Biological Trace Element Research

, Volume 133, Issue 1, pp 20–28 | Cite as

Nutritional Status of Zinc in Children with Down Syndrome

  • Adriana S. Lima
  • Bárbara R. CardosoEmail author
  • Silvia F. Cozzolino


Experimental and clinical studies have established that zinc metabolism is altered in individuals with Down syndrome (DS). The present study intends to evaluate the nutritional status of zinc in children with DS by determining their biochemical and dietary parameters. The investigation was carried out on a group of children with DS (n = 35) and compared with a control group (n = 33), both aging between 4 and 11 years. Weight-for-age, height-for-age, and weight-for-height indexes and diet were evaluated by using a 3-day dietary record. Zinc was evaluated in plasma, erythrocytes, and 24-h urine collection by using the method of atomic absorption spectroscopy. The frequency of short stature was higher in children with DS. Both groups presented high protein content, adequate concentrations of lipids and carbohydrates, and deficit in calories. Adequate zinc intake was observed in 40% of children with DS and in 67% of the control group. Zinc concentrations were significantly lower in plasma and urine and higher in erythrocytes of children with DS. The results allowed us to conclude that the altered zinc nutritional status of individuals with Down syndrome contributes to clinical disturbances that usually appear with aging in these patients.


Down syndrome Nutritional status Zinc Metabolism Children 


  1. 1.
    Zana M, Janka Z, Kálmán J (2007) Oxidative stress: a bridge between Down's syndrome and Alzheimer's disease. Neurobiol Aging 28:648–676CrossRefPubMedGoogle Scholar
  2. 2.
    Schwartzman JS, De Torre CA, Schwartzman F et al (1998) Síndrome de Down. In: Schwartzman JS (ed) Síndrome de Down, 1st edn . São Paulo, São PauloGoogle Scholar
  3. 3.
    Roizen NJ, Patterson D (2003) Down's syndrome. Lancet 361:1281–1289CrossRefPubMedGoogle Scholar
  4. 4.
    Turrens JF (2001) Increased superoxide dismutase and Down's syndrome. Med Hypotheses 56:617–619CrossRefPubMedGoogle Scholar
  5. 5.
    Thiel R, Fowkes SW (2007) Down syndrome and thyroid dysfunction: should nutritional support be the first-line treatment? Med Hypotheses 69:809–815CrossRefPubMedGoogle Scholar
  6. 6.
    De La Torre R, Casado A, Lopez-Fernandez E et al (1996) Overexpression of copper-zinc superoxide dismutase in trisomy 21. Experientia 52:871–873CrossRefGoogle Scholar
  7. 7.
    Salgueiro MJ, Zubillaga M, Lysionek A et al (2007) Zinc as an essential micronutrient: a review. Nutr Res 20:737–755CrossRefGoogle Scholar
  8. 8.
    Licastro F, Mariani RA, Faldella G et al (2001) Immune-endocrine status and coeliac disease in children with Down's syndrome: relationships with zinc and cognitive efficiency. Brain Res Bull 55:313–317CrossRefPubMedGoogle Scholar
  9. 9.
    Licastro F, Chiricolo M, Mocchegiani E et al (1994) Oral zinc supplementation in Down's syndrome subjects decreases infections and normalized some humoral and cellular immune parameters. J Intellect Disabil Res 38:149–162PubMedCrossRefGoogle Scholar
  10. 10.
    Bucci I, Napolitano G, Giuliani C et al (1999) Zinc sulfate supplementation improves thyroid function in hypozincemic Down children. Biol Trace Elem Res 67:257–268CrossRefPubMedGoogle Scholar
  11. 11.
    Blair CK, Roesler M, Xie Y et al (2008) Vitamin supplement use among children with Down's syndrome and risk of leukaemia: a Children's Oncology Group (COG) study. Paediatr and Perinat Epidemiol 22:288–295CrossRefGoogle Scholar
  12. 12.
    Ellis JM, Tan HK, Gilbert RE et al (2008) Supplementation with antioxidants and folinic acid for children with Down's syndrome: randomized controlled trial. BMJ 336:594–597CrossRefPubMedGoogle Scholar
  13. 13.
    Tanner JM, Whitehouse RH (1976) Clinical longitudinal standards for height, weight, height velocity, weigh velocity, and stages of puberty. Arch Dis Child 51:170–179CrossRefPubMedGoogle Scholar
  14. 14.
    World Health Organization (1995) Physical status: the use and interpretation of anthropometry. Technical Report Series n. 854Google Scholar
  15. 15.
