Optimal Nutrition for Down’s Syndrome

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The incidence of Down’s syndrome is 1/1000 people in the UK. A staggering 2 babies are born every day in the UK with Down’s Syndrome, but what is it [1]?

How does it occur?

Down’s syndrome is a hereditary disorder that is caused by an impairment in cell division. This slight mishap during cell division results in an extra Chromosome 21. The cellular process that leads to this is complicated, it is described as non-disjunction. This occurs during cell division. In normal cell division, the cell will split with one chromosome pair contained in one cell and the other pair in the other cell. In non-disjunction division it fails to do this and the pair stays in the cell and continues to divide. Resulting in an extra chromosome at the 21st position. The most common form is called Trisomy Down’s syndrome which is described above and represents 95% of Down’s Syndrome cases.. The presence of an extra chromosome results in both physical mental and emotional symptoms [2,3].

Due to advances in modern medicine, the diagnosis of Down’s Syndrome can be completed prenatally. Highly skilled ultrasound technicians are able to check for ‘markers’ that will indicate the disease. Additionally, they may now also be able to test a sample of the amniotic fluid, umbilical cord blood or small portion of the placenta in order to look for the presence of an extra chromosome [4].

Is there a cause?

There is no definitive cause as of yet, it seems to be a simple mistake in biological processes. However there has been some studies that show, increased maternal age seems to increase likelihood of having a child with down syndrome. The current UK incidence of Down’s Syndrome is 1/1000, however, in mothers over the age of 40 the incidence is 12/1000 babies born [5].

What are classical characteristics of it?

More often than not there are physical characteristics associated with Down’s Syndrome that is detectable to a trained eye. These are:

  • Small hands
  • Shorter than average height
  • Small head
  • Flat face, and back of the head
  • Round cheeks
  • Slanted eyes that have extra skin folds surround them
  • Small mouth
  • Protruding Tongue [1].

However, Down’s syndrome is not only characterised by physical differences by also mental and behavioural.

  • Sleep disorders
  • Anxiety
  • Toileting issues
  • Faddy eating
  • Night Terrors
  • Delayed Development
  • Overactivity and impulsiveness
  • Short attention span and inability to concentrate [6].

How does it effect Nutrition?

Down’s Syndrome can have dietary outcomes, as well as be improved by diet itself. As previously mentioned people with Down’s Syndrome may suffer from Faddy Eating, or Refuse certain types of foods. Many get into habits of only eating one brand, colour or texture which can be hugely limiting to their Nutrition. One of the common symptoms is an enlarged tongue and poor muscle tone which can lead to difficulty swallowing, choking and gagging. More often than not children with down syndrome will require their foods to be pureed/blended. Due to the high level of processing required in food, or due to a faddy approach to eating may be lacking in vital nutrients.

What can be done to help?

It is hard to make a generic sweeping statement about every person that has down syndrome, will also have a deficiency in A-Z vitamins, it is entirely specific to the person. Doctor of Medicine Ruth Harrell declared that supplementing the diet of people with Down’s Syndrome vastly improved IQ and hormone production[7]. Due to eating habits, e.g avoidance of dairy, fruits and Vegetables., common deficiencies that occur are in Vitamin A, E, Zinc, Iron and Calcium. A predominant dietary feature of Down’s Syndrome is Celiac disease, which is an intolerance to the protein in gluten, called Gliadin. The foods most rich in wheat, or rye flours, Cous cous, and Bulgur wheat. Bread and pasta must be avoided at all costs. The common problem with this is that many of these food sources are rich in B-Vitamins. B-vitamins can be consumed in supplement for or also found in yeast, pork, soy and cheese. Additionally, they may deficient in Vitamin D, Calcium, Magnesium, Zinc, Folate, and Iron[8].

The recommendation is that no herbal or botanical supplements should be purchased on taken by people with Down’s Syndrome as there are no supporting studies for their efficacy of use.

  1. Extra 21. (2016). Facts and Figures. Available: http://www.extra21.org.uk/facts-and-figures-faqs/.
  2. Escott-Stump.S. (2015). Down's Syndrome. In: Joyce, J and Malakoff-Klein, E Nutrition and Diagnosis-Related Care. 8th ed. Philadelphia: Wolters Kluwer. Pg.168-169.
  3. NIH. (2012). What causes Down syndrome?. Available: https://www.nichd.nih.gov/health/topics/down/conditioninfo/pages/causes.aspx.
  4. NIH. (2012). How do health care providers diagnose Down syndrome?. Available: https://www.nichd.nih.gov/health/topics/down/conditioninfo/Pages/diagnosed.aspx
  5. Crosta.P. (2016). Down Syndrome: Facts, Symptoms, and Characteristics. Available: http://www.medicalnewstoday.com/articles/145554.php.
  6. Buckley.S, et-al. (2016). Social development for individuals with Down syndrome - An overview. Available: https://www.down-syndrome.org/information/social/overview/
  7. Lenshin, L. (1998). Nutritional Supplements for Down Syndrome: A Highly Questionable
  8. Celiac Disease Foundation. (2016). Vitamins and Supplements.Available: https://celiac.org/live-gluten-free/glutenfreediet/vitamins-and-supplements/.

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