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Digestive Disorders: the Benefit of Vitamins By Laude de Verdun, dietician at the Jérôme Lejeune Institute. A balanced diet – i.e. one that contains all food families in the right quantities – is clearly as important to people with Down syndrome as it is to the general population. Nevertheless, particular attention should be paid to vitamin and mineral micronutrients. Here are a few dietary tips, split into themes. Avitaminosis may be present consistently but may vary in intensity depending on the individual. To maximise vitamin intake, it is important to ensure that certain foods are consumed regularly. For B vitamins Wheat yeast/bran > Daily sprinkled on salads or soup Eggs > 3-6 per week Mushrooms > regularly Foods rich in folic acid: leafy greens, strawberries, cabbage, etc. > every day Wholemeal bread > every day, according to personal tolerance. For fat-soluble vitamins   Vitamin D is the sunshine vitamin. It has a dual origin: endogenous – i.e. it is synthesised by the body in the skin under exposure to sun or ultraviolet rays – and exogenous, i.e. provided by the diet. Vitamin D has many functions for the body, the main one being to increase concentrations of calcium and phosphorus in the blood. It is also involved in other functions (hormonal, immune system). The general population requires 15 µg/d for adult men and women. Dietary intake of vitamin D contributes to about 25% of the requirement, which is why supplements are necessary. But you can prioritise foods with Vitamin D in your diet. These include: Fatty fish > 1 to 2 times a week minimum (sardines, mackerel, salmon, etc.) Dairy products > 3 times a day minimum For vitamin C It is recommended to eat fruit or vegetables (raw vegetables, salad, etc.) with each meal, and possibly as a small snack during the day. Hyperuricemia People with Down syndrome have a predisposition to hyperuricemia (gout attacks). So as a preventive measure, special attention should be paid to how much and how often they eat cold meats and offal. A maximum of once every 15 days in reasonable quantities, as a preventive measure, seems a good frequency. Zinc deficiency People with Down syndrome may have a zinc deficiency. Zinc is involved in the activity of more than 200 enzymes, in particular those that help protect against free radicals and those involved in protein synthesis (hence its importance in cell renewal, healing and immunity). So zinc helps prevent macular degeneration. The consumption of seafood rich in zinc, red meat and wholemeal bread is recommended. Caution: although very rich in zinc, calf's liver and pig's liver are not recommended because of the risk of hyperuricemia Additionally: Constipation prevention Eating fruit (preferably fresh: 2 to 3 per day), raw or cooked vegetables (with each meal), unrefined cereals (wholemeal bread, bran bread, wholegrain cereals) and legumes, while drinking about 1.5 L per day, is recommended to offset the effects of hypotonia on digestion. Regular physical activity like walking or working out on an exercise bike can also help prevent constipation. Premature ageing People with Down syndrome tend to experience a degeneration of the nervous system comparable to that of people with Alzheimer’s disease. One way to fight this degeneration is by regularly eating omega 3 and DHA in particular. It is important to make sure to stay within the RDAs, i.e. 1% of the RDA of omega 3 and 250 mg of DHA per day. So regularly eating sardines, mackerel and and other fatty fish, and alternating cooking oils – opting for walnut and rapeseed oil for seasoning – is recommended....

Excess weight and obesity: understanding the causes in order to provide a remedy By Laude de Verdun, dietician at the Jérôme Lejeune Institute. By properly understanding the mechanisms of weight gain and obesity, we can allow friends and family to educate and help their loved one with Down syndrome. What might be the causes of excess weight and obesity? There may be multiple causes of excess weight or obesity. These can include genetic predisposition, weight-gaining treatments (antipsychotics, antiepileptics), eating habits, food-related impulsivity, lack of options for physical activity and sport, and a sedentary lifestyle. Prevention and treatment of excess weight among people with Down syndrome can be achieved through therapeutic education involving their close circle. It is often complicated for these dependent people to avoid gaining weight. They may have many people around them who aren’t all aware of how important it is to prevent excess weight. People with Down syndrome often gain weight after moving into care home type institutions. Here are some explanations:A culture of giving out little treats at parties or so-called “special” occasions that come around almost daily, and carers who give candy out as rewards too easily.Heavy and unbalanced snacks that are not necessary for adults who have finished growing and have no particular additional needs.Unsuitable portions (which don’t vary according to age, gender and appetite)The lack of an in-house dietician, leading to meals without dietary monitoring on a collective level and a lack of tailored consultation on an individual level.Disrupted sleep: sleep can often be disturbed when sleeping in the same room as other residentsThe presence of vending machinesOn the positive side, vending machines allow them to manage their pocket money, giving them a certain independence. They decide how to use their money. Parents also often mention how vending machines create a convivial atmosphere.On the negative side, vending machines offer food and drink that is very high in sugar. Care homes should choose vending machines that offer healthy produce (fresh fruit, dried fruit, etc.), or only drinks such as coffee, tea and herbal tea, in order to help residents make healthy choices.Little or no physical exercise during the day. People with Down syndrome or a mental disability often take a small bus or car to get to their activities or place of work. They do little physical activity, if any at all. ConclusionIt is important for this population to opt for low GI foods from a young age and to limit snacking and sugar intake outside of meals. Soda and candy vending machines should be banned in care homes in the same way they are in schools in France (law of August 9, 2004 on public health policy, which prohibits the installation of vending machines in schools as of September 1, 2005).Since it has such a significant impact on their health, special attention should be paid to the diet of people with Down syndrome on a daily basis....