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Gruszka J, Włodarek D. General Dietary Recommendations for People with Down Syndrome. Nutrients 2024; 16:2656. [PMID: 39203792 PMCID: PMC11357503 DOI: 10.3390/nu16162656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 07/24/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
Down syndrome (DS) is caused by trisomy of chromosome 21 and is associated with characteristic features of appearance, intellectual impairment to varying degrees, organ defects, and health problems typical of this syndrome. Studies on the frequency of consumption of food products in this group show many irregularities, in particular too low consumption of vegetables and fruits, wholegrain cereal products and dairy products, and excessive consumption of meat products and sweets. It is necessary to correct eating habits. The diets of people with trisomy 21 should be consistent with the recommendations of rational nutrition for the general population and take into account specific dietary modifications related to the occurrence of diseases and health problems characteristic of this syndrome.
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Affiliation(s)
- Joanna Gruszka
- Dieta Plus Nutritional and Dietary Counseling, 45-072 Opole, Poland;
| | - Dariusz Włodarek
- Department of Dietetics, Institute of Human Nutrition Science, Warsaw University of Life Science (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warszawa, Poland
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Anand NS, Zemel BS, Pipan M, Kelly A, Magge SN. Diet Quality and Cardiometabolic Risk Factors in Adolescents with Down Syndrome. J Acad Nutr Diet 2023; 123:253-262. [PMID: 35940494 DOI: 10.1016/j.jand.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Youth with Down syndrome (DS) have a high prevalence of obesity and dyslipidemia. Diet quality may influence cardiometabolic risk (CMR) in youth. OBJECTIVE The aim of this secondary analysis was to investigate the relationship between diet quality (Healthy Eating Index [HEI-2015]) with CMR factors in youth with DS compared with age, sex, race, ethnicity, and body mass index percentile matched, typically developing controls. DESIGN Adolescents (aged 10 to 20 years) with DS and controls of comparable age, sex, race, ethnicity, and body mass index percentile were recruited from 2012 to 2017 for a cross-sectional study from two large children's hospitals (Children's Hospital of Philadelphia and the Children's National Health System in Washington, DC). PARTICIPANTS AND SETTING CMRs in 143 adolescents with DS were compared with 100 controls. Exclusion criteria consisted of major organ-system illnesses. MAIN OUTCOME MEASURES The average of three 24-hour dietary recalls was used to calculate the HEI-2015. Anthropometrics, blood pressure, and fasting labs were collected. STATISTICAL ANALYSES PERFORMED Group differences were tested using Wilcoxon rank-sum tests. Relationships of CMR factors with HEI-2015 score within DS and controls were tested using linear regression models adjusted for sex, age, race, and body mass index z score. RESULTS Compared with controls (n = 100, median age = 14.8 years [interquartile range = 12.2 to 17.3 years]; 41% male; 24% African American; 65% with body mass index ≥85th percentile), adolescents with DS (n = 143, median age = 14.7 years [interquartile range = 11.4 to 17.4 years]; 44% male; 18% African American; 62% with body mass index ≥85th percentile) had higher scores (more aligned with dietary recommendations) for total HEI-2015 (DS: 52.7 [interquartile range = 46.8 to 58.6] vs controls: 45.1 [interquartile range = 39.5 to 55.0]; P < 0.0001). Youth with DS also had higher HEI-2015 component scores for fruits, greens/beans, dairy, refined grains, and saturated fats, but lower whole grains and sodium scores. Within the group with DS, total HEI-2015 was not significantly associated with CMR measures. Whereas HEI-2015 in the DS group was negatively associated with fasting glucose levels, the difference did not meet the set level of statistical significance (-0.14, 95% CI -0.29 to 0.00; P = 0.053). CONCLUSIONS Adolescents in both the control and DS groups reported low-quality diets, although the DS group had HEI-2015 scores more closely aligned with recommendations. In the DS group, diet quality was not significantly associated with CMR factors. Although further research is needed, these results suggest that dyslipidemia in youth with DS may not be related to dietary intake.
