Optimum Diet: talking about health + Down syndrome with Gabi Giacomin

Gabi Giacomin’s passion for health and wellbeing, especially in regard to children with Down syndrome, was evident from the moment we came in contact. I cannot lie – these areas of genetics and nutrition often (most times) go way over my head. So I’m very thankful to Gabi for her dedication to breaking down complex topics so that parents like me can try to make some sense of achieving optimum health for our children, whose extra chromosomes means there is often more going on inside their little bodies than what meets the eye. This is the first post in our series of four Monday Health Talks with Gabi.

Health TalkMy background

I finished a Master of Clinical Practice in Complementary Medicine in 2014, just as I fell pregnant with my daughter Suri. I wanted to specialise in fertility management, and applied to start a PhD on ‘Pregnancy, Diabetes and the Microbiome’ at the Mater Hospital in Brisbane.

As life turned out, I gave birth to a gorgeous, handful of cheekiness with yes…an extra chromosome. When Suri was five months old, I took her to India for acupuncture treatment for children with brain injuries, which we continued here in Australia. Following this, I joined the Down syndrome online forums and my world of friendships and therapies exploded.

Gabi3In some ways I was ready to start a PhD, but what didn’t appeal to me was juggling the deadlines and motherhood. So subconsciously, I decided to undertake my own PhD with the aim of unravelling the cause and treatment for symptoms we associate with Down syndrome.

I stumbled across the work of Dr Amy Yasko and suddenly everything made sense. Dr Yasko is a genetic biologist who, late in her career, studied Naturopathy. Everything about her approach attracted me as she combines the philosophy of Natural Medicine with a background in genetics to evolve her approach for the treatment of children with Autism. So much of what she evolved applies to Down syndrome too.

I believe this combination of nutrition and genetics in treatment, known as ‘Nutrigenomics’, is the way forward. There’s no reason why we, as parents of children with a complex genetic disorder, can’t start to access the full benefits of this now.

Formulations like MSB and Nutrivene, which are supplements that have been developed specifically for people with Trisomy 21, are based on this principle and have been assisting children with Down syndrome for many years. It’s time to take this approach to the next level.

Days of simple treatments and entrusting health experts with generalised information are over. Many parents are taking matters into their own hands and need solid information and a good road map to facilitate healing. I am one of these parents. I hope to support this community by translating this approach to treatment as a practitioner in the future.

Gabi1Finding an Optimum Diet for people with Down syndrome

When it comes to addressing diet, a one-size fits all approach is inadequate to address a complex condition like Down Syndrome because of the diversity of factors involved.

As a Naturopath, treating a person with Down Syndrome can feel like pulling apart the pieces of a puzzle and reorganising them in a pattern which is healthier for them. The puzzle is so complex that moving one piece won’t always be enough to balance them. The pieces have to be addressed and reorganised in relation to each other.

We have to look at health with a wide lens. Multiple factors affect us from within and without including our environment and its toxins, stress, infectious agents we are exposed to and underlying genetic susceptibility. Acting more powerfully than ever before, this combination of risk factors makes it vital we address all contributing factors to a health issue – we no longer have the luxury of limiting our treatment to a single factor.

Nutrigenomics: Treating the individual

“Nutrigenomics is a science focused on the interaction between nutrition and genes, especially with regard to prevention or treatment.”

Through this new science we can begin to understand the underlying expression of genes which are risk factors for conditions such as Down Syndrome.

The optimum dietary approach for a person with Down Syndrome includes a personalised program based on biochemical test results, and follow-up testing undertaken to assess biochemical status and to monitor progress. Simple solutions to dietary treatment are behind us.

A new vista to personalised medicine is now open through the ongoing research of the human genome. By treating each person as unique we can properly address the symptoms associated with Down Syndrome and other complex conditions.

Laying the right groundwork

It is essential to lay the right nutritional groundwork through diet, prior to introducing nutrients via supplements. The basic principle of Naturopathy is to give the body the right environment to support its innate intelligence to facilitate healing. Foundational to this is diet.

It is common sense that if a child follows a program perfectly while living in a toxic environment and eating junk food he isn’t going to progress as easily as if he were avoiding all harmful synthetic food additives and eating healthy whole foods like fruits and vegetables.

The baseline nutrition most of us get everyday comes from food, and for our children we want that food to be the highest quality. Lets consider the optimum environment and diet for sensitive children like those with Down Syndrome.

An Optimum Environment should include fresh, oxygen-rich air and exercise, natural products, air and water purifiers, toxin-free paint, steam cleaning, natural supplements, glass and stainless steel containers, natural cleaning and personal care products, and natural cosmetics.

An Optimum Diet should include pure water, an organic plant-based whole-food diet, moderate in protein, low in saturated fat and fructose, alkalising and toxin free. Foods should be rotated every four days to avoid intolerances.

Foods to eliminate

1. Synthetic food additives, sweeteners, pesticides, antibiotics and hormones should be significantly reduced or eliminated entirely, if possible.

2. Children with neurological conditions like Down Syndrome must eliminate excitotoxins – foods and substances which cause overstimulation of the nerves and nerve damage. The most common examples of excitotoxins are MSG and artificial sweeteners.

3. Specific natural substances found in certain foods tend to increase neurological inflammation and should be avoided or limited in the diet. Calcium intake should be limited to moderate amounts due to its inflammatory effect on the brain when combined with glutamate – an excitotoxin.

