1 / 22

Nutritional Issues in Turner Syndrome

Nutritional Issues in Turner Syndrome . A presentation to the TCGI Annual Conference 2009 Jessica Sheppard. Overview. Features with nutritional impact Short stature Tendency toward overweight High blood pressure High blood lipids Risk of endocrine problems; hypothyroidism, diabetes

odele
Download Presentation

Nutritional Issues in Turner Syndrome

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Nutritional Issues in Turner Syndrome A presentation to the TCGI Annual Conference 2009 Jessica Sheppard

  2. Overview • Features with nutritional impact • Short stature • Tendency toward overweight • High blood pressure • High blood lipids • Risk of endocrine problems; hypothyroidism, diabetes • Risk of impaired bone health • No special diet, no foods that must be eaten or must be avoided

  3. Short Stature • Turner girls are typically 8-10cm shorter than other girls. • Height and weight should be relatively proportional • Adequate nutrition important for growth and development, especially when on hormone treatment

  4. Short Stature/Weight • Lower energy requirements • Modern obesogenic environment • Most food portions are standard

  5. Weight Management • Any unhealthy trend in growth will be picked up at clinic. • Can be easily addressed with moderate lifestyle changes • No less effective in Turner girls/women

  6. Weight Management • ~40 TS girls attending OLCH Endocrine clinic • 10 currently linked in with dietetic service • All for weight management • Similar degree of overweight as non TS girls at first assessment • Seem to experience same level of success with weight management as non TS

  7. Weight Management • Approach has changed over last decade • Focus on behaviour change, SMART goal setting • Sustainable • Measurable • Achievable • Rewarded • Time limited

  8. Weight Management • Individual advice for each client • Based on current lifestyle • No unrealistic targets set • Weight loss rarely appropriate • Progress assessed at each visit based change in BMI relative to population

  9. Weight Management • Several programmes available • Variable results • Measurement of success not necessarily consistent with client expectations • Consistent attendance a problem for all programmes

  10. High blood pressure • Puts stress on circulatory system and kidneys • Regular screening recommended • Weight management, exercise can help

  11. Blood lipids • Cholesterol, Triglycerides • Regular screening recommended • Healthy levels important for everybody • Weight management, exercise can help

  12. Endocrine system • Diabetes Mellitus • Increased risk in TS • Maintenance of a healthy weight can greatly reduce risk • Regular screening recommended • Hypothyroidism • Affects up to 40% of Turner women by age 40 • Regular screening recommended

  13. Bone Health • Two main types of bone • Cortical • ‘Long’ bones e.g. limbs, fingers • Thinner in TS • Does not appear to be related to lack of oestrogen • Trabecular • Vertebrae, hips • Thinner in any oestrogen-deficient condition

  14. Bone Health • Dietary factors: • Vitamin D • Found in and fish, dairy products, vegetable oils • Calcium • Found in dairy products, some fruit and veg, some cereal products • Irish RDAs are higher across all age groups • Phosphate • Found in dairy products, wholegrains

  15. Bone Health • Other protective factors • Oestrogen • Deficiency reduces density of trabecular bone • No effect on cortical bone • Weight bearing exercise • Strengthens bones, muscles, connective tissue • Could reduce risk of falls by improving balance and dexterity

  16. Role of Phytoestrogens • Plant chemicals found mainly in legumes e.g. soya, clover, chickpeas; also in flaxseed • Structurally similar to human oestrogens

  17. Oestradiol (human)

  18. Genistein (phyto)

  19. Phytoestrogens • Believed to have an oestrogen-like effect • Sometimes marketed as a supplement/alternative to hormone replacement • Claims beneficial effects on bone health, hot flushes, reduced risk of hormone related cancers

  20. Phytoestrogens: Evidence • Animal studies:Genistein and Daidzein (found in soy) have been shown to preserve bone mass • Humans: Lower incidence of hip fracture in South-East Asia, where intake of soy is high. However, incidence of other fractures is not reduced

  21. Phytoestrogens: Evidence • Studies have been of small size and short duration • One study showed that enterodiol (found in flaxseed) can limit hot flushes in menopausal women but high dose of flaxseed caused abdominal side effects • Reduced risk of hormone related cancers is not supported by the scientific evidence

  22. Role of Phytoestrogens • No specific benefits, so no need to actively include unless vegan or milk intolerant. Important to choose calcium enriched products • Perfectly safe to consume, no need to avoid

More Related