    Cronk CE, Cronker AC, Pueschel SM et al (1988) Growth charts for children with Down syndrome: 1 month to 18 years of age. Pediatrics 81:102–110PubMedGoogle Scholar
  16. 16.
    McCance RA, Widdowson's EM (1991) The composition of foods, 5th edn. Royal Society of Chemistry, Ministry of Agriculture Fisheries and FoodGoogle Scholar
  17. 17.
    Institute of Medicine/Food and Nutrition Board (2000) Dietary Reference Intakes: Applications in Dietary Assessment, Washington, DCGoogle Scholar
  18. 18.
    Kiilerich S, Christensen MS, Naestoft J et al (1980) Determination of zinc in serum and urine by atomic absorption spectrophotometry, relationship between serum levels of zinc and proteins in 104 normal subjects. Clin Chem Acta 105:231–239CrossRefGoogle Scholar
  19. 19.
    Rodriguez MP, Narizano A, Demczylo V et al (1989) A simpler method for the determination of zinc human plasma levels by flame atomic absorption spectrophotometry. At Spectrosc 10(2):68–70Google Scholar
  20. 20.
    Whitehouse RC, Prasad AS, Rabbani PI et al (1982) Zinc in plasma, neutrophils, lymphocytes and erythrocytes as determined by flameless atomic absorption spectrophotometry. Clin Chem 28:475–480PubMedGoogle Scholar
  21. 21.
    Cordeiro MBC (1994) Adequação alimentar e avaliação do estado nutricional em relação ao zinco em um grupo de idosos institucionalizados [dissertação]. Universidade de São Paulo, São PauloGoogle Scholar
  22. 22.
    Gibson RS (1990) Assessment of trace-element status. In: Gibson RS (ed) Principles of nutritional assessment. New York, New YorkGoogle Scholar
  23. 23.
    Iyengar V, Wolttiez J (1988) Trace elements in human clinical specimens: evaluation of literature data to identify reference values. Clin Chem 34:474–481PubMedGoogle Scholar
  24. 24.
    Brody T (1994) Nutritional biochemistry. San Diego, CaliforniaGoogle Scholar
  25. 25.
    Luke A, Sutton M, Schoeller DA et al (1996) Nutrient intake and obesity in prepubescent children with Down syndrome. J Am Diet Assoc 96:1262–1267CrossRefPubMedGoogle Scholar
  26. 26.
    Cocchi G, Mastrocola M, Capelli M et al (2007) Immunological patterns in young children with Down syndrome: is there a temporal trend? Acta Paediatr 96:1479–1482CrossRefPubMedGoogle Scholar
  27. 27.
    Soto-Quintana M, Alvarez-Nava F, Rojas-Atencio A et al (2003) Diminished zinc plasma concentrations and alterations in the number of lymphocyte subpopulations in Down's syndrome patients. Invest Clin 44:51–60PubMedGoogle Scholar
  28. 28.
    Purice M, Maximilian C, Duritriu I et al (1988) Zinc and copper in plasma and erythrocytes of Down's children. Endocrinologie 26:113–117PubMedGoogle Scholar
  29. 29.
    Marques RC, De Sousa AF, Do Monte SJH et al (2007) Zinc nutritional status in adolescents with Down syndrome. Biol Trace Elem Res 120:11–18CrossRefPubMedGoogle Scholar
  30. 30.
    Keilin D, Mann T et al (1985) Carbonic anhydrase. In: Ohno H, Doi R, Yamamura K (eds) A study of zinc distribution in erythrocytes of normal humans. Blut, MunchenGoogle Scholar
  31. 31.
    Wood RJ (2000) Assessment of marginal zinc status in humans. J Nutr 130:1250S–1254SGoogle Scholar
  32. 32.
    Marques RC, Marreiro DN (2006) Aspectos metabólicos e funcionais do zinco na síndrome de Down. Rev Nutr 19(4):501–510Google Scholar
  33. 33.
    Kanavin OJ, Aaseth J, Birketvedt GS (2000) Thyroid hypofunction in Down's syndrome: is it related oxidative stress? Biol Trace Elem Res 78:35–42CrossRefPubMedGoogle Scholar
  34. 34.
    Muchová J, Sustrová M, Garaiová I et al (2001) Influence of age on activities of antioxidant enzimes and lipid peroxidation products in erytrocytes and neotrophilis of Down syndrome patients. Free Radical Biol Med 31(4):499–508CrossRefGoogle Scholar

Copyright information

© Humana Press Inc. 2009

Authors and Affiliations

  • Adriana S. Lima
    • 1
  • Bárbara R. Cardoso
    • 2
    Email author
  • Silvia F. Cozzolino
    • 1
  1. 1.Faculty of Pharmaceutical SciencesUniversity of São PauloSão PauloBrazil
  2. 2.PRONUT (Program of Applied Human Nutrition) - FSP/FCF/FEAUniversity of São PauloSão PauloBrazil

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