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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