Food Allergies

Some foods are problematic until the gut is in better balance. A leaky gut allows foods to pass into the blood stream, where they act as foreign substances and stimulate an allergic reaction (IgG). The most common allergens which should initially be avoided are dairy, gluten, chocolate and bananas. If you suspect your child has multiple allergies to foods you could try an Elimination Diet or get an IgG Food Sensitivity Profile done. As your child’s gut health improves, these foods cease to be a problem.

You can track improvement via an Intestinal Permeability Test. When sensitivity testing reveals a positive IgE reaction this indicates a true food allergy and these foods must be avoided.

Optimising digestive and immune function will decrease some food allergies. Some will remain, requiring you to move forward avoiding specific foods and ingredients. Always be cautious. If you are concerned about your child’s reaction to a food, simply avoid it.

Balancing GABA and Glutamate

Children with Down Syndrome are born with an excess of the inhibitory neurotransmitter GABA. However they also experience a high rate of Oxidative Stress that damages neurones and exposes them to the harmful effects of excess Glutamate, released from damaged neurones. Optimising the health of neurones in Down Syndrome means moderating the effects of excess glutamate.

The following neurotransmitters are pulled into the cells by glutamate and should be avoided if Glutamate levels are high:

Aspartate, Aspartame, Aspartic acid, Glutamate. Glutamic acid, Glutamine, Monosodium glutamate (MSG), Cysteine, Homocysteine.

Research shows that excess Glutamate can elevate eosinophils causing an inflammatory reaction, increase or cause irregularities in blood pressure and affect areas of the brain involved in speech and language.

A Urinary Amino Acids Test can identify elevated levels of glutamate, glutamine, glutamic acid, aspartate and/OR aspartic acid.

Limiting Sulfur

Child with Down syndrome are born with a CBS (Cystathionine Beta Synthase) mutation and it is important to limit their intake of sulphur-containing foods. Depending on the severity of the CBS over-expression, excess sulphur can trigger chronic stress.

Normally, sulphur is bound to amino acids (such as homocysteine, methionine, SAMe, SAH, or cysteine), and can’t create systemic havoc. However, with increased CBS activity produced, sulphur groups are instead released into the system as toxic sulphites.

If your child has CBS upregulations, avoid foods and nutrients with high sulfur content: Broccoli, Brussel Sprouts, Cabbage, Eggs, Epsom Salt Baths, Garlic, Glucosamine sulfate, Glutathione, Milk thistle, Nuts, Onions, Radish.

A Urinary Amino Acids Test can identify an over expressed CBS enzyme via elevations of Taurine, Ammonia, Citrulline, Methionine, Phenylalanine.

If you would like assistance working out an optimum diet for your child with Down syndrome, contact a qualified Naturopath through an online search of your area or through personal recommendations. A qualified Naturopath will be registered with a Natural Medicine Society and be able to access and interpret Pathology tests. Not all Naturopaths will have knowledge of how to best supplement a child with Down syndrome, so it may be beneficial to ask for recommendations from other families in the Down syndrome community through an online forum.

Gabi Giacomin is a Naturopath (MClP (Comp Med) BHSc (Comp Med)), wife and mother of two beautiful girls, and she is passionate about helping people achieve optimum health. After taking time off to focus on motherhood, Gabi is returning to private practice in the Northern Rivers area in 2016. If you’d like to ask her any questions or go on a waiting list for a consultation, Gabi can be contacted by email or please leave a comment below.

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Bibliography

Bade MA1, Rammeloo EM, Hermans J, de Vries Locher AL, de Graaf EA, Mearin ML. (1995) Symptoms of disease and food allergy in children with Down syndrome. Ned Tijdschr Geneeskd. Aug 19;139(33):1680-4.

Ferguson, LR (2014) Nutrigenomics and Nutrigenetics in Functional Foods and Personalised Nutrition. CRC Press. New York.

Goldman LR1, Koduru S. (2000) Chemicals in the environment and developmental toxicity to children: a public health and policy perspective. Environ Health Perspect. Jun;108 Suppl 3:443-8.

Yasko, A. (2009) Autism: Pathways to Recovery. Neurological Research Institute, Bethel Maine

Ichinohe A, Kanaumi T, Takashima S, Enokido Y, Nagai Y, Kimura H. (2005) Cystathionine beta-synthase is enriched in the brains of Down’s patients. Biochem Biophys Res Commun. Dec 23;338(3):1547-50.

Iyer AM, van Scheppingen J, Milenkovic I, Anink JJ, Lim D, Genazzani AA, Adle-Biassette H, Kovacs GG, Aronica E. (2014) Metabotropic glutamate receptor 5 in Down’s syndrome hippocampus during development: increased expression in astrocytes. Curr Alzheimer Res. 11(7):694-705.

Marc S. Micozzi MD PhD (2011) Fundamentals of Complementary and Alternative Medicine, 4e. Churchill Livingstone. New York.

Martínez-Cué C, Delatour B, Potier MC. (2014) Treating enhanced GABAergic inhibition in Down syndrome: use of GABA α5-selective inverse agonists. Neurosci Biobehav Rev. 2014 Oct;46 Pt 2:218-27.

Sylvester PE. (1984) Nutritional aspects of Down’s syndrome with special reference to the nervous system. Br J Psychiatry. Aug;145:115-20.

Neeha, VS, Kinth P. (2013) Nutrigenomics research: a review. J Food Sci Technol. Jun; 50(3): 415–428.

Reading CM. (1984) Down’s syndrome: nutritional intervention. Nutr Health. 3(1-2):91-111.

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