If you ask Scott Tobin about staying healthy, the 27-year-old Cheney resident quickly turns the conversation to nutrition.
As a Special Olympian, Tobin in recent months has learned more about portion control and piling on vegetables, while staying away from sugary drinks. He also does regular exercising at a small gym in his apartment complex.
“Proteins are good for muscle strength,” Tobin said. “The best hydration is water.”
“I’m trying to eat just a quarter carbs, a quarter protein and half a plate of vegetables,” he said. “That’s what I call portion control on meals. I eat breakfast, snack, lunch, snack, and dinner, so I don’t overeat. The snacks are very little things.”
A high percentage of people with intellectual disabilities are obese, based on national body mass index data. Special Olympics Washington, the state-level organization, began a focus this year to increase community wellness approaches and reduce obesity rates among its athletes.
The state group plans to expand those efforts in 2017 and track results. It has heard from its athlete focus groups that members want to be more active and involved in their communities.
Tobin, who is intellectually disabled, competes in Special Olympics basketball and track and field. He also serves on a regional Special Olympics athlete leadership council. During the past two months while learning healthier habits, Tobin has lost about 10 pounds.
He also enjoys cooking nutritious meals, and his parents have joined his quest for better nutrition.
“The three of us at home are all starting this, because we all need to lose weight, so that’s feeding over into our family dinners,” said Tony Tobin, his father.
Such support networks within families, along with joining nearby walking groups and school clubs, will tie into a program called Healthy Athletes, adopted by Special Olympics worldwide, said Dave Lenox, CEO of Special Olympics Washington.
In the U.S., nearly 4 million adults have an intellectual disability, says the Centers for Disease Control and Prevention. The population is less likely to have health conditions under control, more likely to encounter difficulties in receiving quality health care services, and often receives fewer preventive checkups, according to the CDC.
The CDC and Special Olympics are among organizations working to close those gaps, and Healthy Athletes assists in health screenings, services, referrals and information. The screenings typically occur during Special Olympics sporting events. A second program, Healthy Communities, is also working to improve access and health outcomes for people with intellectual disabilities.
“We started looking at what’s causing some of the medical issues that our athletes have,” Lenox said. “This is when we became more aware of the obesity issue.”
BMI is a measurement of body fat based on height and weight, although thresholds for what’s considered overweight can vary. Based on 2011-14 data under a BMI measurement of 30 or higher, 45.5 percent of adult Special Olympics athletes in the U.S. are obese, compared with 36.4 percent of the general public.
If using the same data under a BMI of 25 or higher threshold, 86.8 percent of people with intellectual disabilities might be considered obese, compared with 69.5 percent of the general public, Lenox said.
Special Olympics tries to ensure athletes seek follow-up care once a health problem is discovered, under its Healthy Communities initiative. If an assessment at a sporting event identifies a concern, an athlete might receive a handout regarding treatment with a provider.
“We try to go into every community and find physicians who are willing to take new patients who have intellectual disabilities, so we can have the referral and say, ‘Take this to this doctor.’ ”
Healthy Athletes also involves partnering with medical providers from various disciplines, including focuses on dental, vision, hearing, dermatology, podiatry and physical or occupational therapy.
“We have an international network now of physicians who help us with doing these assessments,” Lenox said. “We’re trying to build a community of support every place that does Special Olympics, so if our athletes need anything, we have a directory of physicians with all kinds of specialties.”
Special Olympics has trained medical providers on how to communicate better with intellectually disabled patients, such as avoiding dialogue using abstract concepts, Lenox said.
In some instances for medical screening, professionals have redesigned testing and machinery.
Lenox described how he once talked to an athlete about why he wasn’t running at his typical pace, and asked him, “ ‘I know you can run faster, because I’ve run with you, and you’ve run faster than this.’ He looked at me and said, ‘I know, but I have to follow someone so I can see where I’m going.’ ”
During the conversation, Lenox realized the athlete, who wore prescription glasses, hadn’t understood abstract concepts at his latest eye exam. The athlete was asked typical patient questions referring to two separate charts of letters, to respond between the screens which was better, A or B?
“The athlete said he looked at the screen, and there wasn’t an A or a B in any of the rows. He said, ‘I figured if he (the doctor) sees an A or B on that screen, I just told him what I thought he wanted to hear.’ The athlete just didn’t get what he was asking.”
For dentistry issues, “Often, it’s tolerance of pain,” Lenox said. General access to regular health care can be a problem as well.
A program called Washington Team Wellness walks athletes through what they can do each week for better health, such as exercises combined with nutrition and hydration information.
Special Olympics is adding wellness options much like its sport activities, so as athletes attend weekly track practices, they also might plan to participate in a neighborhood or school wellness club.
“They’re unified, meaning half the people have intellectual disabilities and half do not, and they’re doing an activity together as equals,” Lenox said.
It might be as simple as a walking group centered around a neighborhood or church, he said.
“These problems, while more profound in the population with intellectually disabled community, they’re certainly not the only ones,” he added. “There are a lot of people who want to lose weight and want to get healthier. It’s a common goal.
“Maybe you haven’t thought that you can include people with intellectual disabilities who are right in your neighborhood and have the same goals.”
A club also might go to a grocery store to buy healthy ingredients and cook a meal together. The activity could involve how to select a good vegetable, a lean meat, and food preparation, Lenox added, “so it becomes engrained in athletes that, ‘I can have a piece of fruit rather than a candy bar.’ ”
“We’re working on that now, and we’re trying to expand it a little bit, so that in every community where we have Special Olympics, there’s not just sports training, there’s also wellness training.”
An upcoming phase will expand outreach in schools, Lenox said, involving leadership training and unified sports such as flag football or basketball. Clubs can organize inclusive activities or an assembly on anti-bullying, he said.
The Washington organization will work next year on refining its wellness clubs, expanding locations, and gaining baseline data to track progress for people who want to participate.
“We want to know we’re doing something where there’s some proof it impacts the quality of life of our athletes,” Lenox said.
It will look at baseline data against follow-up activity with different kinds of wellness groupings, to gain research on what’s most effective. It will compare progress among athletes who pursue wellness individually along with those who do so within families, a community group, or school club.
“We’ll compare the dynamics of those groups and at the end of a year, we’ll look to see whose BMI went down the most. Then we’ll have some data-driven research and we can say, if you are really serious about losing weight, this is the cohort you want to join.
“If it’s socialization you’re after, then we could say you might want to join a community club. And while you’re doing that, you can work on being a little healthier.”