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Nutrition and Down's Syndrome
By Hwaa Irfan 02/08/2001
The Public Health Service (U.S.) is now recommending that women of childbearing age take steps toward consuming 4mg of the B vitamin folic acid daily. In October of last year, findings published in the American Journal of Clinical Nutrition found that almost 60% of mothers of children with Downs Syndrome (DS) are unable to efficiently metabolize this vitamin. These mothers had a mutation that resulted in the reduced efficiency of an important enzyme. Known as "maternal non-disjunction," the defective process actually occurs before conception, and according to this research, is responsible for 95% of all cases of Downs Syndrome. However, scientists are now discovering that nutrition plays a crucial role in all stages of Down's Syndrome - from birth to old age (Balder).
Downs Syndrome (Trisonomy 21) is a common genetic disorder of the 21st chromosome known to cause mental retardation, physical impairment and physical deformities. Down's Syndrome individuals show significant disturbances in methylation pathways because there is an over manifestation of CBS (an enzyme located on the 21st chromosome) which causes homocysteine (by-product of protein synthesis) to be converted into cysteine (an amino acid) at an accelerated rate. Furthermore, conversion requires the facilitation by serine (an amino acid common to most proteins), which is used to fuel the folic acid cycle. Serine levels have been found to be low in untreated Down's Syndrome individuals. Low serine levels prevent the production of methyl tetrahydrofolate, which is required to recycle homocysteine into methione. When it does convert, there is a homocysteine pool. In Dr. Peter's study of folic acid in DS patients, about 10% of DS children exhibited excessive hyperactivity and/or irritability when given 0.20mg of folic acid which is 10 times the recommended daily allowance (RDA). Although they needed the folic acid, they did
not have sufficient serine levels by which to convert it (Fowkes).
A further study was done on Nurtrichem Pharmacy's "MSB Plus" compound, which includes 45mg of vitamin B-6, 45mcg of vitamin B-12, 1 mg of folic acid, 200mg of serine, 75 mg of methionine and 75mg of cysteine with an increased folate of 3mg (7.5 times the RDA), and 275mg of methionine. Consumption of the "multi-vitamin" intended for DS children, resulted in a substantial number of children exhibiting extreme hyperactivity and irritability. With the discontinuation of the additional folate and methionine the symptoms reversed within days (Balder). Furthermore, many parents have reported cognitive and behavioral improvements after supplementation with methyl donors and methylation catalysts (folic acid and vitamins B-6 and B-12).
Even so, supplementation is crucial for children with Down's Syndrome, as it moderates the effects of the disability and can enhance skills and advantages that the child already has. So, instead of using synthetic vitamins, doctors recommend that supplementation occur naturally. For instance, folic acid can be found naturally in citrus fruits, leafy green vegetables, beans, peas, tuna, eggs etc. In 1998, the Federal Food and Drugs Administration (U.S.) imposed a folic acid fortification requirement onto the producers of wheat flour, commercial, pasta and rice (Fowkes).
However, in DS, the following nutritional measures should be made before supplementing the diet with folic acid
(Fowkes):
1. Check for food sensitivity and allergies. Eliminate allergic foods from the diet. Many DS children are sensitive to wheat and milk.
2. Improve digestion by supplementing the diet with digestive enzymes.
3. Increase antioxidant defense by supplementing the diet with vitamins A, C, E and Beta Carotene.
4. Reduce patient's excessive exposure to direct sunlight.
5. Use olive oil in cooking rather than corn oil.
6. Use plenty of garlic, ginger and onions in the diet.
7. Avoid all aluminum cooking and storage utensils.
8. Add magnesium supplements to the diet to reduce aluminum toxicity.
9. Avoid anti-folate type drugs such as methotroxate, which would further a folate deficiency.
Folic acid is just one of the nutritional factors that show hope for an improved life for Down's Syndrome children. Another metabolic problem that appears in DS individuals is zinc. Zinc is required for proper growth and healing of the immune function, and to produce insulin-like growth factors that are specifically deficient in DS children after about one year of age.
In an earlier DS study, 15 of 22 individuals receiving a zinc sulfate experienced increased growth (Napolitano pg. 46). Dietary zinc supplementation normalizes the thyroid. Before zinc supplementation, plasmic levels of zinc and thymulin, a zinc dependent thymic hormone (THS), were significantly decreased in DS children. After four months of dietary supplementation with zinc sulfate, a normalization of plasmic zinc, thymulin and THS levels were observed. After zinc treatment, there was not detectable difference between DS children and normal children. Clinical evaluation showed that zinc supplementation decreased the incidence of infectious diseases and improved school attendance (Balder).
Growing evidence now shows that many of the symptoms of DS are due to nutritional inadequacy, poor thyroid function and food allergies. The developmental potential of Down's Syndrome children is no longer as limited as once believed. And, it is no longer a factor of just the mother's nutrition, but also of the nutrition of the child.
Sources
Balder, Carl. "Nutrition In Downs Syndrome." Cognitive Enhancement Research Institute.
Fowkes, Sandra. "Nutritional Intervention In Down's Syndrome." Cognitive Enhancement Research Institute.
Napolitano, Vincent. "Down's Syndrome Treatment Book." USA: Homeward Press. 1990.
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