by Nicky Clark is a nutritional therapist in Australia who provides individual nutritional advice to parents of children with Down syndrome.
She has lectured on nutrition for Down syndrome, including at the World Down Syndrome Congress in Brisbane and for the Institute for Optimum Nutrition’s Nutrition Talks series.
Clark also has a son with Down syndrome named Michael. She told Newsweek that she receives “requests from around the world for information and insights” about the diets of people with the disease – and she has shared some of that knowledge with them Newsweek.
Down syndrome, also known as Trisomy 21, is a condition in which people are randomly born with an extra chromosome and as a result have some form of learning disability.
“There really isn’t a lot of research on nutrition and Down syndrome,” Clark said Newsweek. “But when you start to see connections, you can start to develop ideas that would be really worthwhile for people with Down syndrome.”
Much of the advice she gives parents, Clark said, was just standard nutritional education that would apply to any child — but there were also some specific focuses for Down syndrome. For example, picky eating is common.
“There’s just the problems that everyone has when kids are picky eaters,” she said. “Perhaps this is exacerbated by Down syndrome because parents are constantly worried that their child will suffocate or won’t be able to breastfeed.
“It’s an extra layer of concern, and I think that means parents become even more attentive to the child’s needs, and that creates a child who is even pickier about food.”
“But then there are all the sensory things that come with the disability. So it may be that they don’t like the taste of fruit or that all their food needs to be smooth.”
Nutritional counseling for picky eating typically involves providing foods the child will eat, finding ways to increase the nutrient content, and gradually encouraging the child to eat slightly different things.
For example, if a child eats chicken nuggets and french fries, parents might work toward introducing breaded chicken and fried potatoes with a few carrot sticks on the side.
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Clark added that people with Down syndrome have low muscle tone, where relaxed muscles are flaccid than those without Down syndrome, which can make chewing more difficult.
“Chewing can be a problem,” she said. “The food is not chewed very well and they tend to chew very quickly. This leads to digestive problems, and it seems that digestive problems are common.” [among people with Down syndrome]– But there is really very little research to say that.”
Just as every child stuffs food into their mouth and can’t wait to leave the table and play, children with Down syndrome may not chew their food properly, which can lead to digestive problems such as stomach pain, belching, diarrhea, and constipation.
The solution is to encourage slower, more mindful eating during seated meals, with an emphasis on chewing food properly before swallowing.
Another area that can affect anyone, but may affect people with Down syndrome more severely, is oxidative stress, Clark said.
“When I dug into the research and tried to make something of it, I didn’t find much, but I found something about oxidative stress,” she said.
“People with Down syndrome can look old quite early and develop Alzheimer’s around the age of 40. This is because they appear to develop oxidative stress more quickly.”
Oxidative stress is a normal process in the body when byproducts of chemical reactions, called free radicals, damage cells – often called “internal wear and tear” – that is linked to aging and chronic diseases such as heart disease, dementia and obesity.
However, foods containing antioxidants are believed to neutralize free radicals and reduce oxidative stress in the body.
“Oxidative stress is a real thing,” Clark said, adding that one of her main messages was that eating antioxidant-rich foods could be helpful.
Antioxidants are found in many plant foods, especially fruits and vegetables such as berries, citrus fruits and leafy greens, but also in nuts and seeds, fatty fish, extra virgin olive oil, dark chocolate and tea.
Clark said she recommended eating lots of colorful fruits and vegetables and limiting sugar intake because too much sugar can cause additional oxidative stress and increase the risk of Alzheimer’s, which she said is “a real problem” for people with Alzheimer’s down -Syndrome.
“It’s not just sugar, it’s carbohydrates,” Clark said. Refined carbohydrates such as white rice, white bread, pasta, mashed potatoes and fruit juices are all converted into glucose – sugar – in the body and can therefore have the same nutritional effect.
Clark said reducing intake of both high-sugar foods and refined carbohydrates is important advice she has given to parents of children with Down syndrome to reduce oxidative stress, Alzheimer’s risk, and the risk of insulin resistance and weight loss reduce growth – which is also higher in people with Down syndrome.
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“Another thing is that methylation doesn’t seem to be quite right in people with Down syndrome,” Clark said.
Methylation is one of the ways the body interacts with, reads, and interprets DNA. When methylation fails, it can change the way a gene is expressed, potentially increasing the risk of certain diseases.
“There is research that shows that methylation is slightly different in newborns,” Clark said. “And there is a lot of research on methylation and B vitamins. Another one of my recommendations from a nutritional perspective is adding B vitamins.”
B vitamins are a group of nutrients found in meat, fish, eggs, dairy products, and some legumes, seeds, and leafy vegetables.
Clark said there are supplements for people with Down syndrome that target methylation and oxidative stress, but she wouldn’t necessarily recommend them.
“They’re very high doses of B vitamins and antioxidants like selenium, so they fit both of those patterns and make sense, but they’re really high doses and I have a lot of concerns about them being pushed on all these parents who “Don’t take any medication.” “I don’t necessarily know any better,” Clark said.
“High dosages of dietary supplements are dangerous for everyone, without any real thoughtful and well-founded reason for it. It’s not a smart way to use supplements.”
“When I look at my Michael, he is the healthiest person physically. Why would I give a beautiful, perfect child a supplement? That makes no sense.”
On the subject of specific nutrients, Clark would also recommend focusing on zinc, a mineral found in meat, shellfish, dairy, nuts and seeds.
“People with Down syndrome tend to suffer from immune and thyroid problems,” she said, suggesting that zinc could help with both. “And zinc supports antioxidant systems.”
Finally, she emphasized how important proper nutrition is for people with Down syndrome.
“I think that’s the most important thing,” she said. “For people with Down syndrome, there is swimming therapy, speech therapy, occupational therapy, physical therapy, nutritional therapy – all of these therapies that you have to consciously think about doing, but food is just second nature.”
“It’s there, something you have to do three times a day, with impacts on your physical and mental health, so you might as well do it right.”
“And when you talk to parents who are invested in these things and are already doing everything a nutritionist would do, their kids are really healthy, really healthy and really independent, and you think there must be something to that.”
“Anecdotally, you hear families say, ‘We changed the diet, we added this, and we did that, and now they’re better – and you just think food is medicine. It’s so effective.”
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