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Affiliation(s)
- Neha S Anand
- Boston Combined Residency Program, Boston Children's Hospital & Boston Medical Center, Boston, Massachusetts.
| | - Babette S Zemel
- Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Mary Pipan
- Trisomy 21 Program, Division of Developmental Behavioral Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Andrea Kelly
- Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Sheela N Magge
- Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Johns Hopkins University School of Medicine, Baltimore, Maryland
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Sarver DC, Xu C, Velez LM, Aja S, Jaffe AE, Seldin MM, Reeves RH, Wong GW. Dysregulated systemic metabolism in a Down syndrome mouse model. Mol Metab 2023; 68:101666. [PMID: 36587842 PMCID: PMC9841171 DOI: 10.1016/j.molmet.2022.101666] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/14/2022] [Accepted: 12/26/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Trisomy 21 is one of the most complex genetic perturbations compatible with postnatal survival. Dosage imbalance arising from the triplication of genes on human chromosome 21 (Hsa21) affects multiple organ systems. Much of Down syndrome (DS) research, however, has focused on addressing how aneuploidy dysregulates CNS function leading to cognitive deficit. Although obesity, diabetes, and associated sequelae such as fatty liver and dyslipidemia are well documented in the DS population, only limited studies have been conducted to determine how gene dosage imbalance affects whole-body metabolism. Here, we conduct a comprehensive and systematic analysis of key metabolic parameters across different physiological states in the Ts65Dn trisomic mouse model of DS. METHODS Ts65Dn mice and euploid littermates were subjected to comprehensive metabolic phenotyping under basal (chow-fed) state and the pathophysiological state of obesity induced by a high-fat diet (HFD). RNA sequencing of liver, skeletal muscle, and two major fat depots were conducted to determine the impact of aneuploidy on tissue transcriptome. Pathway enrichments, gene-centrality, and key driver estimates were performed to provide insights into tissue autonomous and non-autonomous mechanisms contributing to the dysregulation of systemic metabolism. RESULTS Under the basal state, chow-fed Ts65Dn mice of both sexes had elevated locomotor activity and energy expenditure, reduced fasting serum cholesterol levels, and mild glucose intolerance. Sexually dimorphic deterioration in metabolic homeostasis became apparent when mice were challenged with a high-fat diet. While obese Ts65Dn mice of both sexes exhibited dyslipidemia, male mice also showed impaired systemic insulin sensitivity, reduced mitochondrial activity, and elevated fibrotic and inflammatory gene signatures in the liver and adipose tissue. Systems-level analysis highlighted conserved pathways and potential endocrine drivers of adipose-liver crosstalk that contribute to dysregulated glucose and lipid metabolism. CONCLUSIONS A combined alteration in the expression of trisomic and disomic genes in peripheral tissues contribute to metabolic dysregulations in Ts65Dn mice. These data lay the groundwork for understanding the impact of aneuploidy on in vivo metabolism.
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Affiliation(s)
- Dylan C Sarver
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Cheng Xu
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Leandro M Velez
- Department of Biological Chemistry, University of California, Irvine, Irvine, USA; Center for Epigenetics and Metabolism, University of California Irvine, Irvine, USA
| | - Susan Aja
- Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew E Jaffe
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; The Lieber Institute for Brain Development, Baltimore, MD, USA; Center for Computational Biology, Johns Hopkins University, Baltimore, MD, USA; Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Marcus M Seldin
- Department of Biological Chemistry, University of California, Irvine, Irvine, USA; Center for Epigenetics and Metabolism, University of California Irvine, Irvine, USA
| | - Roger H Reeves
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - G William Wong
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Center for Metabolism and Obesity Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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A six-month multicomponent intervention improves Down syndrome adolescents’ physical fitness. Sci Sports 2022. [DOI: 10.1016/j.scispo.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Ortega Junco E, Quiroga B. Kidney-vascular-bone axis in down syndrome. Nefrologia 2022; 42:363-366. [PMID: 36396571 DOI: 10.1016/j.nefroe.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 06/16/2023] Open
Affiliation(s)
- Esther Ortega Junco
- Servicio de Nefrología, Hospital Universitario de la Princesa, Madrid, Spain
| | - Borja Quiroga
- Servicio de Nefrología, Hospital Universitario de la Princesa, Madrid, Spain.
