Multilevel Nutrition Interventions for Obesity Prevention Among Children With Intellectual and Developmental Disabilities: A Systematic Review

INTRODUCTION: Childhood obesity disproportionately affects children with intellectual and developmental disabilities, in part due to additional risks, including food selectivity, metabolic differences, and systemic inequities. Given the critical role of nutrition in obesity prevention, this systematic review examines the effectiveness of nutrition-based interventions targeting intellectual and developmental disabilities across socio-ecological levels. METHODS: This review followed PRISMA guidelines (PROSPERO ID # CRD42023493651). A search of four electronic databases (PubMed MEDLINE, PsycINFO, CINAHL, Embase) identified articles evaluating nutrition-based obesity prevention interventions for children with intellectual and developmental disabilities. Inclusion criteria encompassed interventions implemented at household, school, community, or policy levels, with outcomes measuring diet-related behaviors and obesity. Outcomes included diet-related behaviors and obesity indicators. Two independent reviewers screened articles, extracted data, and assessed quality. Articles were assessed for methodological quality and intervention effectiveness. RESULTS: Of 3531 initial citations, 10 articles met inclusion criteria. Most interventions were school-based and incorporated nutrition education, behavioral strategies, and environmental modifications. Of these, 80% targeted school-level interventions, with some extending to community and policy levels. Results showed improved diet-related behaviors, especially increased fruit and vegetable intake, though statistically significant reductions in obesity measures were not observed, likely due to small sample sizes and methodological limitations such as lack of control groups. CONCLUSION: Nutrition-based interventions show promise in improving dietary behaviors among children with intellectual and developmental disabilities, but evidence on obesity reduction remains inconclusive. Future research should adopt rigorous study designs and incorporate family and community engagement to enhance intervention efficacy and sustainability.