Uma reflexão sobre as causas da obesidade ou como evitar excesso de peso em crianças com T21. Este texto foi escrito para a Newsletter da Internacional Mosaic Down Syndrom Association (IMDSA) e cedido ao blog pela autora.
A parent’s perspective
by Teresa Paço
I had never thought before about the slow but progressive calorie accumulation resulting from a slower metabolism in DS and yet it makes all the sense. The daily small 15% spare energy really can lead to bigger problems in a long-term period. I’ve always managed my son’s Martim diet (7, MDS) as I would do with any other child, but also a bit instinctively, as I had the idea that kids with DS tend to gain weight. I just didn’t understand why, until now.
So far, Martim never had overweight problems, although he really eats well. When he was about 4 or 6 months he was a bit fat but that's all. Now he is strong but not fat. But I watch it closely.
I never let him eat sweets on a regular basis, as a routine. He didn't get this habit so it is easy to manage. On the other hand, as he doesn't like vegetables as all the kids, I always have soup (lunch and dinner) and try to mix the vegetables with rice or pasta in a subtle way!... It takes some time but, occasionally, a small battle is won and he agrees to go a bit further and try something completely green!
Martim also makes it easy for me because he doesn't like much cakes or desserts. We only have problems with chocolate, which has to be a bit rationated!
Concerning physical activity, Martim is quite active. This part we push a little bit, by putting him into horse riding, scouts activities and the regular sports program at school. He is a bit hypotonic and has to make a bigger effort than his colleagues do. When he complains he is tired, we encourage him to do just a little more and then, in the next time, he will be able to do always a little more. It’s a progressive process: the more he moves, the more he is able to do it. We could see this quite well by observing his evolution in the scouts group. They have the habit of doing long walks and they sometimes go camping, which raises the opportunity for some hiking. In the beginning it was really hard. In the end of the walks, his chief had to carry him several times. But this doesn’t happen anymore, although it took us two years to get here… I guess his muscles are progressively getting better prepared and this helps to overcome hypotonia.
We can still improve many aspects. Concerning food, I am now trying to change some products to light versions. We already use light butter at breakfast and some days ago I extended this to cheese and changed to turkey or chicken ham instead of pork. I increased the fish and white meat (chicken, turkey or rabbit) meals and drastically reduced pork or beef. Olive oil was already present in our cooking habits and I enlarged the variety and quantity of fruit. All the family benefits from these changes, not just Martim. To improve physical activity, I am thinking of promoting some simple activities at home, like… dancing! He loves music and enjoys dancing very much. We sometimes put some nice music and do a dancing session at home with movement schemes I invent. For me, it is just a practical activity to occupy Martim and his younger sister (2 years old) at the same time. It is difficult to get their attention together because of the age difference, but this generally works! I think it is something we can do more often, bearing in mind that it is an aerobic activity that Martim likes and will participate gladly. Other possible activities can be walking more and park further, whenever possible.
So, as a conclusion: I believe we have some luck because Martim doesn't show, so far, a strong tendency to be overweight. But I watch it, and tend to be a bit restrictive as prevention, encouraging a lot of physical activity at the same time.