{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:18:26Z","timestamp":1791497906715,"version":"4.3.4"},"reference-count":52,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Children with DS are at an increased risk of obesity and impaired motor performance. This study aimed to compare body composition and motor performance in children with DS and typically developing (TD) peers and to explore associations between adiposity and motor function. Methods: A cross-sectional study was conducted with 42 children aged 6\u201312 years (23 DS, 19 TD). Body composition was assessed using bioelectrical impedance analysis. Postural stability was evaluated with the Pediatric Balance Scale; hand grip strength with hand dynamometry; physical activity with the PAQ-C; and aerobic endurance with the YMCA 3 min step test. Results: Children with DS exhibited significantly higher adiposity and lower motor performance than their TD peers. In the DS group, body fat mass was negatively correlated with physical activity (r = \u20130.499, p = 0.018), balance (r = \u20130.684, p &lt; 0.001), and aerobic endurance (r = \u20130.389, p &lt; 0.073). Regression analysis identified physical activity and fitness level as significant predictors of BMI in children with DS (R2 = 0.825). Conclusions: Children with DS exhibit higher adiposity and inferior motor performance compared to their TD peers, with strong associations between adiposity and reduced physical activity, balance, and aerobic endurance. These findings underscore the importance of early targeted interventions to improve health outcomes in children with DS, particularly in regions like Saudi Arabia, where prevalence is high.<\/jats:p>","DOI":"10.3390\/children12101298","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T12:05:13Z","timestamp":1758801913000},"page":"1298","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Body Composition and Adiposity in Children with Down Syndrome Compared to Typically Developing Children: The Association with Their Motor Performance"],"prefix":"10.3390","volume":"12","author":[{"given":"Dhoha W.","family":"Binsaddiq","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Saud Al Babtain Cardiac Center, Dammam 32245, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5723-1147","authenticated-orcid":false,"given":"Alaa I.","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Imam Abdulrahman Bin Faisal University, Dammam 31451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8534-6171","authenticated-orcid":false,"given":"Turki S.","family":"Abualait","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Imam Abdulrahman Bin Faisal University, Dammam 31451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"ref_1","first-page":"515","article-title":"Trisomy 21: From chromosome to phenotype","volume":"21","author":"Antonarakis","year":"2020","journal-title":"Nat. Rev. Genet."},{"key":"ref_2","unstructured":"Jung, J.M., Lee, S.Y., Kim, S.H., and Kim, S.J. (2017). Prevalence of Down syndrome and associated conditions: A population-based study. Pediatrics, 139."},{"key":"ref_3","first-page":"993","article-title":"The neuropsychology of Down syndrome: Evidence for hippocampal dysfunction","volume":"90","author":"Lukowski","year":"2019","journal-title":"Child Dev."},{"key":"ref_4","first-page":"1131","article-title":"Down syndrome in Saudi Arabia: Experience at a university hospital","volume":"29","author":"Niazi","year":"2008","journal-title":"Saudi Med. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"107","DOI":"10.5144\/0256-4947.2015.107","article-title":"Prevalence of selected congenital anomalies in Saudi children: A community-based study","volume":"35","year":"2015","journal-title":"Ann. Saudi Med."},{"key":"ref_6","first-page":"627","article-title":"Prevalence of obesity in children and adolescents with Down syndrome: A systematic review","volume":"17","author":"Bertapelli","year":"2016","journal-title":"Obes. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1111\/j.1365-2788.2004.00616.x","article-title":"Obesity in adults with Down syndrome: A case\u2013control study","volume":"49","author":"Melville","year":"2005","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_8","first-page":"228","article-title":"Obesity and overweight prevalence among adolescents with disabilities","volume":"18","author":"Rimmer","year":"2010","journal-title":"Obes. Res."},{"key":"ref_9","first-page":"321","article-title":"Trends in disability prevalence in the United States: 1984\u20131994","volume":"35","author":"Fujiura","year":"1997","journal-title":"Ment. Retard."},{"key":"ref_10","first-page":"103743","article-title":"Physical activity patterns of children and adolescents with Down syndrome: A systematic review","volume":"105","author":"Yamanaka","year":"2020","journal-title":"Res. Dev. Disabil."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Drenowatz, C., Chen, S.T., Cocca, A., Ferrari, G., Ruedl, G., and Greier, K. (2022). Association of body weight and physical fitness during the elementary school years. