as well as healthy portions (see Resources). The MT Disability and Health Program on nutrition indicates that there are three levels of appropriate nutrition: adequate nutrition, individualized nutrition, health promoting nutrition.
Adequate nutrition (level 1): This means that the diet is adequate and safe both in quantity and quality. This includes appropriate food storage and preparation.
Individualized nutrition (level 2): Individual choices are respected. Nutrition takes into account medical and secondary conditions, and other special needs. This could be monitoring diets due to diabetes, kidney disease, or other conditions.
Health Promoting Nutrition: This takes into consideration cholesterol, fat, sugars, sodium and vitamins.
For those that need them, personal care assistants (PCAs) or family caregivers can help support nutrition by recording intake, offering three healthy meals/day, and supporting actual eating (e.g. feeding or adapted utensils). PCAs need to be aware of any food allergies, special diets, feeding/choking/swallowing (using food thickeners, caloric supplements, positioning)4 issues.
The CDC also notes that secondary issues related to inappropriate nutrition can be obesity, depression, and bowel problems.5 With obesity comes high cholesterol/blood pressure/blood sugar resulting in heart conditions and diabetes. The American Academy of Pediatrics (AAP) has a website for families on healthy nutrition for children (see Resources).
Combining Appropriate Nutrition with Physical Activity Results in Best Outcomes
The CDC has information on physical activity, including social distancing (see Resources). Suggestions include walking, including indoor walking. Other suggestions during COVID-19 include family workouts, doing chores, being outside, and exercising while watching TV. The AAP endorses Bright Futures, which has information on physical activity for children, including children with special needs. There is additional information on the AAP family website.
A school-based program called “I Can Do It” helps children with disabilities remain active and healthy. West Virginia University Center of Excellence on Disability has a great website “Exercise is for EVERYbody.” At-home activities include adapted yoga, improving hypotonia (low muscle tone), quick workouts for diverse motor abilities, and weight loss. Schools should have individualized programs and follow the IEP, for example, using adapted PE (physical education.) Being out in the community can include outdoor activities like parks and adaptive playgrounds (see www.accessibleplayground.net/playground-directory) or swimming. Community-based resources are discussed. like Special Olympics, and there is information on adapted baseball through Miracle League or Challenger Little League, as well as many YMCA’s having adapted sports and classes. Ideas on getting active include using fitness trackers and an inclusive workout app. They provide a toolkit for various stages of programs such as thinking about it, preparing, engaging, and growing an existing program.
Adaptive Physical Activity Equipment
The NJ Department of Human Services guide, “Healthy Living for People with Disabilities,” covers various types for adaptive sports equipment. These include:
- Court Chair: A sport wheelchair designed for wheelchair users on the courts (rugby, tennis basketball etc.).
- Hand Cycle: Propelled by the arms rather than the legs, as an alternative to a bicycle.
- Push-Rim Racers: Used by competitive track and marathon runners.
- Beach Access Chair: All-terrain, specialized wheelchair that can be pushed in sand, snow and other soft soils.
- Special Seat Cushions to Prevent Skin Breakdown: Decrease the likelihood of skin breakdown or pressure sores during exercise.
- Wrist and Hand Grips: Gloves or grips improve ability to hold equipment and increase safety.
- Therapy Bands: Provide resistance to movements to build muscle (can be used sitting on the floor, or for standing exercises).
- Stabilizing Straps: Reduce unneeded movement and can prevent injuries or falls.
- Wrist or Ankle Weights: Add extra weight to movements to build muscle.
- Fitness Bands/Pedometer: Measure heart rate and exercise output. Note: for manual chair users, check if it counts arm/wheel turns similar to step trackers.
Benefits of Physical Fitness for People with Disabilities
Georgetown University notes the many benefits of physical activity for people with disabilities. Health problems can be prevented by watching weight/reducing fat and building muscle, which prevents heart and bone diseases. It is reported that people with disabilities who are physically active “have higher esteem, better body images and higher rates of academic success; are more confident and more likely to graduate from high school and matriculate in college.”
Children and adults with disabilities need their nutritional requirements to be addressed. Pairing this with physical fitness aids in the prevention and treatment of disease results in the best health outcomes..
ABOUT THE AUTHOR:
Lauren Agoratus, M.A. is the parent of a young adult with autism and medical complexity. She serves as the State Coordinator for Family Voices-NJ and as the central coordinator in her state’s Family-to-Family Health Information Center. FVNJ and F2FHIC are both housed at the SPAN Parent Advocacy Network (SPAN) at www.spanadvocacy.org
- https://www.cdc.gov/ncbddd/disabilityandhealth/ obesity.html#ref
- www.fitness.gov soon to be replaced by https://health.gov/
- https://ucedd.georgetown.edu/documents/athletic_ equity/Physical_Activity_Proceedings.pdf
Read the article here.