Physical Status and Parent-Child Feeding Behaviours in Children and Adolescents with Down Syndrome in The United Arab Emirates

Abstract

The prevalence of Down syndrome (DS) in the United Arab Emirates (UAE) is high in comparison to the global statistics. The aim of this study is to assess the physical status, feeding problems, parent-child feeding relationship and weight outcome in children and adolescents with DS in the UAE. In this cross-sectional study, 83 individuals aged between 2–19 years with DS were recruited from three humanitarian centres for differently abled in the Emirates of Sharjah and Dubai, UAE. Socio-demographic characteristics; height, weight, BMI and body composition; feeding problems (STEP-CHILD screening tool); and parent-child feeding relationship (child feeding questionnaire—CFQ) were assessed. Correlations and regression analyses were used to determine the relationships and the best predictor of weight outcome (BMI) in DS participants. The median age of the participants was 9 (8) years. Fifty-five (66.3%) males and twenty-eight (33.7%) females constituted a sex ratio of 1.96:1. Five (6.2%) participants were short for their age, and 20.6% were overweight/obese compared to the growth charts for DS population. Body composition of females showed significantly higher percent body fat than males (25.5 (14.3)% vs. 18.2 (4.0)%, p = 0.03; 29.9 (2.8)% vs. 16.3 (12.2)%, p = 0.006) in 5–8.99 years and 12–19.99 years, respectively. The most common feeding difficulties on STEP-CHILD tool were food selectivity (62.2%), continued eating in the presence of food (57.7%) and swallowing without sufficient chewing (50%). Median score of total-CFQ for the parent-child feeding behaviour was 3.2 (1.9); parental restriction 3.3 (1.0); pressure to eat 3.0 (0.8); concern about child weight 3.7 (2.3). Parent-child feeding relationship was significantly positively correlated with feeding problems, and body weight of the participants. The best predictor for BMI was the parental concern about child weight (OR: 1.4, p = 0.02). The findings can be valuable for the health care professionals, parents and caretakers of children and adolescents with DS in emphasizing the need for regular monitoring of their physical status, and feeding behaviours. In addition, it reinforces the role of parents in mindfully managing their child feeding relationship in promoting healthy eating behaviours and weight of their youth with DS.

Nutritional challenges in children and adolescents with Down syndrome

“…Reports on parental feeding practice showed that parents had greater weight concern, used more restrictions (36) and less pressure to eat in their feeding practice of their child with DS compared to siblings (38). Similar, among parents of overweight children with DS use of restrictions and monitoring of food intakes was more frequent (39).…”

“…Preference for selected types of foods were reported as a common food related behaviour in children with DS (36). Despite the fact that children with DS have higher rates of feeding problems and often reduced feeding skills, no correlation between parent reported difficult mealtime behaviours and feeding skills was observed (37).…”

“…Similar, among parents of overweight children with DS use of restrictions and monitoring of food intakes was more frequent (39). A total of 57 % of the parents reported that their child with DS frequently continued to eat as long as food remained present (36). The potential impact of parental practice on eating behaviour and risk of overweight in youth with DS has not been properly investigated.…”

Metabolic Diseases and Down Syndrome: How Are They Linked Together?

“…The percentage of body fat (PBF) measured by bioelectrical impedance is higher in young people with DS [ 48 ]. According to Osaili et al, PBF is elevated in female DS children and adolescents compared to males [ 49 ]. In adults, a study shows no difference in percentage of obesity between male and female DS individuals [ 43 ].…”

“…Due to insufficient mastication associated with rapid swallowing without chewing, DS people can develop a secondary bulimia. In a study of 83 children and adolescents with DS, food selectivity represents 62.2% of feeding difficulties, continued eating in the presence of food 57.7% and swallowing without sufficient chewing 50% [ 49 ].…”