The dietary recommendations for people with Down syndrome are similar to those of the general population. Many people with Down syndrome do not have major health issues, but some do. Below are a few nutrition implications for individuals with Down syndrome along with tips and suggestions on how to treat or manage secondary symptoms. Research suggests that interventions which include parental or caregiver support appear to have greater success for adolescents and young adults with Down syndrome. It is important to not only educate about nutrition and physical activity, but to lead by example.
Overweight and obesity in children and adults with Down syndrome is a great concern and one that should be addressed with a comprehensive nutrition and physical activity program that is tailored to the specific needs of the individual. Weight gain could be due to hypothyroidism or a combination of lack of activity and poor diet habits. A common symptom of Down syndrome is low muscle tone which causes a greater amount of fat mass and less muscle mass in the body. This increased fat mass, along with a higher prevalence of obesity, puts the Down syndrome population at a greater risk for type 2 diabetes and cardiovascular disease. Weight management is an important step in addressing these health concerns. Tips for managing weight include:
- Eating small frequent meals
- Eating a variety of fruits, vegetables, whole grains, lean protein, and low fat dairy
- Limiting excess snacking or grazing, especially processed food and treats
- Drinking more water and less sugary beverages
- Getting plenty of exercise; at least 15-30 minutes each
- Getting involved in the kitchen by:
- Assisting in grocery shopping
- Participating in menu planning
- Offering suggestions of what to eat during the week. Caregivers can assist in making ideas healthy.
- Gathering ingredients for the recipe, help prepare the food, set the table, or wash dishes.
It is common for someone with Down syndrome to be diagnosed with Type 1 Diabetes at a young age. Caretakers of people with Down syndrome should look for these symptoms of diabetes:
- Increased thirst
- Frequent urination
- Unexpected weight loss
- Fatigue or extreme tiredness
Type 1 diabetes is treated with diet and medication to get blood sugar to a normal level. Diabetes education classes are the best way to teach caregivers and people with Down syndrome about diabetes management.
People with Down syndrome are more likely to develop Celiac disease than the general population in the United States, with the incidence estimated at 7% to 16%. Celiac disease is an autoimmune disorder that is characterized by sensitivity to gluten which is found in wheat, barley, and rye. When a person with celiac disease ingests gluten, an immune response is triggered that that damages the lining of the small intestines. Treatment for celiac disease is a lifelong, gluten-free diet.
People with Down syndrome are at an increased risk of constipation due to low muscle tone and a sedentary lifestyle. Below are ways to prevent or treat constipation.
- Drink fluids throughout the day, preferably water: 6-8 eight-ounce glasses per day
- Increase the amount of dietary fiber consumed each day. Be sure to drink extra water when eating more food with dietary fiber. Examples include:
- raw fruits and vegetables. Leave skin on as it is a great source of fiber.
- dried fruits such as raisins, prunes, and figs.
- high fiber grains/cereal products: bran, whole-wheat flour, whole cornmeal, wheat bran cereals (All Bran, Bran Buds, Bran Chex), bran flakes (Raisin Bran), Grape-Nuts, Shredded Wheat, Fiber One.
- Eat small frequent meals during the day.
- If the problem persists, consult with the registered dietitian nutritionist or physician about taking a fiber supplement such as Miralax or Benefiber.
Studies have shown that 13-55 percent of people with Down syndrome will develop thyroid issues at some point in their life. They may be at higher risk for being diagnosed with Hashimoto’s Thyroiditis, usually causing hypothyroidism, Graves’ Disease, usually causing hyperthyroidism, or Thyroid dysgenesis, which is hypothyroidism found at birth. Symptoms of a thyroid issue can be seen at birth or later in life. Signs of hyperthyroidism (an overactive thyroid) include changes in sleep habits, changes in energy, feeling hot, or unexpected weight loss. Signs of hypothyroidism (an underactive thyroid) are lack of energy, fatigue, feeling cold, or unexpected weight gain. Recognizing these symptoms may be difficult to identify, but especially difficult in a child with Down syndrome. Bring up any concerns with a physician. Treatment for these conditions is a spectrum. Many nutrients are needed in optimizing thyroid function, however, iodine, vitamin D, selenium, and B12 are among the most beneficial.
Gastroesophageal Reflux Disease (GERD)
GERD is a condition where stomach contents reflux back into the esophagus causing several uncomfortable symptoms including heartburn, sore throat, regurgitation, chest pain, and difficulty swallowing. GERD is a concern for children and adults with Down syndrome and can interfere with nutrient intake. The following suggestions may be helpful in minimizing GERD symptoms:
- Eat small, frequent meals
- Wait at least an hour after a meal to exercise
- Do not lie flat after a meal
- Drink before or after meals, not during
- Talk to your health provider about medication
- Avoid spicy foods, citrus, caffeine, chocolate, or dairy
- Losing weight
About 40-50 percent of babies born with Down syndrome have a heart defect. Depending on the severity of the defect, a newborn may require nutrition support or a feeding tube if surgery is required. Throughout childhood and into adulthood, it is important to maintain a heart healthy diet full of fruits, vegetables, fiber, and water while limiting processed foods, sweets, and sugary beverages. Adults with Down syndrome are at risk for developing cardiovascular disease that can be prevented with diet. Learn more about a heart healthy diet from the American Heart Association.
People with Down syndrome of all ages may have difficulty feeding, eating, drinking, or swallowing. These issues may improve or resolve with maturity and therapy. However, some issues may persist throughout the lifetime. It’s common for people with Down syndrome to be born with a narrow palate or small mouth, making their tongue seem enlarged. This can make chewing, swallowing, and speaking more difficult. A feeding therapy team can help make suggestions on ways to modify nutritious food to make it easy and safe to eat. Textures and skills may increase over time to a regular texture diet, or they may continue to be modified throughout the lifetime.