International Journal of Public Health

, Volume 62, Issue 8, pp 921–928 | Cite as

Association of poverty and social exclusion with body mass index among Special Olympics athletes in Europe

  • Pauli Rintala
  • Viviene A. Temple
  • Meghann Lloyd
  • Chris Faro
  • John T. Foley
Original Article



To examine the association of a risk of poverty and social exclusion (AROPE), age, and gender with the body mass index (BMI) status of European Special Olympics athletes.


BMI records were available for 1905 children and youth and 5517 adults from the Special Olympics International (SOI) Health Promotion database. AROPE was extracted from EU Eurostat statistics. Logistic regression analyses were used to predict BMI status.


For children/youth and adults, respectively, 9.4 and 6.3% were underweight and 25.3 and 44.6% were overweight/obese. Being underweight was significantly associated with higher AROPE rates. Being female and lower AROPE rates were significantly associated with overweight/obesity for both children/youth (OR 1.27; 95% CI 1.07–1.50 and OR 0.97; 95% CI 0.96–0.98) and adults (OR 1.55; 95% CI 1.39–1.72 and OR 0.96; 95% CI 0.95–0.98).


The Europe 2020 “platform against poverty” strategy aims to ensure that those experiencing poverty and social exclusion share the benefits of economic growth. These findings suggest that SOI health promotion efforts to foster healthy BMI are needed and should be tailored to specific social and economic circumstances in Europe.


Intellectual disability Underweight Overweight Special Olympics Body mass index Poverty and social exclusion 


Compliance with ethical standards

All procedures performed in the study were in accordance with the ethical standards of the institutional research committees of each participating university. In order of authorship: University of Jyväskylä, University of Victoria, University of Ontario Institute of Technology, and State University of New York College at Cortland.


