Abstract

Objective
To describe the use of nutritional supplements and blood status (hemogram, lipidogram, hepatic function, inflammatory markers, minerals, and homocysteine) in a sample of Brazilian T21 children with private health support before their first consultation with a T21 expert.

Method
This descriptive cross-sectional study enrolled 102 participants. Brazilian families with a T21 member under 18 years old were contacted and those that consented answered a survey regarding socio-demographics and the use of nutritional supplements and shared the blood tests that their T21 members have collected for the first consultation with a T21 expert.

Results
Frequencies and percentages were used to describe the variables. The most used supplements included vitamins (A, C and D), minerals (zinc and iron), omega-3, and antioxidants (curcumin). Hypothyroidism was observed in 56.9% of the participants. Hemogram alterations (increased hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin and red cell distribution width, leukopenia, and lymphocytopenia), dyslipidemia, altered hepatic and inflammatory blood markers were frequently found.

Conclusions
Nutritional supplements (mainly vitamins, minerals, omega-3 and antioxidants) are frequently used by Brazilian T21 children independently of professional counseling and/or supervision and should be a question to be raised during the clinical anamnesis since some of them may impact medical conduct. Moreover, many blood tests are altered in this population and clinicians should be aware of them in order to warrant an appropriate screening and the implementation of risk management measures as soon as possible and improve the general health of these persons.

Introduction

Down syndrome or trisomy 21 (T21) is the most common genetic disorder with a prevalence ranging from 1:600 to 1:800 live births in Brazil.1 The decreased life expectancy is attributed to associated risk factors but it has greatly increased with improved health care in the past decades. Despite this, many Brazilian families report that primary care clinicians usually do not follow the basic recommendations regarding health assistance for persons with T21 published by the Brazilian Ministry of Health.1 To avoid inappropriate health monitoring, many families that have resources consult with one of the few specialized clinicians with knowledge in T21, and those who do not, seek information on social networks.

In the last 10 years, social networks have become popular for caregivers to exchange information. On the one hand, these networks increase awareness about educational, health, and social issues related to the T21 population. On the other hand, the exchange of information on medication, nutritional supplements, and dietetic interventions may lead to decision-making without professional counseling and monitoring, bringing risks to the health of these persons.

Results

After the invitation, 189 families demonstrated interest to participate in the study and were contacted privately. Of those, 109 signed the informed consent. However, 7 families were excluded because they did not answer the survey (n = 1) or did not submit the blood exams (n = 6). The results reported represent 102 participants from 13 out of 26 Brazilian states.

Participants aged from 3 months to 16 years and data are presented in the Tables by age category, i.e., infants (≤ ۲۴ months, n = 47), children (from 25 months to ≤۱۲ years, n = 50), and teenagers (>12 years, n = 5).