Dietary aspects related to health and obesity in Williams syndrome, Down syndrome, and Prader-Willi syndrome

Abstract

Background: Dietary aspects that might contribute to development of obesity and secondary conditions are not well documented in genetic subgroups associated with intellectual disability.

Objective: To describe the intake frequencies of selected foods in participants with Prader-Willi syndrome (PWS), Down syndrome (DS), and Williams syndrome (WS), and investigate the association with body mass index (BMI). To explore food-related autonomy and intake frequencies among persons with DS in different living arrangements.

Methods: Self-reported intake frequencies and measurement of plasma carotenoids and erythrocyte content of omega-3 fatty acids (FAs) were investigated in persons aged 16-42 years, with WS (n=21), DS (n=40), and PWS (n=20).

Results: A larger proportion of participants with PWS showed high-frequency intake of fruits (p=0.012) and vegetables (p=0.004), and had higher plasma carotenoids (p<0.001) compared to participants with DS and WS. Furthermore, a larger proportion of participants with WS were low-frequency consumers of fish (p=0.005), less likely to use omega-3 FA supplements (p=0.023), and had reduced erythrocyte concentrations of long-chain omega-3 FAs (p<0.001), compared to participants with PWS and DS. In DS, BMI was negatively associated with plasma carotenoids. Increased proportions of participants living in communities showed high-frequency intake of precooked meals (p=0.030), and a tendency toward high-frequency consumption of soft drinks (p=0.079), when compared to peers living with relatives. Participants in community residences were also more likely to participate frequently in food-related decisions and preparations.

Conclusions: Persons with WS had a less-favorable dietary pattern when compared to persons with PWS. A larger proportion of persons living in communities frequently consumed precooked meals and showed a tendency of high-frequency soft drink consumption. Otherwise, their intake frequencies of the investigated foods were similar to those living with relatives, but they participated more frequently in decisions and preparations of foods.

Keywords: autonomy; carotenoids; developmental disability; diet; intellectual disability; living arrangements; obesity; omega-3 fatty acids.

Fig. 1

Proportion low- and high-frequency consumers by diagnosis. Intake frequencies are presented as a percentage of the population diagnosed with WS (n=21), DS (n=24) or PWS (n=20). *p<0.05 when participants with PWS were compared to participants with WS and DS using logistic regression models adjusted for BMI.

Fig. 2

The association between BMI and total carotenoids by diagnosis. Scatter plot include participants with DS (n=40), participants with PWS (n=20), and participants with WS (n=21). The correlation was tested by use of person's correlation and significant for persons with DS, r−0.33, p=0.039.

Fig. 3

Proportion low- and high-frequency consumers based on living arrangement. Intake frequencies are presented as a percentage of the population with DS living with relatives (n=16) or in communities (n=24). *p<0.05 when participants with DS living in community residences were compared to diagnose specific peers living with relatives using chi-square tests.

Fig. 4

Food-related autonomy for persons with Down syndrome in different living arrangements. Degrees of participation are presented as a proportion (%) of the population living with relatives (n=16) or in communities (n=24). *p<0.05 when participants living in community residences were compared to participants living with relatives using chi-square tests. **p<0.001 when participants living in community residences were compared to participants living with relatives using chi-square tests.