title: Body mass index of children and youth with an intellectual disability by country economic status.
abstract: OBJECTIVE
  Individuals with intellectual disabilities are at higher risk for health disparities including overweight and obesity; however, little is known at the population level about the BMI status of children and youth with intellectual disabilities. This study is a secondary analysis of BMI status (underweight, normal weight, overweight and obese) in children and youth (8-<18years) participating in Special Olympics by country economic status.
  
  
  METHODS
  A total of 14,032 participants (n=8,856 male) measured height and weight records were available from the Special Olympics International Health Promotion database. The 141 countries in the database were re-coded according to the World Bank's classification of country economic status. BMI prevalence rates were calculated for underweight, normal weight, overweight, and obesity for children and youth using IOTF cutoffs by economic status. Chi-squared analyses and Fisher's exact test were used to examine differences in weight status by economy and sex.
  
  
  RESULTS
  Overall, 27.87% of Special Olympics participants from low-income economies, 31.04% from lower middle-income, 25.29% from upper middle-income, and 42.36% from high-income economies had BMI levels outside of the normal range. The low-income countries had higher rates of underweight and the high-income countries had higher rates of obesity.
  
  
  CONCLUSIONS
  The high levels of both underweight and overweight/obesity found in this population of children and youth participating in Special Olympics represents a double burden of health risk. More research is needed to understand why this population experiences such disparities in BMI status and to develop health promotion initiatives targeted at this population.
authors.affiliation: University of Ontario Institute of Technology, Oshawa, ON, Canada. Electronic address: Meghann.lloyd@uoit.ca.
authors.forename: Meghann
authors.initials: M
authors.lastname: Lloyd
authors.affiliation: State University of New York at Cortland, Cortland, NY, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Foley
authors.affiliation: University of Victoria, Victoria, BC, Canada.
authors.forename: Viviene A
authors.initials: VA
authors.lastname: Temple
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D016208:Databases, Factual; D005260:Female; D014943:Global Health; D006801:Humans; D008607:Intellectual Disability / Q000150:complications*; D008297:Male; D050177:Overweight / Q000150:complications / Q000191:economics* / Q000453:epidemiology*; D015995:Prevalence; D012959:Socioeconomic Factors; D013177:Sports; D013851:Thinness / Q000150:complications / Q000191:economics* / Q000453:epidemiology*
keywords: BMI; Children; Health disparity; Intellectual disability; Obesity; Overweight; Special Olympics; Underweight; World economic status; Youth