title: Overweight and obesity in children and adolescents with Down syndrome-prevalence, determinants, consequences, and interventions: A literature review.
abstract: BACKGROUND
  Children with Down syndrome (DS) are more likely to be overweight or obese than the general population of youth without DS.
  
  
  OBJECTIVE
  To review the prevalence of overweight and obesity and their determinants in youth with DS. The health consequences and the effectiveness of interventions were also examined.
  
  
  METHODS
  A search using MEDLINE, Embase, Web of Science, Scopus, CINAHL, PsycINFO, SPORTDiscus, LILACS, and COCHRANE was conducted. From a total of 4280 studies, we included 45 original research articles published between 1988 and 2015.
  
  
  RESULTS
  The combined prevalence of overweight and obesity varied between studies from 23% to 70%. Youth with DS had higher rates of overweight and obesity than youths without DS. Likely determinants of obesity included increased leptin, decreased resting energy expenditure, comorbidities, unfavorable diet, and low physical activity levels. Obesity was positively associated with obstructive sleep apnea, dyslipidemia, hyperinsulinemia, and gait disorder. Interventions for obesity prevention and control were primarily based on exercise-based programs, and were insufficient to achieve weight or fat loss.
  
  
  CONCLUSIONS
  Population-based research is needed to identify risk factors and support multi-factorial strategies for reducing overweight and obesity in children and adolescents with DS.
authors.affiliation: CAPES Foundation, Ministry of Education of Brazil, Brasília, DF 70040-020, Brazil; Growth and Development Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas, SP 13083-887, Brazil. Electronic address: fbertapelli@gmail.com.
authors.forename: Fabio
authors.initials: F
authors.lastname: Bertapelli
authors.affiliation: Department of Physical Therapy, College of Health Professions, Wichita State University, Wichita, KS 67260-0043, USA. Electronic address: ken.pitetti@wichita.edu.
authors.forename: Ken
authors.initials: K
authors.lastname: Pitetti
authors.affiliation: Department of Kinesiology, Mississippi State University, Mississippi State, Starkville, MS 39762, USA. Electronic address: sagiovlasitis@colled.msstate.edu.
authors.forename: Stamatis
authors.initials: S
authors.lastname: Agiovlasitis
authors.affiliation: Growth and Development Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas, SP 13083-887, Brazil; Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas, SP 13083-970, Brazil. Electronic address: gilguer@fcm.unicamp.br.
authors.forename: Gil
authors.initials: G
authors.lastname: Guerra-Junior
mesh_terms: D000293:Adolescent; D002648:Child; D004032:Diet; D004314:Down Syndrome / Q000453:epidemiology* / Q000378:metabolism / Q000534:rehabilitation; D050171:Dyslipidemias / Q000453:epidemiology; D004734:Energy Metabolism; D015444:Exercise; D005081:Exercise Therapy; D006801:Humans; D006946:Hyperinsulinism / Q000453:epidemiology; D020738:Leptin / Q000378:metabolism; D009765:Obesity / Q000453:epidemiology* / Q000378:metabolism / Q000534:rehabilitation; D050177:Overweight / Q000453:epidemiology / Q000378:metabolism / Q000534:rehabilitation; D015995:Prevalence; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology
chemical_list: D020738:Leptin
keywords: Down syndrome; Obesity; Overweight; Youths