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19063441"},{"key":"ref_12","first-page":"126","article-title":"Physical fitness of adolescents with and without Down syndrome","volume":"28","author":"Cowley","year":"2011","journal-title":"Adapt. Phys. Act. Q."},{"key":"ref_13","first-page":"227","article-title":"Cardiorespiratory responses to submaximal exercise in adolescents and adults with Down syndrome","volume":"73","author":"Pitetti","year":"1992","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2051","DOI":"10.1016\/j.apmr.2005.06.003","article-title":"A systematic review of the outcomes of cardiovascular exercise programs for people with Down syndrome","volume":"86","author":"Dodd","year":"2005","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_15","first-page":"507","article-title":"Motor development and physical activity in children with Down syndrome: A meta-analysis","volume":"66","author":"Cai","year":"2022","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"142","DOI":"10.3345\/cep.2021.00479","article-title":"Gross motor dysfunction and balance impairments in children and adolescents with Down syndrome: A systematic review","volume":"65","author":"Jain","year":"2022","journal-title":"Clin. Exp. Pediatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1111\/jir.12580","article-title":"A schedule of gross motor development for children with Down syndrome","volume":"63","author":"Winders","year":"2019","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_18","first-page":"68","article-title":"Lower body strength of children and adolescents with and without mild mental retardation: A comparison","volume":"19","author":"Pitetti","year":"2002","journal-title":"Adapt. Phys. Act. Q."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/00001577-200113010-00004","article-title":"Hip abductor and knee extensor muscle strength of children with and without Down syndrome","volume":"13","author":"Mercer","year":"2001","journal-title":"Pediatr. Phys. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"Bull","year":"2020","journal-title":"Br. J. Sports Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1097\/PEP.0000000000000556","article-title":"Physical activity levels of children with Down syndrome","volume":"31","author":"Fox","year":"2019","journal-title":"Pediatr. Phys. Ther."},{"key":"ref_22","first-page":"364","article-title":"Impaired balance and postural stability in children with Down syndrome","volume":"58","author":"Jung","year":"2017","journal-title":"Gait Posture"},{"key":"ref_23","first-page":"346","article-title":"Balance and postural control in children with Down syndrome","volume":"40","author":"Mierzejewski","year":"2014","journal-title":"Gait Posture"},{"key":"ref_24","first-page":"329","article-title":"Postural stability in children with Down syndrome","volume":"15","author":"Saied","year":"2014","journal-title":"Egypt. J. Med. Hum. Genet."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1080\/00336297.2008.10483582","article-title":"A developmental perspective on the role of motor skill competence in physical activity: An emergent relationship","volume":"60","author":"Stodden","year":"2008","journal-title":"Quest"},{"key":"ref_26","first-page":"24","article-title":"Dietary pattern, physical activity and body composition of children with and without Down syndrome: A case\u2013control study","volume":"29","author":"AlSaab","year":"2023","journal-title":"J. Intellect. Disabil."},{"key":"ref_27","first-page":"394","article-title":"Investigating the relationship between physical fitness and body composition in children with Down syndrome","volume":"11","author":"Pitchford","year":"2018","journal-title":"Disabil. Health J."},{"key":"ref_28","first-page":"543","article-title":"Fat and lean masses in youths with Down syndrome: Gender differences","volume":"31","author":"Ara","year":"2010","journal-title":"Res. Dev. Disabil."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Belleri, P., Mazzuca, G., Pietrobelli, A., Zampieri, N., Piacentini, G., Zaffanello, M., and Pecoraro, L. (2024). The role of diet and physical activity in obesity and overweight in children with Down syndrome in developed countries. Children, 11.","DOI":"10.3390\/children11091056"},{"key":"ref_30","first-page":"410","article-title":"Postural control in children with Down syndrome","volume":"19","author":"Cardoso","year":"2015","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Vega-Ramirez, L., P\u00e9rez-Ca\u00f1averas, R.M., and De Juan Herrero, J. (2021). There is an inverse correlation between basic motor skills and overweight in schoolchildren aged 8 to 12. Children, 8.","DOI":"10.3390\/children8121198"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"S60","DOI":"10.1519\/JSC.0b013e31819df407","article-title":"Youth resistance training: Updated position statement paper from the National Strength and Conditioning Association","volume":"23","author":"Faigenbaum","year":"2009","journal-title":"J. Strength Cond. Res."