Down Syndrome (Holistic)

About This Condition

Enjoy a higher quality of life by managing the medical conditions often associated with this genetic disease. According to research or other evidence, the following self-care steps may be helpful.
  • Think zinc

    With a doctor's supervision, improve immune function, reduce infection rates, and stimulate growth by taking 1 mg per 2.2 pounds (1 kg) of body weight per day, along with a copper supplement providing 1 to 3 mg per day, as recommended by a doctor

  • Get some extra E

    Check with a nutritional health professional for advice on taking 100 to 400 IU per day vitamin E to improve antioxidant protection

  • Discover acetyl-L-carnitine

    Take 500 mg of this nutritional supplement three times per day to improve visual memory and attention

  • Get a checkup

    Work with a qualified healthcare provider to find out if celiac disease or other causes of food sensitivities may be compromising nutritional health

  • Work in a workout

    Increase physical activity to improve strength and endurance that can be compromised in people with Down syndrome

About

About This Condition

Down syndrome is a genetic abnormality caused by a defect of chromosome 21. People with Down syndrome have varying degrees of cognitive and developmental disabilities and suffer from a wide array of other symptoms, such as premature aging with development of Alzheimer’s disease before the age of 40, short stature and flaccid musculature, frequent infections, autoimmune disease, hypothyroidism, leukemia, and heart defects.1

Down syndrome is the most common genetic disorder, occurring at a rate of about one in 700 to 800 births.2

Symptoms

Newborns with Down syndrome may be lethargic, rarely cry, and have extra skin around the neck. Children and adults with Down syndrome may have slanted eyes, flattened nose, large tongue, small ears, short fingers, and broad hands, and may have difficulty performing routine activities of daily life.

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.3, 4Malabsorption 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.5 Researchers have long suggested that gluten sensitivity may be a cause for malabsorption in many Down syndrome patients.6, 7 Many recent studies have established a link between Down syndrome and celiac disease.8, 9, 10, 11, 12, 13, 14, 15, 16, 17 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.18, 19, 20, 21 One study found antibodies to proteins from egg and dairy to be elevated in a high percentage of Down syndrome patients.22 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.23 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.24 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.25 Although some studies have found that people with Down syndrome do not benefit as much from exercise as people without Down syndrome,26, 27, 28 intervention trials have found that those who become physically active do improve in strength and endurance.29, 30 Cardiac effects of Down syndrome, such as mitral valve prolapse, may reduce the exercise capacity of these individuals.31 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.32 This potential benefit of exercise, however, has not yet been tested.

Supplements

What Are Star Ratings?
Supplement Why
3 Stars
Zinc
1 mg per 2.2 lbs (1 kg) of body weight daily
Zinc may improve immune function, reduce infection rates, and stimulate growth. Take under a doctor’s supervision.

Blood levels of the antioxidant minerals selenium and zinc were normal in one study of people with Down syndrome, but others have found selenium and zinc levels to be low. In some studies more than 60% of patients with Down syndrome had low zinc levels. A preliminary study of selenium supplementation in children with Down syndrome found that the antioxidant activity in the body improved; however, the implications of this finding on the long-term health of these people is unclear. Zinc is critical for proper immune function, and in one preliminary study the majority of patients with Down syndrome examined had low zinc levels and low immune cell activity. Supplementation with zinc resulted in improved immune cell activity. In preliminary intervention trials, improved immune cell activity was associated with reduced rates of infection in Down syndrome patients given supplemental zinc in the amount of 1 mg per 2.2 pounds of body weight per day. A controlled trial, however, did not find zinc, at 25 mg daily for children under 10 years of age and 50 mg for older children, to have these benefits. Zinc has other roles in the body; preliminary data have indicated that zinc supplementation, at 1 mg per 2.2 pounds of body weight per day, improved thyroid function in Down syndrome patients, and increased growth rate in children with Down syndrome.
2 Stars
Acetyl-L-Carnitine
500 mg three times per day
Acetyl-L-carnitine appears to improve visual memory and attention in people with Down syndrome.

Acetyl-L-carnitine is a compound that occurs naturally in the brain and plays a role in the normal functioning of the nervous system. In a preliminary trial, patients with Down syndrome were given 500 mg of L-acetyl-carnitine three times daily for 90 days and were observed to improve in visual memory and attention. Similar improvement was not seen in untreated patients, nor in patients with mental deficiency unrelated to Down syndrome who were also given L-acetyl-carnitine. More research into the effects of L-acetyl-carnitine in people with Down syndrome is needed.
2 Stars
Green Tea Catechins
Refer to label instructions
In double-blind studies of young adults with Down syndrome, supplementation with epigallocatechin-gallate (EGCG; a flavonoid present in green tea) significantly improved measures of cognitive function.
In double-blind studies of young adults with Down syndrome, supplementation with epigallocatechin-gallate (EGCG; a flavonoid present in green tea) for 3-12 months significantly improved measures of cognitive function (episodic memory, visual recognition memory, inhibitory control, and adaptive behavior), compared with a placebo. The amount of EGCG given was 9 mg per 2.2 pounds of body weight per day.
2 Stars
Vitamin E
100 to 400 IU daily
Taking vitamin E may improve antioxidant protection. Ask your doctor before supplementing with this vitamin.

