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However, in the absence of national nutritional guidelines in individuals with DS, further work is needed to understand their dietary and physical activity patterns. In this work we retrieved caregivers\u2019 responses on those aspects. Methods: We analyzed data from a cross-sectional online survey of caregivers of individuals with DS conducted as part of the GO-DS21 project and reported in the accompanying paper (nutrients-4216283) (n = 764). We explored physical activity patterns, dietary habits, beliefs around weight-loss interventions and caregiver confidence that family members with DS would engage in a healthier lifestyle. Associations were examined using correlation analysis, and cumulative and binary logistic regression models. Results: Caregivers reported that most individuals with DS exercised 1\u20133 times per week, with frequency declining with age. Males were more likely to exercise daily than females. Caregiver exercise frequency was positively correlated with that of their DS family member (\u03c1 = 0.521, p &lt; 0.001), suggesting clustering of shared health behaviors within households. In adjusted models, caregivers who exercised regularly had up to thirteen-fold higher odds of having a physically active family member with DS (aOR = 13.02, 95% CI: 7.40\u201324.06, p &lt; 0.001). Fried food consumption and higher snack frequency were independently associated with perceived obesity status, while sugar-sweetened beverage consumption was not. Caregivers favored exercise as a weight-loss strategy, while anti-obesity drugs were endorsed by only 11% of caregivers primarily and were more likely to be endorsed when obesity was perceived (aOR = 4.21, 95% CI: 2.44\u20137.39, p &lt; 0.001). Finally, caregiver confidence that their family member with DS would engage in healthier behaviors was associated with perceived obesity status and strongly associated with higher physical activity levels (aOR 14.68, 95% CI: 6.59\u201333.40, p &lt; 0.001). Conclusions: In this large European caregiver survey, reported consumption of selected energy-dense foods was generally low, although fried food intake and higher snack frequency were associated with perceived obesity. Physical activity patterns were closely aligned between caregivers and individuals with DS, suggesting shared household health behaviors. These findings highlight the importance of involving caregivers and family environments in lifestyle interventions aimed at supporting physical activity and weight management in individuals with DS.<\/jats:p>","DOI":"10.3390\/nu18111692","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T13:28:21Z","timestamp":1779802101000},"page":"1692","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Caregiver-Associated Physical Activity Patterns, Dietary Behaviors and Interventional Beliefs in Individuals with Down Syndrome: Insights from a Large European Survey"],"prefix":"10.3390","volume":"18","author":[{"given":"Thomas","family":"Cahill","sequence":"first","affiliation":[{"name":"Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Nalesso","sequence":"additional","affiliation":[{"name":"Institut de G\u00e9n\u00e9tique et de Biologie Mol\u00e9culaire et Cellulaire (IGBMC), INSERM, CNRS, Universit\u00e9 de Strasbourg, UMR7104, U1258, 67404 Illkirch-Graffenstaden, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pat","family":"Clarke","sequence":"additional","affiliation":[{"name":"European Down Syndrome Association, 1210 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0836-6491","authenticated-orcid":false,"given":"Maria","family":"Martinez de Lagran","sequence":"additional","affiliation":[{"name":"Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Strydom","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology, and Neuroscience, King\u2019s College London, London SE5 8AB, UK"},{"name":"South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK"},{"name":"The LonDowns Consortium, London SE5 8AF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Chan","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2462-7150","authenticated-orcid":false,"given":"Marie-Claude","family":"Potier","sequence":"additional","affiliation":[{"name":"Institut du Cerveau\u2014Paris Brain Institute-ICM, CNRS, APHP, H\u00f4pital de La Piti\u00e9 Salp\u00eatri\u00e8re, Inserm, Sorbonne Universit\u00e9, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7874-3822","authenticated-orcid":false,"given":"Johannes","family":"Beckers","sequence":"additional","affiliation":[{"name":"Institute of Experimental Genetics, German Research Centre for Environmental Health, Helmholtz Zentrum M\u00fcnchen, Ingolstaedter Landstr. 1, 85764 Neuherberg, Germany"},{"name":"German Centre for Diabetes Research (DZD), Ingolstaedter Landstr. 1, 85764 Neuherberg, Germany"},{"name":"Experimental Genetics, School of Life Sciences Weihenstephan, Technische Universit\u00e4t M\u00fcnchen, Altekademie 8, 85354 Freising, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7075-9192","authenticated-orcid":false,"given":"Klaus","family":"Langohr","sequence":"additional","affiliation":[{"name":"Integrative Pharmacology and Systems Neuroscience Research Group, Neuroscience Research Program, Hospital del Mar Research Institute, 08003 Barcelona, Spain"},{"name":"Department of Statistics and Operations Research, Universitat Polit\u00e8cnica de Catalunya\u2014BarcelonaTECH, 08034 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0540-5053","authenticated-orcid":false,"given":"Pietro","family":"Li\u00f2","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Technology, University of Cambridge, Cambridge CB3 0FD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael de","family":"La Torre","sequence":"additional","affiliation":[{"name":"Integrative Pharmacology and Systems Neuroscience Research Group, Neuroscience Research Program, Hospital del Mar Research Institute, 08003 Barcelona, Spain"},{"name":"CIBER de Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n, Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Forcano","sequence":"additional","affiliation":[{"name":"Integrative Pharmacology and Systems Neuroscience Research Group, Neuroscience Research Program, Hospital del Mar Research Institute, 08003 Barcelona, Spain"},{"name":"CIBER de Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n, Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9932-0754","authenticated-orcid":false,"given":"Anne","family":"Hiance-Delahaye","sequence":"additional","affiliation":[{"name":"Institut J\u00e9r\u00f4me Lejeune, 75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7049-6900","authenticated-orcid":false,"given":"Yann","family":"H\u00e9rault","sequence":"additional","affiliation":[{"name":"Institut de G\u00e9n\u00e9tique et de Biologie Mol\u00e9culaire et Cellulaire (IGBMC), INSERM, CNRS, Universit\u00e9 de Strasbourg, UMR7104, U1258, 67404 Illkirch-Graffenstaden, France"},{"name":"PHEN\u2014Institut Clinique de la Souris (PHEN-ICS), INSERM, CNRS, Universit\u00e9 de Strasbourg, UAR2062, US66, 67404 Illkirch-Graffenstaden, France"},{"name":"CNRS, CELPHEDIA-Core, UAR2052, 94800 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0853-6865","authenticated-orcid":false,"given":"Mara","family":"Dierssen","sequence":"additional","affiliation":[{"name":"Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain"},{"name":"Universitat Pompeu Fabra (UPF), Campus Uuniversitari Mar, 08005 Barcelona, Spain"},{"name":"Biomedical Research Networking Center for Rare Diseases (CIBERER), 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"GO-DS21 Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref_1","unstructured":"(2026, February 26). 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