NUTRITION AND A CHILD WITH DS-PART 1

NUTRITION AND A CHILD WITH DS

 The nutritional requirements, the ratio of basic nutritional components & their importance are the same as for typical child. Actually there are no special or different criteria for nutrition in a child with DS. What differs is the metabolism and calorie requirement. Therefore the only difference would be the selection of food. Mothers are too much worried as far as feeding of a child with DS is concerned. I thought if the basics of nutrition & its components, good food/bad food and sources of various nutrients are clear, mothers would be able to select & prepare food easily.

THE BASICS OF NUTRITION:

Nutrition consists of MACRO-NUTRIENTS & MICRO-NUTRIENTS. 

Macro-nutrients:

·       Carbohydrates

·       Proteins

·       Fats

·       Fibers

·       Water

Micro-nutrients:

·       Vitamins

·       Minerals

CARBOHYDRATES:

Carbohydrates are the body’s main source of fuel and are made up of sugars, starches and fiber. Our bodies break down most carbs into single molecules of sugar which can then be absorbed into the bloodstream.

SIMPLE CARBOHYDRATES (Simple sugar)

Simple carbohydrates are already single or double molecules of sugar and  are quickly absorbed and contain little to no nutritional value, other than providing the body with instant energy.  

Ends with 'ose'

·       Monosaccharide: Single molecule sugar-Glucose, Fructose (found in fruits), Galactose

·       Disaccharides: Two molecules of sugar with a bond- Sucrose(table sugar which comes from beet or sugar cane), Maltose, Lactose(found in dairy)

 They are important energy source but if consumed alone can lead to sudden increase in blood sugar followed by a sharp fall. The result could be a sudden jolt of energy quickly followed by feeling tired. That is why mono & disaccharides should be consumed with oligo & polysaccharides.

Processed food have high amount of monosaccharides but are not good for health. High fructose & refined sugar intake leads to increased plasma triglycerides that ultimately results in obesity.

COMPLEX CARBOHYDRATES:

Complex carbohydrates are made up of many sugar molecules strung together like a chain. Complex carbohydrates take a longer time to digest and thus help maintain long-term energy production. Complex carbohydrates contain starch and fiber which are important for good health.
Complex carbohydrates include grains, vegetables, nuts and seeds, beans and legumes, corn and potatoes. 

  

·       Oligosaccharides: 3-10 sugar molecules linked in a chain- Rafinose, Stachyose

Sources

·       Polysaccharides: >10 sugar molecules linked in a chain-Starch, Glycogen, Soluble & Insoluble fibers.

Sources of starch

Sources of Glycogen

Sources of Soluble & Insoluble fibers

Dietary fibers are polysaccharides. A diet rich in soluble fiber binds cholesterol and bile acids for excretion rather than absorption, resulting in an overall lower body cholesterol. Moreover the soluble type attracts water to form a gel during digestion, thereby slow the process & allow proper digestion. Contrary to this in insoluble fibers the sugar units are linked together in such a way that the body can't break the bonds and digest them. Thus fibers transit through small intestine without digestion to colon and help in excretion of toxins and waste products, relieves constipation. Based on this nature of  fibers, Carbohydrates can be grouped as digestible & indigestible.

We already know that indigestible fibers(carbohydrates) act as a broom & sweep the colon clean, they also undergo bacterial fermentation to increase the growth of healthy bacteria in the lower gut. Thereby they alter composition of microflora in the colon in a beneficial way & maintain intestinal integrity. Thus indigestible carbohydrates act as probiotics. 

By now I hope you have clear idea about Carbohydrates. I will give some more details about good & bad Carbohydrates & few more sources of carbohydrates. Before that I would like to make you understand the meaning of Pro & Prebiotics.

Probiotics: Probiotics refer to useful living organisms that maintain intestinal integrity. Lactic acid producing living bacteria are beneficial. Yogurt or curd are traditional form of consumption of such bacteria.

Prebiotics: Prebiotics refer to substances that promote growth of useful bacteria in large intestine. Food sources of prebiotics are oat meal,whole grain, legumes, onions, greens & fruits.  

   

Few more examples of healthy carbs & sources of fibers.

Vegetable Source of fibers

There are standard recommended dietary allowances. Around 45-60% calories should be obtained from carbohydrate.

Refined carbs are foods that have been highly processed by food manufacturers.  For example, refined grains are striped of their fiber (the germ and the bran). Complex carbs that have been refined loses its complex structure along with all the properties that made it a healthy choice.  When complex carbs are refined they then become a simple carbohydrate and is processed by the body as such. Samples of refined carbs are white rice, white bread, sugary cereals, pasta, noodles, packed cookies, crackers & pastries. Liquid refined carbs are aerated drinks, tinned fruit juices & beverages. The sugar gets absorbed quickly resulting in an excess available energy. The body uses only the energy it needs immediately and stores the rest as fat. As excess glucose is now stored in fat cells, you become hungry again and look for more refined carbs to satisfy the craving. This is addictive cycle and the result is rapid weight gain.

Now lets have a look at composition of body.

The composition is reverse than the calorie allowance. Unused sugar is stored as fat so we need to be very careful in selecting the carbohydrate compounds. 

I hope CARBOHYDRATE is now clearly understood.

I will explain all the nutrients, their functions & sources one by one. Then we will understand what is the difference when we are feeding a child with Down Syndrome.

Next would be PROTEIN....

See you soon....