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Effects of calcium and training on the development of bone density in children with Down syndrome
Sharif Mohammad Reza1, Hemayattalab Rasool, Sayyah Mansour
1Department of Pediatrics, Kashan University of Medical Sciences, Iran.
Insights
Weight-bearing exercise and calcium intake significantly improve bone mineral density (BMD) in children with Down syndrome (DS). Combined interventions showed the greatest gains, highlighting the importance of both factors for bone health in this population.
Area of Science:
- Pediatrics
- Orthopedics
- Genetics
Background:
- Children with Down syndrome (DS) often exhibit lower bone mineral density (BMD), increasing fracture risk.
- Understanding factors that influence BMD development in DS is crucial for targeted interventions.
Purpose of the Study:
- To investigate the combined and individual effects of physical training and calcium supplementation on BMD in children with DS.
- To determine the optimal strategy for enhancing bone health in this population.
Main Methods:
- A 4-month randomized controlled trial involving 48 children with DS (ages 7-12).
- Four groups were established: exercise and calcium intake (Ex(+)Ca(+)), calcium intake only (Ex(-)Ca(+)), exercise only (Ex(+)Ca(-)), and control (Ex(-)Ca(-)).
- Interventions included 45-minute weight-bearing exercise sessions thrice weekly and/or daily intake of calcium-enriched milk with vitamin D.
Main Results:
- All intervention groups demonstrated increased femoral neck BMD compared to the control group.
- The Ex(+)Ca(+) group showed a 5.96% greater increase in BMD than the Ex(+)Ca(-) group (p<0.01).
- Weight-bearing exercise alone yielded a 3.52% greater BMD increase than calcium intake alone (p<0.01), indicating exercise's significant impact.
Conclusions:
- Combined weight-bearing exercise and calcium supplementation are effective in significantly increasing BMD in children with DS.
- Weight-bearing exercise appears to have a more pronounced effect on BMD than calcium supplementation alone.
- These findings support the integration of exercise and nutritional strategies to improve bone health outcomes in children with Down syndrome.
Abstract:
In this study we examined the effects of physical training and calcium intake on the development of bone mineral density (BMD) in children with Down syndrome (DS). A total of 48 children with DS (age 7-12 years old) matched for age and BMD were assigned to four groups exercise and calcium intake (Ex(+)Ca(+)), calcium intake-no-exercise (Ex(-)Ca(+)), exercise no-calcium intake (Ex(+)Ca(-)) and non-exercise-no-calcium intake (Ex(-)Ca(-)). The training protocol included 45 min of weight bearing exercise performed 3 sessions per week in addition to dietary calcium rich food intake of enriched cow milk with vitamin D containing 200 mg calcium per serving or no enriched dietary supplement for a duration of 4 months. Data analysis was performed on data by using t-test, one-way ANOVA analysis and Tukey post hoc tests to determine the main and combined effects of training and calcium regiment on BMD. All groups showed greater femoral neck BMD after 4 months. The increase in femoral neck BMD in the Ex(+)Ca(+) group was 5.96% greater than the Ex(+)Ca(-) group (p<0.01). The effect of training was greater than calcium intake alone. The Ex(+)Ca(-) group achieved 3.52% greater BMD than Ex(-)Ca(+) group (p<0.01). In this study, all the experimental groups had greater BMD than the no-calcium-no-exercise group that served as the control group (p<0.01). It was concluded that additional weight bearing exercise and calcium supplementation resulted in a greater increase in BMD in children with DS.
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