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Ortega Junco E, Quiroga B. El eje riñón-vaso-hueso en el síndrome de Down. Nefrologia 2022. [DOI: 10.1016/j.nefro.2021.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Ross CF, Bernhard CB, Surette V, Hasted A, Wakeling I, Smith-Simpson S. Eating behaviors in children with down syndrome: Results of a home-use test. J Texture Stud 2022; 53:629-646. [PMID: 35696524 DOI: 10.1111/jtxs.12703] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/30/2022] [Accepted: 06/04/2022] [Indexed: 11/29/2022]
Abstract
Children with Down syndrome (DS) display a disproportionate number of health challenges, including feeding and swallowing difficulties and food texture sensitivities. To start addressing food texture challenges early in life, the aim of this research was to understand mealtime behaviors and identify preferred food textures of children with DS. Children (aged 11 to 58 months) with DS (n = 111) and without (typically developing, TD; n = 107) participated in a home use test evaluating snack products of varying textures. Parents recorded their children's reactions to each food product; a panel of trained coders coded videos for mealtime behaviors. Children were also identified as food texture sensitive (TS) or non-texture sensitive (NTS). Results showed that age, TS, the presence of a DS diagnosis and the TS*DS interaction influenced the child's behaviors to the food products. Children with DS were more likely to increase distance from the food, mouth/suck on the food, and less likely to chew/much on the food compared to children TD. Children with DS also ate significantly less than typically developing children. Similar mealtime behaviors were observed between the children with TD/<30 months of age and children with DS regardless of age (p < .05). While children with DS/TS had a higher disposition for the dissolvable texture, along with products that were salty and cheesy, children with DS/NTS had a greater tolerance for more textures in general, including crunchy and grainy. Overall, this research identified mealtime behaviors in children with DS, determined overall disposition of children with DS to foods of differences sensory properties, and demonstrated the influence of TS on a child's disposition to a food. This research will be extended to develop acceptable and innovative food products for children with DS/TS.
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Affiliation(s)
- Carolyn F Ross
- School of Food Science, Washington State University. Pullman, Washington, USA
| | | | - Victoria Surette
- School of Food Science, Washington State University. Pullman, Washington, USA
| | - Anne Hasted
- Qi Statistics Ltd. West Malling, Washington, UK
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Magenis ML, de Faveri W, Castro K, Forte GC, Grande AJ, Perry IS. Down syndrome and breastfeeding: A systematic review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:244-263. [PMID: 33234015 DOI: 10.1177/1744629520970078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Several conditions related to serious difficulty in initiating and maintaining breastfeeding in neonates with Down syndrome are described in the literature. This study aimed to investigate the frequency of breastfeeding in neonates with Down syndrome, as well as the reasons for not breastfeeding, through a systematic literature review by searching MEDLINE via PubMed, Cochrane Library, Scopus, Embase via Elsevier, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Sixteen studies were included with a total sample size of 2022 children with Down syndrome. The frequency of exclusive breastfeeding was 31.6-55.4%, with five studies reporting breastfeeding for longer than 6 months. Breastfeeding from birth was present for 48-92.5% of the children with Down syndrome in six studies. Two studies reported that around 50% and 23.3% of the children with Down syndrome were never breastfed, and rates of breastfeeding in infants with Down syndrome were lower than those in controls in three studies. The reasons for not breastfeeding or cessation of breastfeeding were associated with Down syndrome-specific challenges, maternal reasons, and healthcare aspects.
