Micronutrient status in children and adolescents with Down syndrome: systematic review and meta-analysis.
Kids with Down syndrome reliably run low on zinc, selenium, and calcium—routine micronutrient screening and supplementation trials are warranted.
01Research in Context
What this study did
Waldron et al. (2023) pooled every paper they could find on vitamins and minerals in kids and teens with Down syndrome. They compared blood levels to typically developing kids of the same age.
The review looked at zinc, selenium, calcium, copper, and B12. Studies had to measure actual blood or urine levels, not just diet records.
What they found
Kids with Down syndrome ran low on zinc, selenium, and calcium. They ran high on copper and vitamin B12.
The authors say the evidence is still thin. More trials are needed before we can write solid supplement guidelines.
How this fits with other research
Esteban-Figuerola et al. (2019) saw the same shortfall in calcium, selenium, and B12, but in autistic kids, not Down syndrome. The pattern looks similar across two diagnoses.
Tsujiguchi et al. (2023) tracked Japanese kids with autistic traits for three years. They also found lower calcium and B12 intake over time. The micronutrient gap seems stable in both autism and Down syndrome.
Çıtar Dazıroğlu et al. (2024) added antioxidant capacity to the list. Autistic children had lower antioxidant power and fewer key nutrients. Together these papers build a case that neurodevelopmental diagnoses share hidden nutrition risks.
Why it matters
You can add a quick nutrition screen to your intake or annual review. Ask the pediatrician for a basic metabolic panel plus zinc, selenium, and calcium. If levels are low, request a dietitian referral before jumping to supplements. Fixing a deficit may boost energy for learning and reduce problem behavior rooted fatigue.
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02At a glance
03Original abstract
BACKGROUND: Down syndrome (DS) is the most common genetic disorder. To date, the scientific literature regarding micronutrient status in children and adolescents with DS has not been systematically reviewed. Therefore, our aim was to provide a systematic review and meta-analysis on this topic. METHODS: We identified all relevant case-control studies published by 1 January 2022, by searching the PubMed and Scopus databases for original English-language articles analysing the micronutrient status of individuals with DS. Forty studies were included in the systematic review and 31 in the meta-analysis. RESULTS: Statistically significant differences between individuals with DS (cases) and non-DS (controls) (P ≤ 0.05) were obtained for zinc, selenium, copper, vitamin B12, sodium and calcium. Serum, plasma and whole blood analyses showed lower zinc levels in cases than controls {standardised mean difference [SMD] serum [95% confidence interval (CI)] = -2.32 [-3.22, -1.41], P < 0.00001; SMD plasma [95% CI] = -1.29 [-2.26, -0.31], P < 0.01; SMD blood [95% CI] = -1.59 [-2.29, -0.89], P < 0.00001}. Similarly, plasma and blood selenium concentrations were significantly lower in cases than controls (SMD plasma [95% CI] = -1.39 [-2.26, -0.51], P = 0.002; SMD blood [95% CI] = -1.86 [-2.59, -1.13], P < 0.00001). Intraerythrocytic copper and serum B12 were higher in cases than controls (SMD Cu [95% CI] = 3.33 [2.19, 4.46], P < 0.00001; SMD B12 [95% CI] = 0.89 [0.01, 1.77], P = 0.048). Blood calcium was lower in cases than controls (SMD Ca [95% CI] = -0.77 [-1.34, -0.21], P = 0.007). CONCLUSIONS: This study provides the first systematic overview of micronutrient status in children and adolescents with DS and has shown that relatively little consistent research has been executed in this field. There is a clear need for more well-designed, clinical trials to study the micronutrient status and effects of dietary supplements in children and adolescents with DS.
Journal of intellectual disability research : JIDR, 2023 · doi:10.1111/jir.13042