Causes of Obesity in Three Different Groups of People

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Australian children between 6-18 years old with Prader-Willi syndrome (PWS group), Down syndrome (T21 group), and lifestyle-related obesity (LRO group) were the participants in the experiment.

For the sake of this summary assignment, I will primarily be focusing on the results from the experiments performed on children with Down syndrome. In order to measure hyperphagia and physical inactivity in the participants, the parents of the participants completed a questionnaire and survey containing questions that were indicators of each tendency. The results from the questionnaire and survey collected from each group were compared to one another and the conclusions were based on comparative data, essential for interpretation.

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Obesity in individuals with Down syndrome has been recognized to have been caused by certain metabolic factors and hypothyroidism, but hyperphagia has not been tested. This article, though it does explore other conditions, is the first to explore hyperphagia in people with Down syndrome. The participants in each group were recruited, and their parents consented to their children partaking in the experiment. The members of the T21 group were contacted by The Down Syndrome Association of Victoria by mail in which they were recruited if the parents responded to the letter with a phone call (members of the other groups were recruited in a similar manner). Each group was relatively similar in size; the T21 group consisted of 17 individuals, the PWS group, 16, and the LRO group, of 19. The experiment required these three groups to compare the results with one another.

Since there is little to no research about the presence of hyperphagia (abnormally increased appetite) in individuals with Down syndrome, the article's hypotheses are comparative to the other participant groups.

The researchers hypothesized that children with Down syndrome would have more hyperphagia than the LRO group, but less than the PWS group, and less physical activity engagement than the LRO group. To test this, the family was provided with the hyperphagia questionnaire, the Children’s Leisure Activities Study Survey (CLASS), and questioned about food restrictions at home in addition to the demographics of the child. The hyperphagia questionnaire examined factors such as hyperphagic drive, behavior, and severity.

The CLASS measured the amount of time spent participating in physical activities as well as sedentary activities. This study had no independent variable, as the participants were observed in their daily lives and nothing changed in order to observe the dependent variable. The dependent variable in the experiment was the level of obesity in the child compared to the other participants. The data collected from the questionnaires were analyzed using univariable linear regression and chi-squared tests to compare total and mean scores, demographic and clinical variables, and the scores between diagnostic groups. Overall, this data supported the article’s hypothesis.

The characteristics of each study group were analyzed, displaying factors that could affect the results in some way. For example, the PWS and T21 groups had relatively more women as participants and all participants were living in the family home. When comparing the hyperphagia scores between groups, the T21 group fell between the LRO and PWS, as predicted in the hypothesis. Children with Down syndrome have less hyperphagia than those with PWS, but more than the children in the LRO group. When comparing CLASS scores, there was no major difference in the amount of time spent engaged in physical activity between the groups. However, there was a higher presence of engagement in sedentary activity in the LRO group compared to the T21 group. Though this does not directly support the hypothesis, the author does claim that children in the T21 group spend more time engaging in sedentary activities, with the exception of computer-related activities.

With this one exception, children with Down syndrome have more hyperphagia and perform more sedentary activities in a week than children in the LRO group. In regard to the supportive results from the experiment, there were several implications and limitations that should be addressed. First of all, the reason as to why there should be an exception made to the results is because children with Down syndrome often do not have the intellectual capability to navigate computer programs and activities independently, therefore making them less likely to spend a large amount of time on them. This may also apply to their capability in accessing organized sports or programs involving physical activity.

The article also addresses where error may have occurred in the experiment. The CLASS results depended on parent recollection, therefore leading to possible measurement error. Also, the hyperphagia questionnaire was developed for people with PWS, and not Down syndrome or people with LRO. Lastly, it is addressed that the experiment could have benefitted from more participants, generating more generalizable results. Despite these implications, the experiment demonstrated how hyperphagia and sedentary activities can play a role in the obesity of people with Down syndrome, along with metabolic factors and hypothyroidism.