Dietary intake practices of adults with intellectual disability in a controlled care centre environment

Abstract

Background and aim: Globally, inadequate nutrition and consequently, obesity is highly prevalent among adults with intellectual disability. Overweight and obesity leads to an increased risk for the development of non-communicable diseases, such as diabetes mellitus, cardiovascular diseases, and cancer. Secondary conditions may result in further disability, pain, loss of employment, and depression in adults with intellectual disability. Dietary intake studies concerning the intellectually disabled population have revealed insufficient fibre, fruits and vegetables, and excessive total fat, saturated fat, and sodium consumption. Unfortunately, research is lacking in this population, especially in South Africa. Therefore, it is necessary to assess the dietary intake practices of adults with intellectual disability in a controlled, care centre environment in South Africa with the future aim of compiling intervention programmes to improve the overall quality of life in this population. Methods: The researcher used qualitative and quantitative methods to collect data. Quantitatively demographic, anthropometric, and dietary data were recorded of 66 adults (18-40 years) with intellectual disability at two care centres. The measuring instrument used for the dietary intake was a three-day food wastage study on different days, within three weeks. All snacks that the adults with intellectual disability bought at the snack shop and supermarket during the three days, were recorded. The adults with intellectual disability received three meals per day with one snack at 10:00 prepared at a central kitchen from a fixed menu. Qualitative data on the dietary intake practices during meals, between meals, and other eating occasions were recorded via three focus group discussions with caregiver staff who know the adults with intellectual disability well. Results: The mean body mass index of the men (27.3) and women (33.1) with intellectual disability in this study indicated overweight and obesity respectively. The dietary diversity and quality of the adults with intellectual disability's diet, and the menus at the care centres were low. Dietary intake was compared to the Food Based Dietary Intake Guidelines of South Africa. Fibre, carbohydrate, fruit, and vegetable dietary intake were lower than recommendations. In contrast, sodium, total fat, saturated fat, and added sugar intakes were higher than recommendations. The most popular snacks and drinks consumed by the adults with intellectual disability in this study population were salted crisps and carbonated drinks. During the focus group discussions, the caregivers complained about high-fat cooking methods used by the cooks, and therefore, expressed a need for cooking skills training. Additionally, the caregivers expressed a need for more variety in the menus, healthier snacks, and improved communication between them. Conclusion: The dietary intake of the adults with intellectual disability was not according to recommendations. The following observations translate into recommendations made in order to improve the overall quality of dietary intake of the adults with intellectual disabilities. There is a need at the centres for training in cooking skills, menu planning, and basic nutrition. The adults with intellectual disability need guidance and training in good nutrition and healthy food choices. Continuous, professional input from dietitians is recommended for the compilation of menus, as well as the training of both the staff and the adults with intellectual disability.