الفهرس 
1.IntroductionOnly 14 pages are availabe for public view
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Abstract
Down syndrome (DS) incidence is around 1 in every 1100 live births. Children with Down syndrome may or may not have typical intellectual abilities. Individuals with IQs between 50 and 70 or 35 and 50 are considered overweight. Mistakes in diet cause health issues in children with Down syndrome. Children with Down syndrome have marginal vitamin, mineral, and fiber deficiencies. Parents and caregivers can improve their children with DS’s quality of life by intervening in their diet early on, thereby reducing the risk or delaying the onset of several problems connected with the condition.
First Phase
First, researchers compared the nutritional status of DS and non-DS children. The second aim was to evaluate their diets and define their food habits.
The cases involved forty-two children with DS (24 boys and 18 girls) recruited from Menoufia and Gharbia governorates. In addition, children without DS (84, 48 boys, 36 girls) were also matched and similar.
The inclusion criteria include; age between 6 and 11 years, males and females, being born and living in Egypt, having down syndrome, and consenting to participate (Parents or guardian).
Children with DS without obesity, serious diseases that may interfere with DS, rigorous athletes, girls who began menstruation, children who take medications that may interfere with DS measures, hospitalized DS children, severe DS children, and disabled DS children were excluded from the study.
All necessary data was collected using a questionnaire. The questionnaire collected data about socioeconomic, health, anthropometric, dietary, and nutrient intakes. Energy and nutrient intakes were compared to dietary recommendations.
All children’s blood samples measured total cholesterol, HDL, TG, and lactate dehydrogenase (LDH).
A Stanford Binet Intelligence Scales, Fifth Edition (SB-5) intelligence quotient (IQ) was used to assess the intelligence level. Professional psychologists used the Stanford-Binet and Wechsler intelligence scales for children to measure IQ in this study.
SPSS version 23 analyzed the collected data. Frequency, percentage, mean, and SD were tabulated. Independent sample t.test were conducted to find significant differences between DS and non-DS children.
Most (61.9%) of non-DS and DS children lived in rural areas, and 100% of DS and 95.2% of non-DS attended elementary school. The non-DS group’s monthly income was much higher than the DS group (10714.36550.0 vs. 3047.61912.0 EGP).
Non-DS children were taller than DS. Despite the non-DS group’s lower body weight, statistical analysis found no significant differences. BMI, arm circumference, TSF, and arm muscle circumference were significantly higher in DS children (P=0.000), especially BMI. None of the DS children were average weight, while 38.1% of the non-DS children were. Most children with DS (85.7%) were obese, compared to 28.6% without DS.
The mean LDH level in DS children was significantly higher than in non-DS children. Non-DS and DS children had similar total cholesterol and LDL levels. DS children had higher triglyceride levels than non-DS children. Non-DS children had higher HDL than DS children.
Non-DS children had higher overall, nonverbal, verbal, and battery IQs than DS children.
Non-DS children eat three meals a day, while DS children eat four. Non-DS and DS children ate breakfast daily. DS children prefer light tea, while non-DS children prefer moderate or strong tea. Two-thirds of non-DS children ate meat and preferred it without fats, but more than half of DS children did. Compared to non-DS children, 91.0% of DS children ate skinless chicken. Non-DS and DS children ate fried foods at 95.0%. In the non-DS group, most people took three sugar teaspoons (61.9%), and no one took four. Non-DS and DS children eat sweets. Children with and without DS eat pickles. 90.5% of DS children do not eat spicy foods. Compared to non-DS children, 90.5% do not eat nuts.
Non-DS and DS groups ate similarly. Both groups met less than 80% of standard requirements, but the statistical analysis found no differences. Non-DS children consume more protein, fat, and protein than DS children. Non-DS and DS groups met more than 200% of their protein needs, but non-DS met 89.1% of their fat needs, and DS met 79.4%. Non-DS children ate more animal protein and fat than DS children, according to statistics. DS group consumed more than the non-DS group, but there was no statistical difference. Both groups did not meet their carbohydrate needs (59.9% non-DS, 68.3% DS). The DS group consumed significantly more fiber (P=0.048) than the non-DS group, but neither met 20% of their fiber needs.
Non-DS children consumed significantly more animal iron than DS children). The non-DS and DS zinc, phosphorus, thiamin, riboflavin, and vitamin C intakes met needs. The non-DS group’s calcium and vitamin A intakes were significantly (P0.05) higher than those of the DS group, but neither met 60% of their needs. This second phase aimed to develop nutritional formulas for children with DS using only locally sourced and naturally occurring ingredients and then to experiment with those formulas’ impact on the children’s cognitive performance, body composition, and blood biomarkers.
Second Phase
This phase is the intervention phase. A group of Egyptian children with Down syndrome (DS) participated in a randomized clinical trial (ages 6 to 12-year-old). Children of the DS were enlisted from the Egyptian governorates of Menoufia and Gharbia. Participants were included if they met all of the following criteria: (1) they were between the ages of 6 and 12, (2) they were either boys or girls, (3) they were Egyptian citizens, (4) they had been diagnosed with down syndrome, and (5) they agreed to participate in the study and signed consent forms.
Forty children with DS, aged 6 to 12, whom all received routine medical treatment, were recruited for the study. In order to experiment with the effects of the suggested recipes (Chocolate Bars), all DS children were divided into four groups (10 each).
I-Control group: children received standard medical therapy and placebo chocolate bars (same amount as other groups) throughout the trial.
II-First formula group: DS children received medical therapy and first formula (chocolate bars supplemented with suggested ingredients).
III- Second formula group: when DS children receive medical therapy (chocolate bars supplemented with suggested ingredients).
IV-Third formula group: DS children received medicinal therapy, and third formula (chocolate bars supplemented with suggested ingredients).
After 12 weeks, the kids were given 30 grams of chocolate daily.
Walnuts, omega-3 fatty acids, fiber, and vitamin and mineral supplements were included in the original combination.
The second recipe is called for wheat germ, omega-3 fatty acids, fiber, and vitamin and mineral supplements.
Peanuts, omega-3 fatty acids, fiber, and vitamin and mineral supplements were included in the third recipe.
The placebo group just consumed chocolate bars with the same amount of cholate added.
The nutritional content of the new formulations was evaluated using chemical analysis and panel tests.
The nutrition intervention was preceded and followed by anthropometric assessments. All children in the study had blood drawn at the beginning and end of the study to measure total cholesterol (TC), high-density lipoprotein (HDL), triglycerides (TG), and lactate dehydrogenase (LDH). The IQs of children with DS were measured by trained psychologists using the Stanford-Binet and Wechsler intelligence tests before and after the trial.