  1. ALSWH (2007) ALSWH Data dictionary supplement. Section 3 Anthropometry. Research Centre for Gender, Health and Ageing. University of Newcastle. Accessed Jan 2017
  2. Antufermo M, Di Meglio E (2012) Population and social conditions. Eurostat: Statistics in Focus 9/2012. Accessed May 2017
  3. Begarie J, Maiano C, Leconte P, Ninot G (2013) The prevalence and determinants of overweight and obesity among French youths and adults with intellectual disabilities attending special education schools. Res Dev Disabil 34:1417–1425. doi: 10.1016/j.ridd.2012.12.007 CrossRefPubMedGoogle Scholar
  4. Bergström H, Hagströmer M, Hagberg J, Schafer Elinder L (2013) A multi-component universal intervention to improve diet and physical activity among adults with intellectual disabilities in community residences: a cluster randomised controlled trial. Res Dev Disabil 34:3847–3857. doi: 10.1016/j.ridd.2013.07.019 CrossRefPubMedGoogle Scholar
  5. Bhaumik S, Watson JM, Thorp CF, Tyrer F, McGrother CW (2008) Body mass index in adults with intellectual disability: distribution, associations and service implications: a population-based prevalence study. J Intellect Disabil Res 52:287–298CrossRefPubMedGoogle Scholar
  6. Bigby C (2012) Social inclusion and people with intellectual disability and challenging behaviour: a systematic review. Int J Dev Disabil 37:360–374. doi: 10.3109/13668250.2012.721878 CrossRefGoogle Scholar
  7. Black RE, Morris SS, Bryce J (2003) Where and why are 10 million children dying every year? Lancet 361:2226–2234. doi: 10.1016/S0140-6736(03)13779-8 CrossRefPubMedGoogle Scholar
  8. Braithwaite J, Mont D (2009) Disability and poverty: a survey of World Bank poverty assessments and implications. ALTER Eur J Dis Res 3:219–232CrossRefGoogle Scholar
  9. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320:1240–1243CrossRefPubMedPubMedCentralGoogle Scholar
  10. Cole TJ, Flegal KM, Nicholls D, Jackson AA (2007) Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ 335:194–202. doi: 10.1136/bmj.39238.399444.55 CrossRefPubMedPubMedCentralGoogle Scholar
  11. de Winter CF, Bastiaanse LP, Hilgenkamp TIM, Evenhuis HM, Echteld MA (2012) Overweight and obesity in older people with intellectual disability. Res Dev Disabil 33:398–405. doi: 10.1016/j.ridd.2011.09.022 CrossRefPubMedGoogle Scholar
  12. Emerson E (2007) Poverty and people with intellectual disabilities. Ment Retard Dev Disabil Res Rev 13:107–113CrossRefPubMedGoogle Scholar
  13. European Commission (2010) Europe 2020. A strategy for smart, sustainable and inclusive growth. Accessed May 2017
  14. Eurostat (2016a) Eurostat statistics explained. Accessed May 2017
  15. Eurostat (2016b) Eurostat statistics explained. People at risk of poverty or social exclusion. Accessed 10 May 2016
  16. Eurostat (2016c) Glossary: at risk of poverty or social exclusion (AROPE). Accessed 11 May 2016
  17. Gazizova D, Puri BK, Singh I, Dhaliwal R (2012) The overweight: obesity and plasma lipids in adults with intellectual disability and mental illness. J Intellect Disabil Res 56:895–901. doi: 10.1111/j.1365-2788.2011.01468.x CrossRefPubMedGoogle Scholar
  18. Harrison K et al (2011) Toward a developmental conceptualization of contributors to overweight and obesity in childhood: the six-Cs model. Child Dev Perspect 5:50–58. doi: 10.1111/j.1750-8606.2010.00150.x CrossRefGoogle Scholar
  19. Hsu SW, Yen CF, Hung WJ, Lin LP, Wu CL, Lin JD (2012) The risk of metabolic syndrome among institutionalized adults with intellectual disabilities. Res Dev Disabil 33:615–620. doi: 10.1016/j.ridd.2011.09.005 CrossRefPubMedGoogle Scholar
  20. Lloyd M, Temple VA, Foley JT (2012) International BMI comparison of children and youth with intellectual disabilities participating in Special Olympics. Res Dev Disabil 33:1708–1714. doi: 10.1016/j.ridd.2012.04.014 CrossRefPubMedGoogle Scholar
  21. Lloyd M, Foley JT, Temple VA (2014) Body mass index of children and youth with an intellectual disability by country economic status. Prev Med 69:197–201. doi: 10.1016/j.ypmed.2014.10.010 CrossRefPubMedGoogle Scholar
  22. McGrath L, Jones RSP, Hastings RP (2010) Outcomes of anti-bullying intervention for adults with intellectual disabilities. Res Dev Disabil 31:376–380. doi: 10.1016/j.ridd.2009.10.006 CrossRefPubMedGoogle Scholar
  23. Melville CA, Cooper SA, Morrison J, Allan L, Smiley E, Williamson A (2008) The prevalence and determinants of obesity in adults with intellectual disabilities. J Appl Res Intellect Dis 21:425–437CrossRefGoogle Scholar
  24. Mouridsen SE, Rich B, Isager T (2002) Body mass index in male and female children with infantile autism. Autism 6:197–205CrossRefPubMedGoogle Scholar
  25. Ng M et al (2014) Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the global burden of disease study 2013. Lancet 384:766–781. doi: 10.1016/s0140-6736(14)60460-8 CrossRefPubMedPubMedCentralGoogle Scholar
  26. Nota L, Ferrari L, Soresi S, Wehmeyer M (2007) Self-determination, social abilities and the quality of life of people with intellectual disability. J Intellect Disabil Res 51:850–865. doi: 10.1111/j.1365-2788.2006.00939.x CrossRefPubMedGoogle Scholar
  27. Olympics Special (2007) Healthy choices, healthy athletes: Health promotion guide for Clinical Directors. Special Olympics, Washington, DCGoogle Scholar
  28. Persoskie A, Ferrer RA (2017) A most odd ratio: interpreting and describing odds ratios. Am J Prev Med 52:224–228. doi: 10.1016/j.amepre.2016.07.030 CrossRefPubMedGoogle Scholar
  29. Prospective Studies Collaboration (2009) Body-mass index and cause-specific mortality in 900,000 adults: collaborative analyses of 57 prospective studies. Lancet 373:1083–1096. doi: 10.1016/S0140-6736(09)60318-4 CrossRefPubMedCentralGoogle Scholar
  30. Sari HY, Bahceci B (2012) Nutritional status of children with an intellectual disability. Int J Disabil Hum Dev 11:17–21CrossRefGoogle Scholar
  31. Schalock RL (2011) The evolving understanding of the construct of intellectual disability. Int J Dev Disabil 36:227–237. doi: 10.3109/13668250.2011.624087 CrossRefGoogle Scholar
  32. Simmonds M et al (2015) The use of measures of obesity in childhood for predicting obesity and the development of obesity-related diseases in adulthood: a systematic review and meta-analysis. Health Technol Assess 19:1–336. doi: 10.3310/hta19430 CrossRefPubMedPubMedCentralGoogle Scholar
  33. Sohler N, Lubetkin E, Levy J, Soghomonian C, Rimmerman A (2009) Factors associated with obesity and coronary heart disease in people with intellectual disabilities. Soc Work Health Care 48:76–89CrossRefPubMedGoogle Scholar
  34. Soler Marín A, Xandri Graupera J (2011) Nutritional status of intellectual disabled persons with Down syndrome. Nutr Hosp 26:1059–1066. doi: 10.1590/S0212-16112011000500021 PubMedGoogle Scholar
  35. Special Olympics (2016) Special Olympics global strategic plan 2016–2020. Washington, DC. Accessed May 2017
  36. Temple VA, Foley JT, Lloyd M (2014) Body mass index of adults with intellectual disability participating in Special Olympics by world region. J Intellect Disabil Res 58:277–284. doi: 10.1111/jir.12011 CrossRefPubMedGoogle Scholar
  37. Temple VA, Foley JT, Lloyd M (2015) Body mass index of adult Special Olympians by country economic status. J Policy Pract Intellect Disabil 12:235–243. doi: 10.1111/jppi.12123 CrossRefGoogle Scholar
  38. Vidmar S, Carlin J, Hesketh K, Cole T (2004) Standardizing anthropometric measures in children and adolescents with new functions for egen. Stat J 4:50–55Google Scholar
  39. Weitoft GR, Eliasson M, Rosén M (2008) Underweight, overweight and obesity as risk factors for mortality and hospitalization. Scand J Public Health 36:169–176. doi: 10.1177/1403494807085065 CrossRefGoogle Scholar
  40. World Health Organization (1995) Physical status: the use and interpretation of anthropometry (Technical Report Series No. 854). World Health Organization, GenevaGoogle Scholar

Copyright information

© Swiss School of Public Health (SSPH+) 2017

Authors and Affiliations

  • Pauli Rintala
    • 1
  • Viviene A. Temple
    • 2
  • Meghann Lloyd
    • 3
  • Chris Faro
    • 4
  • John T. Foley
    • 4
  1. 1.Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
  2. 2.School of Exercise Science, Physical and Health EducationUniversity of VictoriaVictoriaCanada
  3. 3.Faculty of Health SciencesUniversity of Ontario Institute of TechnologyOshawaCanada
  4. 4.Physical Education DepartmentState University of New York College at CortlandCortlandUSA

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