Question:
What vitamins and supplements would you recommend for adults 18+ with Down syndrome? I have read that 2x the recommended daily dose of fish oil has been linked to improved cognition, for instance.
Answer:
For many people (not all), eating a healthy diet gives their bodies all the nutrients they need. My recommendation is to look at one’s diet first before considering supplements. I recommend a well-balanced diet that provides the macronutrients (carbohydrates, protein, and fat) and the vitamins and minerals needed. If you are uncertain, a registered dietician can provide guidance. If a healthy diet is being followed, supplementation may not be needed.
Supplements may be needed if there are vitamin deficiencies that cannot be addressed through diet. Vitamin D plays an important role in bone health. It is found in some foods and is made from cholesterol when the skin is exposed to sunlight. Vitamin D deficiency can be a common deficiency in northern climates, especially during the winter when there is less direct sun exposure. A vitamin supplement may be needed, especially if you live further north.
Vitamin B12 is another vitamin to consider. Vitamin B12 deficiency is more common in people who follow certain diets that may not provide enough vitamin B12 (such as a vegan diet). Vitamin B12 deficiency is also more common in people who have certain digestive disorders (such as celiac disease). Celiac disease is more common in people with Down syndrome so these individuals may also be deficient in vitamin B12. More information on vitamin B12 is available at this link.
There are some data (in people without Down syndrome) that fish oil (omega-3 fatty acids) may improve cognition. Older studies found that individuals benefitted if the fish oil came from food rather than in a supplement form. A more recent small study (33 individuals) showed that it took higher doses of fish oil (such as those that come from supplements) for the omega-3 to reach the brain (measured in the spinal fluid), especially for those with APOE4 gene (who are at a greater risk for Alzheimer’s disease). The answer is not yet known if those higher levels in the spinal fluid will improve cognition or reduce Alzheimer’s disease. Additional study is being done. This has not been studied in people with Down syndrome.
Another study found that people who were cognitively healthy but had coronary artery disease (blockages in the arteries supplying blood to the heart) who took omega-3 supplement had better preserved brain function than those who didn’t take the supplement. There is a saying, “Good for the heart, good for the brain,” which the study would seem to support. The challenge in translating that finding from people without Down syndrome (such as in this study) to people with Down syndrome is that people with Down syndrome have much more Alzheimer’s disease but much less coronary artery disease. The articles at this link and this link share more information on this topic. This difference makes it clear that more study is needed to improve our understanding, especially in people with Down syndrome.
My recommendation for a person with Down syndrome is to:
- Review the diet and optimize nutrients from the diet
- Consider a vitamin D supplement, especially if you live further north
- Consider reviewing your food intake with a dietician to make sure you are getting appropriate nutrients, especially if you eliminate some foods from your diet (such as a vegan diet). Supplements may be needed based on that review.
- Watch for and consider participating in studies on cognition (particularly those that look at nutritional supplements)