One of the areas our patients find challenging to making healthy choices is in the availability of food options in group settings, workshops, and community events. The limited choices in vending machines – often limited to candy, cookies, and soda – make it difficult for those trying to make healthy selections. An occasional treat is certainly not unreasonable but, if those are the only choices, the person trying to eat healthier will have to skip the snack and watch while the others eat and drink.
A further challenge is for those on special diets. We received a note from a concerned staff person who reported that the prescribed menu is followed closely at home. However, at work, events, and in the community, the diet is not followed. It is often stated that it is the person’s right to choose his diet. 
While this is true, allowing individuals to make choices should be in tandem with providing appropriate education, encouragement, and example. When the individual with Down syndrome has money to spend in the community, appropriate educational efforts should be provided to help the individual select foods that are appropriate for the particular diet. This is a responsibility of staff and others but also a benefit. We have seen family and staff getting personal benefit when setting an example of healthy behavior or sharing in healthy behavior with the person with Down syndrome.
There are a number of ways to educate the individual with Down syndrome. One of the best ways we find is using visual, non-food motivators and rewarding progress with praise. We also find demonstrating healthy behavior is beneficial. People with DS can be very observant and learn well from watching others. Whatever method of teaching and/or modeling is used, it will likely need to be repeated. Especially if choices are available that are less healthy, continued regular reminders will probably be necessary. The above teaching methods help reduce the need for “nagging” and put more control and decision-making in the hands of the individual with DS without eliminating the need for ongoing teaching by family or staff.