Down Syndrome
Healthy Lifestyle Tips
A number of studies have examined the nutritional status of children with Down syndrome. These children consume lower amounts of calories but are more likely to be obese and to have specific nutrient deficiencies in their diets.54,55Malabsorption is thought to contribute to the health consequences of Down syndrome, such as cardiovascular disease and Alzheimer’s disease, and in a small preliminary study, stool analyses showed that all of four Down syndrome patients examined had insufficient digestion.56 Researchers have long suggested that gluten sensitivity may be a cause for malabsorption in many Down syndrome patients.57,58 Many recent studies have established a link between Down syndrome and celiac disease.59,60,61,62,63,64,65,66,67,68 The immune systems of individuals with celiac disease produce antibodies to gliadin, a protein from wheat gluten and some other grains, and these antibodies damage the intestines resulting in malabsorption and diarrhea. The treatment for celiac disease is complete avoidance of dietary gluten. The prevalence of celiac disease among people with Down syndrome in these studies ranged between 3.9% and 16.9%, more than 100 times the prevalence in the general population. Antibodies to gliadin have been found to be elevated in many people with Down syndrome who do not express the severe symptoms of celiac disease.60,70,64,66 One study found antibodies to proteins from egg and dairy to be elevated in a high percentage of Down syndrome patients.73 Patients with Down syndrome should be evaluated by a doctor for these types of food sensitivities, as well as for celiac disease.
A comparison study found that children with Down syndrome were likely to have less physical activity than other children, suggesting that the condition itself may not be responsible for the tendency toward obesity.74 In another study, adults with Down syndrome were more likely to be obese if they had poor social connections, even after the effects of physical activity and diet were taken into account.75 People with Down syndrome were found to have lower muscle strength and lower bone mineral density than both healthy individuals and people with mental retardation but without Down syndrome. These findings have led researchers to emphasize the importance of physical training for individuals with Down syndrome.76 Although some studies have found that people with Down syndrome do not benefit as much from exercise as people without Down syndrome,77,78,79 intervention trials have found that those who become physically active do improve in strength and endurance.79,81 Cardiac effects of Down syndrome, such as mitral valve prolapse, may reduce the exercise capacity of these individuals.82 Exercise has been suggested as a preventive measure to improve blood flow to the brain and to protect against Alzheimer’s disease, because people with Down syndrome have a high risk for developing this disease at a young age.83 This potential benefit of exercise, however, has not yet been tested.