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Rogers SL, Smith B, Mengoni SE. Relationships between feeding problems, eating behaviours and parental feeding practices in children with Down syndrome: A cross-sectional study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:596-606. [PMID: 34913544 DOI: 10.1111/jar.12972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 11/16/2021] [Accepted: 11/29/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Research investigating feeding problems in children with Down syndrome is scarce. This study investigated feeding problems, eating behaviours and parental feeding practices in children with Down syndrome (n = 40), and typically developing (TD) children of the same age and sex (n = 40). METHOD Parents of children aged 6-months to 5-years in the UK completed questionnaires assessing their child's feeding problems and eating behaviours and parental feeding practices. RESULTS For children with Down syndrome, feeding problems were: significantly greater than for TD children; negatively associated with breast milk duration and appetite during exclusive milk feeding; and positively associated with drinking more slowly. For both groups, feeding problems were significantly correlated with more food avoidant eating behaviours. CONCLUSIONS This study provides new information about the relationships between feeding problems and eating behaviours in early development. Longitudinal research is needed to further investigate these relationships, so that effective support can be developed for families.
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Affiliation(s)
- Samantha L Rogers
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
| | - Bobbie Smith
- Department of Psychology and Sport Sciences, University of Hertfordshire, Hatfield, UK
| | - Silvana E Mengoni
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
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Zhen L, Moxon J, Gorton S, Hook D. Can I breastfeed my baby with Down syndrome? A scoping review. J Paediatr Child Health 2021; 57:1866-1880. [PMID: 34586684 DOI: 10.1111/jpc.15765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/04/2021] [Accepted: 09/08/2021] [Indexed: 12/13/2022]
Abstract
AIM To summarise existing evidence about barriers and enablers to breastfeeding babies with Down syndrome (DS) in peer-reviewed literature. METHODS Ovid Medline, CINAHL, Scopus and Ovid Emcare were searched. Inclusion and exclusion criteria were used to screen yielded articles and those meeting the criteria were included for data extraction. Two authors extracted data including outcomes, design, definition of DS, barriers and enablers to breastfeeding babies with DS. RESULTS Sixteen studies met the inclusion and exclusion criteria. Barriers and enablers were categorised into maternal, child and health professional factors. CONCLUSIONS This review identified a significant literature gap related to breastfeeding babies with DS and more definitive research under current standards is needed. Mothers reported the need for high-quality health professional breastfeeding support and evidence-based effective breastfeeding techniques. A collaborated and concerted approach from both mothers and health professionals is important to optimise breastfeeding for babies with DS.
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Affiliation(s)
- Lijiin Zhen
- James Cook University (JCU) Clinical School, Townsville University Hospital, Townsville, Queensland, Australia
| | - Joseph Moxon
- James Cook University (JCU) Clinical School, Townsville University Hospital, Townsville, Queensland, Australia
| | - Susan Gorton
- James Cook University (JCU) Clinical School, Townsville University Hospital, Townsville, Queensland, Australia
| | - Daniel Hook
- James Cook University (JCU) Clinical School, Townsville University Hospital, Townsville, Queensland, Australia
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Bandini LG, Curtin C, Phillips SM, Rogers GT, Eliasziw M, Perelli J, Jay L, Maslin M, Must A. Nutrient adequacy, dietary patterns and diet quality among children with and without intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:898-911. [PMID: 34342094 PMCID: PMC9229407 DOI: 10.1111/jir.12871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 05/13/2021] [Accepted: 07/13/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Children with intellectual disabilities (ID) frequently have feeding problems, but there has been limited research on nutrient intake, dietary patterns and diet quality in this population. METHOD Nutrient intakes, dietary patterns and the Healthy Eating Index were compared between 48 children with ID and 55 typically developing (TD) children aged 3-8 years who participated in the Children's Mealtime Study. Three-day food records that included two weekdays and one weekend day were used to assess dietary intake. Food intake was entered into the Nutrition Data System for Research for analysis of nutrient intake, dietary patterns and diet quality. Height and weight were measured to determine body mass index (BMI). The relation of dietary patterns to weight status was also assessed. RESULTS Typically developing children and children with ID met the Estimated Average Requirement/Adequate Intake (EAR/AI) for most nutrients. However, a substantial number of children in both groups did not meet the EAR for vitamins E and D and calcium and the AI for vitamin K. Only one TD child met the AI for potassium. A small percentage of children in both groups did not meet the EAR for vitamin A and vitamin C, and in the ID group, a small percentage did not meet the EAR for vitamin B12 . Children in the ID group consumed, on average, fewer servings of vegetables than TD children (0.5 vs. 1.2, P < 0.001), but there was no significant difference in servings of fruit (0.8 vs. 1.1, respectively), fruit juice (less than a half serving in both groups), sugar-sweetened beverages (less than a half serving in both groups) or snacks (1.1 vs. 1.4, respectively) after adjusting for BMI z-score, parental education and race. We found a significant correlation between snack intake and BMI z-score among children with ID but not among TD children (r = 0.48, P < 0.0001 vs. r = 0.19, P = 0.16, respectively). The Healthy Eating Index indicated, on average, poor overall diet quality in both groups (58.2 in the ID group and 59.1 in the TD group). CONCLUSIONS This study suggests that the diets of children with ID, as in TD children, need improvement. Targeting healthy eating in children with ID would improve diet quality and overall health.
