Table 1.

Options for the maintenance of bone health in Down syndrome

DIETARY

Adequate calcium (Indicate normal range)

Age<50 (1,000 mg/day) total dietary and supplemental calcium

Age>50 (1,200 mg/day) total dietary and supplemental calcium

Vitamin D

Age<50 (400–800 international units (IU) daily*)

Age>50 (800–1,000 international units (IU) daily*)

Healthy food choices and a well-balanced diet

Dairy products, fish, fruits and vegetables

EXERCISE

Weight-bearing exercise as indicated and tolerated

Support and encourage appropriate activity levels

High-impact weight-bearing exercise e.g.: Hiking, stair-climbing

Low-impact weight-bearing exercise e.g.: Fast walking, low-impact aerobics

Non-Impact exercise as indicated and tolerated

Increase muscle strength to decrease the risk of falls and fracture

Improve balance, posture and daily function

Muscle-strengthening exercise e.g.: Functional movements (standing and rising up on your toes), Using elastic exercise bands.

ENDOCRINE

Endocrine management decisions

Routine Bone Density measurements (annual)

Follow Thyroid hormone levels, (T3, T4, TSH)

Identify Celiac disease

^*According to the Institute of Medicine (IOM), the safe upper limit of vitamin D is 4,000 IU per day for most adults