The Basics: Part II

These posts might be a little more technical than you would like, but I feel that in order to WANT to make the appropriate changes for our children in the area of food, we must understand why. In The Basics: Part I we went over the glycemic index & what it means not just for those with Prader-Willi, but everyone. The glycemic index is one of the baselines for which we want to create our meals/snacks around. Personally, I think everyone should use this when choosing what to eat.

In a paper written in part by our favorite doctor, she concluded after a study of 63 children, that a macronutrient balanced diet had much better outcomes than a energy (calorie) restricted diet alone. The kids (ages 2-10) who used the macronutrient ratio of 45% carbs, 30% fat & 25% protein with 20 grams of fiber per day had on average 20% LESS body fat at the end of the study. WOW!

What is a macronutrient? They are the three groups we are trying to balance: Carbohydrates, Fats & Protein. Carbohydrates are mostly made up of starches & sugars. Fat has several different types including saturated, monounsaturated, polyunsaturated & essential fatty acids. Protein is mostly made up of amino acids (long chains of amino acids). A little fun fact: the first amino acid ever isolated was in asparagus!

The typical weight gain in a child with PWS, which usually precedes an increase in appetite starts between 18 - 36 months. This weight gain has been hypothesized to be a result of decreased overall energy of the child & possibly abnormalities in carbohydrate metabolism. There is a difference in hormones with people who have PWS, including high levels of ghrelin** & low levels of insulin**, which are considered to contribute to the appetite abnormalities.

Back to macronutrients! You have probably all seen the new 'My Plate' which took the place of our popular food pyramid. I like the My Plate idea for kids without PWS, but luckily we have our own special plate & it looks like this:

High Quality Proteins:

• Lean cuts of meat
• Lean ground meat
• Nuts & Seeds
• Nut butters
• Eggs
• Seafood
• Soy products (ie: tofu)

High Quality Carbohydrates:

• Green leafy veggies
• Berries
• Vegetables
• Fruit

High Quality Fats:

• Nuts
• Avocados
• Olives
• Fish 
• Some cheese

 Big No No's for Prader-Willi Syndrome:

• Pasta 
• White Potatos
• Rice

Next time I'll talk about more about these macronutrients & what the different types are within each. Also how the body breaks them down & uses them for energy. The balancing we use for these macronutrients is essential in keeping energy levels steady & being able to use diet for optimal overall performance. Claire is in 4 therapy sessions per week, takes one nap & has a typical bed/awake time. We believe that with Claire's balanced macronutrient diet, only using qualifying foods, and the fact she's on a pretty strict routine, is the reason she is doing so incredibly well. She can do an hour and a half of straight physical therapy and not get sleepy. She also does back to back occupational & speech therapy and is still rearing to go after those are over. 
(UPDATE 1/1/2015: Claire is now 3 & has been in preschool since September. She goes 3 half days at a private preschool & LOVES it. She has since been diagnosed with severe apraxia of speech. She has 5 therapy sessions per week plus one session of hippotherapy. She takes a nap on occasion & is still doing very well in the area of energy.)

We are in a Mom's Group here in southwest Florida & we do play dates at least one to two times per week. She is always able to keep up with the kids her age & a few years older with no problem whatsoever. I know at almost 2 years old we have not begun to deal with a lot of the things that come with Prader-Willi Syndrome in behavior & physical attributes, but that is why we are so adamant about getting in front of potential problems before they surface. It's easier to start with a preventative approach rather than fix a problem. 


**Ghrelin is a hunger-stimulating hormone that is found in the lining of the stomach & in certain cells of the pancreas. For further information about ghrelin, click here: Ghrelin Info 
**Insulin is a hormone produced in certain cells of the pancreas & is responsible for the carbohydrate & fat metabolizing of the body. Insulin causes cells in the liver, skeletal muscles, and fat tissue to absorb glucose from the blood. For further information on insulin, click here:Insulin Info