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Affiliation(s)
- L G Bandini
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Health Sciences, Boston University, Boston, MA, USA
| | - C Curtin
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Worcester, MA, USA
| | - S M Phillips
- Department of Nursing and Health Professions, Rivier University, Nashua, NH, USA
| | - G T Rogers
- Jean Mayer USDA Human Nutrition Research Center on Aging, Boston, MA, USA
| | - M Eliasziw
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - J Perelli
- Department of Health Sciences, Boston University, Boston, MA, USA
| | - L Jay
- Center for Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - M Maslin
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - A Must
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
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Roccatello G, Cocchi G, Dimastromatteo RT, Cavallo A, Biserni GB, Selicati M, Forchielli ML. Eating and Lifestyle Habits in Youth With Down Syndrome Attending a Care Program: An Exploratory Lesson for Future Improvements. Front Nutr 2021; 8:641112. [PMID: 34568399 PMCID: PMC8455913 DOI: 10.3389/fnut.2021.641112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 08/04/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction: Children with Down Syndrome (DS) have nutritional problems with unknown implications besides increased potential for obesity. Their food habits are unknown. We aim to delineate eating and lifestyle habits of DS children attending a multispecialist program to identify the challenges they face and the potential improvements. Patients and Methods: We interacted with 34 DS children (22 males, 12 females, 2-16 years old) and their families. Food habits, medical conditions and treatments, degrees of development and physical activity, anthropometric and laboratory data were recorded over 6 months and analyzed. A 3-day food diary and a 24-h recall food frequency questionnaire were administered. Results: Twenty-nine (85%) children completed meals, only 11 (32%) received alternative food such as milk. Weaning regularly started in 25 (73%) children. Preschool children introduced adequate calories and nutrients. School children and adolescents did not reach recommendations. All age groups, as the general pediatric population, excessively ate protein and saturated fat, and preferred bread, pasta, fruit juices, meat and cold cuts. Peculiarly, pulses and fish were adequately assumed by preschool and school children, respectively. Five children (15%) were overweight/obese. Conclusions: Dietary excesses commonly found in the general pediatric population are also present in this DS group, proving a narrowing gap between the two. DS group performed better nutritionally in the early years and overweight/obesity occurrence seems contained. DS children may benefit from a practical yet professional care-program in which nutrition education may improve their growth, development and transition into adulthood.