Alzheimer’s disease , cataracts, autoimmune diseases, and a general increase in the pace of aging are all seen in people with Down syndrome. These associated conditions are similar in that they involve damage to body tissues by free radicals. It is believed that the genetic defect that produces Down syndrome increases the need for antioxidants (nutrients that prevent free-radical damage), and several studies of blood and urine biochemistry have shown this to be true. In a preliminary study, vitamin E protected cells of people with Down syndrome from the oxidative damage to which they are most susceptible. However, blood levels of vitamin C and vitamin E, two antioxidant nutrients, have not been found to be different when compared with those of healthy individuals. The role of vitamin E and other antioxidants in treating Down syndrome needs further exploration.
1 Star
Folic Acid
Refer to label instructions
People with Down syndrome may be deficient in folic acid and may benefit from supplementation.

The red blood cells of people with Down syndrome are unusual in ways that suggest either vitamin B12 or folic acid deficiency. However, folic acid levels have been found to be normal in each of these studies, and only one study has found lower levels of vitamin B12 in Down syndrome as compared with healthy individuals. Intervention trials using either vitamin B12 or folic acid have not been done.
1 Star
Multivitamin
Refer to label instructions
Children with Down’s syndrome who take a daily multivitamin may experience improved intellectual functioning.

In a double-blind trial, improvement was reported in the intellectual functioning of five children with Down’s syndrome given a daily high-potency multivitamin-mineral supplement. This sparked interest in further research, but in a larger double-blind trial that followed, no benefit was observed. A later controlled trial found that multivitamin and mineral supplementation had no greater effect than did placebo in children with Down’s syndrome. A review of the research found no compelling reason to give multivitamin or B vitamin supplements to people with Down’s syndrome.
1 Star
Selenium
Refer to label instructions
People with Down syndrome may be deficient in selenium. A preliminary study found that antioxidant activity in the body improved when children with Down syndrome took selenium.

Blood levels of the antioxidant minerals selenium and zinc were normal in one study of people with Down’s syndrome, but others have found selenium and zinc levels to be low. In some studies more than 60% of patients with Down’s syndrome had low zinc levels. A preliminary study of selenium supplementation in children with Down’s syndrome found that the antioxidant activity in the body improved; however, the implications of this finding on the long-term health of these people is unclear. Zinc is critical for proper immune function, and in one preliminary study the majority of patients with Down’s syndrome examined had low zinc levels and low immune cell activity. Supplementation with zinc resulted in improved immune cell activity. In preliminary intervention trials, improved immune cell activity was associated with reduced rates of infection in Down’s syndrome patients given supplemental zinc in the amount of 1 mg per 2.2 pounds of body weight per day. A controlled trial, however, did not find zinc, at 25 mg daily for children under 10 years of age and 50 mg for older children, to have these benefits. Zinc has other roles in the body; preliminary data have indicated that zinc supplementation, at 1 mg per 2.2 pounds of body weight per day, improved thyroid function in Down’s syndrome patients, and increased growth rate in children with Down’s syndrome.
1 Star
Vitamin B12
Refer to label instructions
People with Down syndrome may be deficient in vitamin B12 and may benefit from supplementation.

The red blood cells of people with Down syndrome are unusual in ways that suggest either vitamin B12 or folic acid deficiency. However, folic acid levels have been found to be normal in each of these studies, and only one study has found lower levels of vitamin B12 in Down syndrome as compared with healthy individuals. Intervention trials using either vitamin B12 or folic acid have not been done.

References

1. Reading CM. Down's syndrome: nutritional intervention. Nutr Health 1984;3:91-111 [review].

2. Teksen F, Sayli BS, Aydin A, et al. Antioxidative metabolism in Down syndrome. Biol Trace Elem Res 1998;63:123-7.

3. Luke A, Sutton M, Schoeller DA, Roizen NJ. Nutrient intake and obesity in prepubescent children with Down syndrome. J Am Diet Assoc 1996;96:1262-7.

4. Chad K, Jobling A, Frail H. Metabolic rate: a factor in developing obesity in children with Down syndrome? Am J Ment Retard 1990;95:228-35.

5. Abalan F, Jouan A, Weerts MT, et al. A study of digestive absorption in four cases of Down's syndrome. Down's syndrome, malnutrition, malabsorption, and Alzheimer's disease. Med Hypotheses 1990;31:35-8.

6. Reading CM. Down's syndrome: nutritional intervention. Nutr Health 1984;3:91-111 [review].

7. Storm W. Prevalence and diagnostic significance of gliadin antibodies in children with Down syndrome. Eur J Pediatr 1990;149:833-4.