},{"key":"ref_33","first-page":"1197","article-title":"Cardiorespiratory fitness in children and adolescents with Down syndrome","volume":"35","author":"Fernhall","year":"2013","journal-title":"Disabil. Rehabil."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"601","DOI":"10.2147\/TCRM.S10235","article-title":"Reduced exercise capacity in persons with Down syndrome: Cause, effect, and management","volume":"6","author":"Mendonca","year":"2010","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_35","first-page":"e20180962","article-title":"Co-occurring medical conditions in children and adolescents with Down syndrome: A health supervision guideline","volume":"142","author":"Capone","year":"2018","journal-title":"Pediatrics"},{"key":"ref_36","first-page":"63","article-title":"Physical activity and sedentary behaviour in youth with Down syndrome: A systematic review","volume":"6","author":"Braithwaite","year":"2017","journal-title":"Prev. Med. Rep."},{"key":"ref_37","first-page":"168","article-title":"Body composition and physical fitness in adolescents with Down syndrome","volume":"32","author":"Ara","year":"2011","journal-title":"Res. Dev. Disabil."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1152\/japplphysiol.00001.2008","article-title":"Arterial function in youth: Window into cardiovascular risk","volume":"105","author":"Fernhall","year":"2008","journal-title":"J. Appl. Physiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.ridd.2014.10.022","article-title":"Associations of physical activity with fatness and fitness in adolescents with Down syndrome: The UP&DOWN study","volume":"36","author":"Villagra","year":"2015","journal-title":"Res. Dev. Disabil."},{"key":"ref_40","first-page":"342","article-title":"Barriers and motivators to participation in physical activity in adolescents with Down syndrome: A qualitative study","volume":"58","author":"Oftedal","year":"2014","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1080\/13638490500353202","article-title":"Physical activity patterns in children with and without Down syndrome","volume":"9","author":"Stettler","year":"2006","journal-title":"Pediatr. Rehabil."},{"key":"ref_42","first-page":"307","article-title":"Do children with Down syndrome perform sufficient physical activity to maintain good health? A pilot study","volume":"26","author":"Shields","year":"2009","journal-title":"Adapt. Phys. Act. Q."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.ridd.2016.06.018","article-title":"Overweight and obesity in children and adolescents with Down syndrome\u2014Prevalence, determinants, consequences, and interventions: A literature review","volume":"57","author":"Bertapelli","year":"2016","journal-title":"Res. Dev. Disabil."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Webster, E.K., Sur, I., Stevens, A., and Robinson, L.E. (2021). Associations between body composition and fundamental motor skill competency in children. BMC Pediatr., 21.","DOI":"10.1186\/s12887-021-02912-9"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1111\/jar.12659","article-title":"Systematic review of sedentary behaviour in people with Down syndrome across the lifespan: A clarion call","volume":"33","author":"Agiovlasitis","year":"2020","journal-title":"J. Appl. Res. Intellect. Disabil."},{"key":"ref_46","first-page":"21","article-title":"Associations between physical fitness and overweight in children and adolescents: A systematic review","volume":"47","author":"Kelly","year":"2013","journal-title":"Br. J. Sports Med."},{"key":"ref_47","first-page":"163","article-title":"Autonomic dysfunction in Down syndrome and its relationship with obesity","volume":"205","author":"Villagra","year":"2019","journal-title":"J. Pediatr."},{"key":"ref_48","unstructured":"Wells, J.C.K. (2017). The Evolutionary Biology of Human Body Fatness: Thrift and Control, Cambridge University Press."},{"key":"ref_49","first-page":"113","article-title":"Physical activity among youth with Down syndrome: A scoping review","volume":"222","author":"Oreskovic","year":"2020","journal-title":"J. Pediatr."},{"key":"ref_50","first-page":"121","article-title":"Prevalence of overweight and obesity in children and adolescents aged 2\u201316 years","volume":"60","author":"Alias","year":"2013","journal-title":"Endocrinol. Nutr."},{"key":"ref_51","first-page":"1433","article-title":"Physical fitness and activity in youth with Down syndrome: A review","volume":"43","year":"2021","journal-title":"Disabil. Rehabil."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2344","DOI":"10.1056\/NEJMra1706537","article-title":"Down syndrome","volume":"382","author":"Bull","year":"2020","journal-title":"N. Engl. J. Med."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/10\/1298\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:49:29Z","timestamp":1760035769000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/10\/1298"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,25]]},"references-count":52,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["children12101298"],"URL":"https:\/\/doi.org\/10.3390\/children12101298","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,25]]}}}