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Affiliation(s)
| | - Guido Cocchi
- Pediatrics, University of Bologna, Bologna, Italy
| | | | | | | | | | - Maria Luisa Forchielli
- Pediatrics, University of Bologna, Bologna, Italy
- Health Science and Technologies Interdepartmental Center for Industrial Research (CIRI-SDV), University of Bologna, Bologna, Italy
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Skrzypek M, Koch W, Goral K, Soczyńska K, Poźniak O, Cichoń K, Przybysz O, Czop M. Analysis of the Diet Quality and Nutritional State of Children, Youth and Young Adults with an Intellectual Disability: A Multiple Case Study. Preliminary Polish Results. Nutrients 2021; 13:nu13093058. [PMID: 34578938 PMCID: PMC8470530 DOI: 10.3390/nu13093058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Considering the limited amount of available data on the diet quality of children, adolescents, and young adults with an intellectual disability (ID) in Poland, as well as the higher incidence of nutritional disorders among people with ID in comparison to the general population, a study was conducted to assess the quality of diet in community-dwelling young individuals with ID. (2) Methods: A multiple-case study was carried out to obtain data on anthropometric parameters and food records over a three-day observation period for 18 subjects with ID. The nutritional value of the products and dishes consumed by the subjects was calculated using the commercial computer program Kcalmar.pro (Hermax, Poland), which contains the Polish database of the nutritional value of food products and dishes. The results presented here are those of a pilot study of a wider research project. (3) Results: The study group consisted of seven women (38.9%) and 11 men (61.1%) with an average age of 12.94 years (range 4.00-22.00) and an average BMI of 25.2 (range 14.5-35.4). The obtained results confirmed the suboptimal pattern of nutrition in children and adolescents with ID. Regarding energy intake and dietary macronutrients, only in 27.8% of cases, energy intake exceeded the Estimated Energy Requirement corresponding to age, sex, body weight, and height. Most of the respondents were characterized by correct intake of proteins, fats, and carbohydrates, and 83.3% showed excessive intake of saturated fatty acids. Excessive intake of vitamins B1, B2, and B6 was observed in all subjects, and that of vitamins B3 (niacin), B12, A, and C in the vast majority of subjects, while deficiency of vitamin D was observed in all individuals and folic acid in 22.2% of individuals. Excessive intake of minerals, such as sodium, phosphorus, and magnesium was noted among most of the respondents, while the intake of calcium and iodine was found to be insufficient. Compared to people with less severe ID (grades 1 and 2), people with grade 3 ID showed significantly lower intake/reference fulfillment of dietary components such as vitamin B6, potassium, phosphorus, iron, copper, iodine, magnesium, and zinc. No significant differences were noted in the nutritional reference fulfillment for various nutrients among the groups distinguished by sex, nutritional status, or the cause of ID. (4) Conclusion: Health supervision guidelines proposed for persons with ID should take into account the dietary practices of the families caring for them, with an emphasis on the prevention and correction of irregularities that may reduce the effectiveness of rehabilitation and deteriorate the health of the affected people. Caregivers/parents of each person with ID who took part in the study were given individualized dietary advice aimed at correcting the dietary abnormalities.
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Affiliation(s)
- Michał Skrzypek
- Department of Clinical Dietetics, Medical University of Lublin, Chodźki 1 Street, 20-093 Lublin, Poland; (K.G.); (K.S.); (O.P.); (K.C.); (O.P.)
- Correspondence: (M.S.); (W.K.)
| | - Wojciech Koch
- Department of Food and Nutrition, Medical University of Lublin, Chodźki 4a Street, 20-093 Lublin, Poland
- Correspondence: (M.S.); (W.K.)
| | - Karolina Goral
- Department of Clinical Dietetics, Medical University of Lublin, Chodźki 1 Street, 20-093 Lublin, Poland; (K.G.); (K.S.); (O.P.); (K.C.); (O.P.)
| | - Klaudia Soczyńska
- Department of Clinical Dietetics, Medical University of Lublin, Chodźki 1 Street, 20-093 Lublin, Poland; (K.G.); (K.S.); (O.P.); (K.C.); (O.P.)
| | - Olga Poźniak
- Department of Clinical Dietetics, Medical University of Lublin, Chodźki 1 Street, 20-093 Lublin, Poland; (K.G.); (K.S.); (O.P.); (K.C.); (O.P.)
| | - Klaudia Cichoń
- Department of Clinical Dietetics, Medical University of Lublin, Chodźki 1 Street, 20-093 Lublin, Poland; (K.G.); (K.S.); (O.P.); (K.C.); (O.P.)
| | - Olga Przybysz
- Department of Clinical Dietetics, Medical University of Lublin, Chodźki 1 Street, 20-093 Lublin, Poland; (K.G.); (K.S.); (O.P.); (K.C.); (O.P.)