8. Zubillaga P, Vitoria JC, Arrieta A, et al. Down's syndrome and celiac disease. J Pediatr Gastroenterol Nutr 1993;16:168-71.

9. Castro M, Crino A, Papadatou B, et al. Down's syndrome and celiac disease: the prevalence of high IgA-antigliadin antibodies and HLA-DR and DQ antigens in trisomy 21. J Pediatr Gastroenterol Nutr 1993;16:265-8.

10. Jansson U, Johansson C. Down syndrome and celiac disease. J Pediatr Gastroenterol Nutr 1995;21:443-5.

11. George EK, Mearin ML, Bouquet J, et al. High frequency of celiac disease in Down syndrome. J Pediatr 1996;128:555-7.

12. George EK, Mearin ML, Bouquet J, et al. Screening for coeliac disease in Dutch children with associated diseases. Acta Paediatr Suppl 1996;412:52-3.

13. Bonamico M, Rasore-Quartino A, Mariani P, et al. Down syndrome and coeliac disease: usefulness of antigliadin and antiendomysium antibodies. Acta Paediatr 1996;85:1503-5.

14. Gale L, Wimalaratna H, Brotodiharjo A, Duggan JM. Down's syndrome is strongly associated with coeliac disease. Gut 1997;40:492-6.

15. Carlsson A, Axelsson I, Borulf S, et al. Prevalence of IgA-antigliadin antibodies and IgA-antiendomysium antibodies related to celiac disease in children with Down syndrome. Pediatrics 1998;101:272-5.

16. Hansson T, Anneren G, Sjoberg O, et al. Celiac disease in relation to immunologic serum markers, trace elements, and HLA-DR and DQ antigens in Swedish children with Down syndrome. J Pediatr Gastroenterol Nutr 1999;29:286-92.

17. Pueschel SM, Romano C, Failla P, et al. A prevalence study of celiac disease in persons with Down syndrome residing in the United States of America. Acta Paediatr 1999;88:953-6.

18. Castro M, Crino A, Papadatou B, et al. Down's syndrome and celiac disease: the prevalence of high IgA-antigliadin antibodies and HLA-DR and DQ antigens in trisomy 21. J Pediatr Gastroenterol Nutr 1993;16:265-8.

19. Lazzari R, Collina A, Arena G, et al. Celiac disease in children with Down's syndrome. Pediatr Med Chir 1994;16:467-70 [in Italian].

20. Bonamico M, Rasore-Quartino A, Mariani P, et al. Down syndrome and coeliac disease: usefulness of antigliadin and antiendomysium antibodies. Acta Paediatr 1996;85:1503-5.

21. Carlsson A, Axelsson I, Borulf S, et al. Prevalence of IgA-antigliadin antibodies and IgA-antiendomysium antibodies related to celiac disease in children with Down syndrome. Pediatrics 1998;101:272-5.

22. Kanavin O, Scott H, Fausa O, et al. Immunological studies of patients with Down's syndrome. Measurements of autoantibodies and serum antibodies to dietary antigens in relation to zinc levels. Acta Med Scand 1988;224:473-7.

23. Sharav T, Bowman T. Dietary practices, physical activity, and body-mass index in a selected population of Down syndrome children and their siblings. Clin Pediatr 1992;31:341-4.

24. Fujiura GT, Fitzsimons N, Marks B, Chicoine B. Predictors of BMI among adults with Down syndrome: the social context of health promotion. Res Dev Disabil 1997;18:261-74.

25. Angelopoulou N, Matziari C, Tsimaras V, et al. Bone mineral density and muscle strength in young men with mental retardation (with and without Down syndrome). Calcif Tissue Int 2000;66:176-80.

26. Eberhard Y, Eterradossi J, Therminarias A. Biochemical changes and catecholamine responses in Down's syndrome adolescents in relation to incremental maximal exercise. J Ment Defic Res 1991;35:140-6.

27. Pitetti KH, Climstein M, Campbell KD, et al. The cardiovascular capacities of adults with Down syndrome: a comparative study. Med Sci Sports Exerc 1992;24:13-9.

28. Millar AL, Fernhall B, Burkett LN. Effects of aerobic training in adolescents with Down syndrome. Med Sci Sports Exerc 1993;25:270-4.

29. Millar AL, Fernhall B, Burkett LN. Effects of aerobic training in adolescents with Down syndrome. Med Sci Sports Exerc 1993;25:270-4.

30. Peran S, Gil JL, Ruiz F, Fernandez-Pastor V. Development of physical response after athletics training in adolescents with Down's syndrome. Scand J Med Sci Sports 1997;7:283-8.

31. Pueschel SM, Werner JC. Mitral valve prolapse in persons with Down syndrome. Res Dev Disabil 1994;15:91-7.

32. Crawford JG. Alzheimer's disease risk factors as related to cerebral blood flow. Med Hypotheses 1996;46:367-77 [review].

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