Written by Emily Hatch, CSCS

Obesity is a well-known issue within our society that has become even more pronounced during the COVID-19 Pandemic. Our commutes to work are often through the kitchen, we have more access to food, and when boredom sets in, we often turn to snacking.  Obesity, which “is a term that reflects excess adipose tissue,” affects around 30.4% of U.S. adults and 18% of children (Jacobs, 2018, p110).  Even more, adults with disabilities have a disproportionately higher rate of obesity (36%) and 22% of children with disabilities are affected by obesity (CDC.com).
 
According to the CDC, “adults with excess weight are at even greater risk during the COVID-19 pandemic.” Not only is obesity linked to an impaired immune system, but it “decreases lung capacity and reserve and can make ventilation more difficult” (CDC.com). Even more, 30.2% “of [the] hospitalizations were attributed to obesity,” which further shows the duty we, as trainers and societal members, must address this issue and slow the curve of COVID-19 (CDC.com). 
 
Simply put, obesity occurs when the “intake [of calories] exceeds expenditure over an extended period of time” (Jacobs, 2018, p.110). This excess intake may lead to “subclinical inflammation, vascular and metabolic dysfunction, and hormonal irregularities” (Jacobs, 2018, p. 110). Those who are obese may even experience a leptin resistance, which is “a protein produced in fat cells” that tells us we are full (Jacobs, 2018, p.111). So, what are some things we can do to encourage movement, create easier access to healthy foods and prevent further individuals from becoming compromised?
 
For many adults and children, habit formation is critical to develop healthy eating patterns and exercise regimens.  However, within the population we serve, those with developmental disabilities, combating poor food habits and exercise routines can be challenging and often requires a support system. In our experience, we have come across many clients who experience food sensitivities, are on medications that make weight loss challenging, may experience a lack of resources to healthy foods or may suffer from pain that discourages movement. We also have those who are thoroughly into video games, which increases both screen time and sitting time. We acknowledge these challenges but also have some great techniques for both clients and trainers to encourage movement and healthy lifestyle changes!

1. Pokeman Go! - This is an amazing way to get clients moving, especially for those who enjoy video games!
2. Welcome the client with open arms - Often, those with obesity may feel shame or embarrassment when going into a gym. Judgement and shame may discourage someone from coming back.
3. Begin the workout slowly. “A carefully graded progression is critical” especially because a client may experience joint pain (Jacobs, 2018, p.115).  Remind your client that their joint pain can improve, “sometimes dramatically, following weight loss of as little as 5% to 10% of body weight” (Jacobs, 2018, p.115). 
4. Go for a walk in the woods!  Moving your body and being in nature is both physically and mentally beneficial. Try and shoot for a 30 minute walk, at least 5 times per week (Jacob, 2018).
5. Food journal! Decreasing caloric intake is essential for decreasing body mass.  According to Jacob (2018), a “plant based diet has been shown to predict successful weight loss maintenance” (p.114).
6. Hydrate. Nothing is better for our bodies than water!

 
In my training experience, I have had the pleasure of working with many clients and families who are motivated to make lifestyle changes. And although not everyone has that support, we, as a training community, need to encourage individuals, as well as community members, to promote healthier food choices and lifestyle choices from an early age.  The CDC also recommends community engagement within schools, hospitals, and childcare environments where we can teach healthy choices. Working on “neighborhood design, access to healthy, affordable foods and beverages, and access to safe and convenient places for physical activity” is also an essential step for our society to combat the negative effects of poor lifestyle choices, which can lead to obesity (CDC.com).  However, as best we can, it is our duty as trainers to continue to fight for healthier lifestyles, create positive exercise environments and develop positive relationships for the prevention of a continued obesity pandemic.

References
 
Jacobs, Patrick L. (2018). Nsca’s essentials of training special populations. Library of Congress Cataloging-
in-Publication Data.

Written by Emily Hatch, CSCS

Down Syndrome is characterized by “a genetic disorder that results in a trisomy (three copies) of the 21st human chromosome” (Jacobs, L Patrick, 2018). Along with the trisomy of the 21st chromosome, those with Down Syndrome also experience hyper-mobility in multiple joints. This hyper-mobility allows for an adjustment in training modalities for these individuals.

​According to OrthoInfo, individuals with Down Syndrome may experience joint instability within their neck, knees, and hips while also dealing with various foot issues, including bunions and flat feet (2019). In order to improve these areas of the body, it is vital to strengthen the ligaments that are associated with these areas and “have optimal alignment of hips, knees and ankles to support” postural alignment (Gadson et al., 2018). The following exercises are imperative for an optimally designed workout tailored to an individual with Down Syndrome. In addition, these exercises can help to avoid immobilization or surgery.

            References

Gadson, Andrea PT, MPT; Shimanek,P PT, DPT, (2018, Aug). Physical therapy for adolescents thru adulthood with down syndrome. https://www.nads.org/wpcontent/uploads/2018/08/Shimanek-NADS-2018-PT-for-adolescents-thru-adults-with-DS.pd

Jacobs, Patrick L. (2018). Nsca’s essentials of training special populations. Library of Congress Cataloging-
in-Publication Data.
​
(2019, Jan). Down syndrome: musculoskeletal effects. OrthoInfo. orthoinfo.aaos.org