| | - Marcin Czop
- Department of Clinical Genetics, Medical University of Lublin, Radziwiłłowska 11 Street, 20-080 Lublin, Poland;
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Agostini CDO, Poloni S, Barbiero SM, Vian I. Prevalence of breastfeeding in children with congenital heart diseases and down syndrome. Clin Nutr ESPEN 2021; 44:458-462. [PMID: 34330505 DOI: 10.1016/j.clnesp.2021.03.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/07/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND According to the World Health Organization, the worldwide incidence of Down syndrome is one in a thousand live births a year. Of these, it is estimated that 20-60% have congenital heart disease, a factor that hinders breastfeeding. Considering the numerous benefits of breastfeeding, a study verifying this prevalence in children with Down syndrome and congenital heart disease is indispensable, and this is not yet evidenced in the literature. The aim of this study is to verify the prevalence of breastfeeding in children with Down syndrome and congenital heart disease admitted to a referral hospital in cardiology. METHODS Cross-sectional study with 62 patients, aged between 0 and 5 years. Anthropometric variables (weight, height) and data related to breastfeeding were collected. Statistical analysis was performed using the SPSS® version 26.0 statistical software. RESULTS The prevalence of breastfeeding was of 80.6%, but the median of exclusive breastfeeding was of only 3 days. Only 38.7% received breastfeeding for more than 6 months. The main reasons for interruption were difficulty in sucking and tiredness to breastfeed. Statistical significance was evidenced when comparing the time of exclusive breastfeeding and maintenance with the mother's education, with p = 0.006 and p = 0.041, respectively. No relationship was found between nutritional status and breastfeeding. CONCLUSIONS Despite the high prevalence of breastfeeding, the maintenance time is well below the recommendations. Therefore, further monitoring and promotion of breastfeeding is necessary for this population, given the countless benefits of breast milk.
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Affiliation(s)
- Clarissa de Oliveira Agostini
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil
| | - Soraia Poloni
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Sandra Mari Barbiero
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil
| | - Izabele Vian
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil.
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Nutritional challenges in children and adolescents with Down syndrome. THE LANCET CHILD & ADOLESCENT HEALTH 2020; 4:455-464. [DOI: 10.1016/s2352-4642(19)30400-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/15/2019] [Accepted: 11/27/2019] [Indexed: 12/14/2022]
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Stefanowicz-Bielska A, Wierzba J, Stefanowicz J, Chamienia A. Factors affecting the prevalence of overweight and obesity in children with Down Syndrome. Minerva Pediatr (Torino) 2020; 74:151-159. [PMID: 32418401 DOI: 10.23736/s2724-5276.20.05694-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to determine the influence of environmental factors on the occurrence of overweight and obesity in children with Down syndrome. METHODS The study was conducted in a group of children with Down Syndrome under the care of the Genetic Clinic in Gdansk from May 2017 to December 2018. RESULTS The study included 26 female patients and 22 male patients with Down Syndrome, aged 7 to 18 years. The children were divided into two groups: group 1, with normal body weight and underweight; and group 2, with obesity and overweight. Overweight and obesity were diagnosed in 19% of children with Down Syndrome. The BMI analysis of the parents showed that the fathers of children with obesity and overweight had a higher BMI (P=0.043). In the group of children with overweight and obesity, obesity was more common in siblings (P=0.029), and sucking disorders were less frequent in the infancy period (P=0.015). Children with obesity and overweight were more likely to eat white bread (P=0.039), milk and other dairy products (P=0.04), and eggs (P=0.029) and ate more often between meals (P=0.022). CONCLUSIONS In families of children with Down Syndrome affected by overweight and obesity, nutritional disorders were more frequent in the other members of the family. More frequent unhealthy dietary choices were found in children with Down Syndrome affected by overweight and obesity than in children with a normal body weight and underweight. It is necessary to educate families about the principles of a healthy lifestyle, as it can improve the quality of life of patients with Down syndrome and the whole family.
