BACKGROUND Previous research indicates that individuals with intellectual and developmental disabilities (IDDs) are at risk for poor diet quality. OBJECTIVE The purpose of this secondary analysis was to determine whether two different weight-loss diets affect energy intake, macronutrient intake, and diet quality as measured by the Healthy Eating Index-2010 (HEI-2010) during a 6-month weight-loss period and 12-month weight-management period, and to examine differences in energy intake, macronutrient intake, and HEI-2010 between groups. DESIGN Overweight/obese adults with IDDs took part in an 18-month randomized controlled trial and were assigned to either an enhanced Stop Light Diet utilizing portion-controlled meals or a conventional diet consisting of reducing energy intake and following the 2010 Dietary Guidelines for Americans. Proxy-assisted 3-day food records were collected at baseline, 6 months, and 18 months, and were analyzed using Nutrition Data System for Research software. HEI-2010 was calculated using the data from Nutrition Data System for Research. PARTICIPANTS/SETTING The study took place from June 2011 through May 2014 in the greater Kansas City metropolitan area. MAIN OUTCOME MEASURES This was a secondary analysis of a weight-management intervention for adults with IDDs randomized to an enhanced Stop Light Diet or conventional diet, to examine differences in energy intake, macronutrient intake, and HEI-2010 across time and between groups. STATISTICAL ANALYSES PERFORMED Independent- and paired-samples t tests and general mixed modeling for repeated measures were performed to examine group differences and changes at baseline, 6 months, and 18 months between the enhanced Stop Light Diet and conventional diet groups. RESULTS One hundred and forty six participants (57% female, mean±standard deviation age=36.2±12.0 years) were randomized to either the enhanced Stop Light Diet or conventional diet group (77 enhanced Stop Light Diet, 69 conventional diet) and provided data for analysis at baseline, 124 completed the 6-month weight-loss period, and 101 completed the 18-month study. Participants on the enhanced Stop Light Diet diet significantly reduced energy intake at 6 and 18 months (both P<0.001), but those on the conventional diet did not (both P=0.13). However, when accounting for age, sex, race, education level, and support level (mild vs moderate IDD), there was a significant decrease during the 18-month intervention in energy intake for the enhanced Stop Light Diet and conventional diet groups combined (P<0.01 for time effect), but no significant group difference in this change (P=0.39 for group-by-time interaction). There was no significant change in total HEI-2010 score at 6 and 18 months (P=0.05 and P=0.38 for the enhanced Stop Light Diet group; P=0.22 and P=0.17 for the conventional diet group), and no significant group difference at 6 and 18 months (P=0.08 and P=0.42). However, when participants' age, sex, race, education level, and support level were accounted for, mixed modeling indicated a significant increase in total HEI-2010 scores for the enhanced Stop Light Diet and conventional diet groups combined during the 18-month intervention (P=0.01 for time effect). CONCLUSIONS The results of this study found that after controlling for demographic factors, individuals with IDDs can decrease their energy intake and increase their diet quality, with no significant differences between the enhanced Stop Light Diet and conventional diet groups.

中文翻译：

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智力和发育障碍成人 18 个月体重管理随机对照试验期间能量摄入和饮食质量的变化

背景 先前的研究表明，智力和发育障碍 (IDD) 的个体有饮食质量差的风险。目的 本次分析的目的是确定两种不同的减肥饮食是否会影响 6 个月减肥期间的能量摄入、宏量营养素摄入和饮食质量，如健康饮食指数 2010 (HEI-2010) 所衡量的那样和 12 个月的体重管理期，并检查各组在能量摄入、常量营养素摄入和 HEI-2010 方面的差异。设计 患有 IDD 的超重/肥胖成年人参加了一项为期 18 个月的随机对照试验，并被分配到使用部分控制膳食的增强型停止光饮食或传统饮食，包括减少能量摄入并遵循 2010 年美国人饮食指南。在基线、6 个月和 18 个月收集代理辅助的 3 天食物记录，并使用营养数据系统研究软件进行分析。HEI-2010 是使用营养研究数据系统中的数据计算得出的。参与者/地点 该研究于 2011 年 6 月至 2014 年 5 月在堪萨斯城大都市区进行。主要结局指标 这是对随机接受强化停止光饮食或传统饮食的 IDD 成人体重管理干预的二次分析，以检查不同时间和组间能量摄入、常量营养素摄入和 HEI-2010 的差异。执行的统计分析 对重复测量进行独立和配对样本 t 检验以及一般混合建模，以检查基线、6 个月、强化停止光饮食组和传统饮食组之间的间隔为 18 个月。结果 146 名参与者（57% 女性，平均±标准差年龄 = 36.2±12.0 岁）被随机分配到增强型停止光饮食组或常规饮食组（77 名增强型停止光饮食，69 例常规饮食）并提供数据对于基线分析，124 人完成了 6 个月的减肥期，101 人完成了 18 个月的研究。增强型停止光饮食的参与者在 6 个月和 18 个月时显着减少了能量摄入（均 P<0.001），但传统饮食的参与者没有（均 P=0.13）。然而，当考虑到年龄、性别、种族、教育水平和支持水平（轻度与中度 IDD）时，在 18 个月的能量摄入干预期间，增强型停止光饮食和常规饮食组的能量摄入量有显着减少（时间效应 P<0.01），但这种变化没有显着的组间差异（P=0.39 for group-by -时间互动）。6 个月和 18 个月时 HEI-2010 总分无显着变化（增强型停止光饮食组 P=0.05 和 P=0.38；常规饮食组 P=0.22 和 P=0.17），无显着变化6 个月和 18 个月时的差异（P=0.08 和 P=0.42）。然而，当考虑到参与者的年龄、性别、种族、教育水平和支持水平时，混合模型表明在 18 个月的干预期间，增强型停止光饮食和传统饮食组的 HEI-2010 总分显着增加（时间效应 P=0.01）。