Nicky Clark is a nutritional therapist in Australia who provides personalized nutritional advice to parents of children with Down syndrome.
She has lectured on nutrition for Down Syndrome, including when the World Down Syndrome Congress came to Brisbane, and for the Institute for Optimum Nutrition's Nutrition Talks series.
Clark also has a son with Down syndrome named Michael. She told me Newsweek that she receives 'requests from all over the world for information and insight' about nutrition for people with the condition - and she shared some of that knowledge with Newsweek.
Down syndrome, also known as trisomy 21, is a condition in which people are accidentally born with an extra chromosome and as a result have a form of learning disability.
"There really hasn't been much research on diet and Down syndrome," Clark said Newsweek. "But if you start connecting the dots, you can start to come up with ideas that are actually worth pursuing for people with Down syndrome."
Much of the advice she gives to parents, Clark said, was just standard nutrition education that would apply to any child - but there were also some specific points to consider for Down syndrome. For example, picky eating is common.
"There's just the issues that everyone experiences when kids are picky eaters," she said. "This may be exacerbated in Down syndrome, because parents are constantly afraid that their child will choke or not be able to breastfeed.
"It's an extra layer of care, and I think this means that parents are even more considerate of the child's needs, creating a child who is even more picky about food.
"But then you also have the sensory things that come with the disability. So they may not like the taste of fruit, or they may need all their food to be smooth."
Nutritional advice for picky eating usually involves providing foods the child eats while finding ways to increase their nutritional value and gradually encouraging the child to eat slightly different things.
For example, if a child is eating chicken nuggets and fries, parents can work on introducing breaded chicken and fried potatoes, with some carrot sticks on the side.
Clark added that people with Down syndrome have low muscle tone, with relaxed muscles being more lax than in people without the condition, and this can make chewing more difficult.
"Chewing can be a problem," she said. "The food is not chewed as well and they tend to chew very quickly. That leads to digestive problems, and there seems to be a high prevalence of digestive problems [among people with Down syndrome]- but when I say this, there really has been very little research done.
So just as every child puts food in their mouth and impatiently leaves the table to go play, children with Down syndrome may not chew their food properly and this can cause digestive problems such as stomach pain, belching, diarrhea and constipation.
The solution is a matter of encouraging slower, more mindful eating during sedentary meals, with an emphasis on chewing food thoroughly before swallowing.
Another area that can affect anyone but may affect people with Down syndrome more strongly 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 did find things about oxidative stress," she said.
"People with Down syndrome can start to look old early, and around age 40 they develop Alzheimer's disease. That's because they seem to develop oxidative stress more quickly."
Oxidative stress is a normal process that occurs in the body when byproducts of chemical reactions called free radicals damage cells - often called "internal wear and tear" - which has been linked to aging and chronic diseases such as heart disease, dementia and obesity. .
But foods containing antioxidants are believed to neutralize free radicals and reduce oxidative stress in the body.
"The oxidative stress is real," says Clark, adding that one of her key messages was that eating foods rich in antioxidants can help.
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, oily fish, extra virgin olive oil, dark chocolate and tea.
Clark said she recommended eating plenty of brightly colored fruits and vegetables and limiting sugar intake, because too much sugar can cause additional oxidative stress - and can also increase the risk of Alzheimer's disease, which she said is "a real problem." for people with diabetes. Down syndrome.
"It's not just sugars, it's carbohydrates too," says Clark. Refined carbohydrates, such as white rice, white bread, pasta, mashed potatoes and fruit juice, are all converted into glucose (sugar) in the body and so can have the same nutritional effect.
Reducing intake of both sugary foods and refined carbohydrates, Clark said, was key advice she gave to parents of children with Down syndrome, to reduce oxidative stress, the risk of Alzheimer's disease and the risk of insulin resistance and reduce weight. gain - which is also higher in people with Down syndrome.
"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. If methylation goes wrong, it can change the way a gene is expressed, potentially increasing the risk of certain diseases.
"There is research showing that methylation in newborns is a little bit off," says Clark. "And there has been a lot of research on methylation and B vitamins. Another 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, as well as some legumes, seeds and leafy vegetables.
Clark said there are supplements created for people with Down syndrome that target methylation and oxidative stress, but she wouldn't necessarily recommend them.
"They're really high doses of B vitamins and antioxidants, like selenium, so they fit into these two patterns and make sense, but they're really high doses, and I'm very concerned that they're being forced on all these parents who don't ." "I don't necessarily know any better," Clark said.
"High doses of supplements are dangerous for everyone without a well-considered, well-founded reason. It is not a smart way to use supplements.
"When I look at my Michael, he is the most physically healthy person. Why would I supplement a beautiful, perfect child? It doesn't make sense."
In terms of specific nutrients, Clark would also recommend focusing on zinc, a mineral found in meat, shellfish, dairy products, nuts and seeds.
"People with Down syndrome often suffer from immune problems and thyroid problems," she said, implying that zinc could help with both. "And zinc supports antioxidant systems."
Finally, she emphasized the importance of good nutrition for people with Down syndrome.
"I think this is the most important thing," she said. 'For people with Down syndrome there is swimming therapy, speech therapy, occupational therapy, physiotherapy and nutritional therapy - all these therapies that require you to consciously think about doing them, but eating is just a given.
'It's there, something you have to do three times a day, with consequences for physical and mental health, so you might as well do it right.
"And when you talk to parents who have invested in this kind of thing and are already doing everything a nutritionist would do, their children are very healthy, very well and very independent, and you think: there must be something in that.
"Anecdotally, you hear families say, we changed the diet, we added this, and we did this, and they're better now - and you just think, food is medicine. It's so powerful."
Do you have a tip about a food story that Newsweek should cover? Is there a nutritional problem you are concerned about? Let us know at [email protected]. We can ask experts for advice and your story can be included Newsweek.