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Affiliation(s)
- Anna Stefanowicz-Bielska
- Department of Internal and Pediatric Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdansk, Poland -
| | - Jolanta Wierzba
- Department of Internal and Pediatric Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Joanna Stefanowicz
- Department of Pediatrics, Hematology and Oncology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Andrzej Chamienia
- Department of Internal and Pediatric Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdansk, Poland
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Grabeklis AR, Skalny AV, Skalnaya AA, Zhegalova IV, Notova SV, Mazaletskaya AL, Skalnaya MG, Tinkov AA. Hair Mineral and Trace Element Content in Children with Down's Syndrome. Biol Trace Elem Res 2019; 188:230-238. [PMID: 30209729 DOI: 10.1007/s12011-018-1506-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 09/02/2018] [Indexed: 10/28/2022]
Abstract
The objective of the present study was to assess the level of minerals and trace elements in 40 children with Down's syndrome and 40 controls aged 1-2 years old. Hair mineral and trace element analysis was performed using inductively coupled plasma mass spectrometry. The obtained data demonstrate that hair levels of Mg, P, I, Cr, Si, Zn, and Pb in Down's syndrome patients exceeded the respective control values by 36, 36, 93, 57, 45, 28, and 54%, whereas hair mercury was more than twofold lower in children with Down's syndrome. The observed difference in the levels of trace elements was age-dependent. In particular, in 1-year-olds, major differences were observed for essential elements (Cr, Si, Zn), whereas in 2-year-olds-for toxic elements (Hg, Pb). At the same time, hair P levels in Down's syndrome patients were 14 and 35% higher at the age of 1 and 2 years in comparison to the respective controls. Multiple regression analysis demonstrated that a model incorporating all elements, being characterized by a significant group difference, accounted for 42.5% of status variability. At the same time, only hair phosphorus was significantly interrelated with Down's syndrome status (β = 0.478; p < 0.001). Principal component analysis (PCA) used As, Ca, Cr, Fe, Hg, I, Mg, P, Pb, Se, Si, Sn, and Zn as predictors, with the resulting R2 = 0.559. The OPLS-DA models also separated between Down's and health control groups. Therefore, 1-2-year-old patients with Down's syndrome are characterized by significant alterations of mineral and trace element status.
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Affiliation(s)
- Andrey R Grabeklis
- Yaroslavl State University, Yaroslavl, Russia
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Anatoly V Skalny
- Yaroslavl State University, Yaroslavl, Russia.
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation.
- All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR), Moscow, Russia.
| | | | - Irina V Zhegalova
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Svetlana V Notova
- Orenburg State University, Orenburg, Russia
- Federal Research Centre of Biological Systems and Agro-technologies of the Russian Academy of Sciences, Orenburg, Russia
| | | | - Margarita G Skalnaya
- Yaroslavl State University, Yaroslavl, Russia
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Alexey A Tinkov
- Yaroslavl State University, Yaroslavl, Russia
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
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García-Hoyos M, Riancho JA, Valero C. Bone health in Down syndrome. Med Clin (Barc) 2017; 149:78-82. [PMID: 28571965 DOI: 10.1016/j.medcli.2017.04.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 01/08/2023]
Abstract
Patients with Down syndrome have a number of risk factors that theoretically could predispose them to osteoporosis, such as early aging, development disorders, reduced physical activity, limited sun exposure, frequent comorbidities and use of drug therapies which could affect bone metabolism. In addition, the bone mass of these people may be affected by their anthropometric and body composition peculiarities. In general terms, studies in adults with Down syndrome reported that these people have lower areal bone mineral density (g/cm2) than the general population. However, most of them have not taken the smaller bone size of people with Down syndrome into account. In fact, when body mineral density is adjusted by bone size and we obtain volumetric body mineral density (g/cm3), the difference between both populations disappears. On the other hand, although people with Down syndrome have risk factor of hypovitaminosis D, the results of studies regarding 25(OH)D in this population are not clear. Likewise, the studies about biochemical bone markers or the prevalence of fractures are not conclusive.
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Affiliation(s)
- Marta García-Hoyos
- Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, España
| | - José Antonio Riancho
- Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, España
| | - Carmen Valero
- Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, España.
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