What You Should Know About Your Child’s Bone Health
Parents should be aware of what osteoporosis is and why it concerns their children. There are steps you can take while they are young to protect children from getting osteoporosis later in life.
What Is Osteoporosis?
Osteoporosis is a disease that gradually weakens bones until they break easily, sometimes after little or no injury. The bones most likely to be affected are the hip, spine, and wrist. Osteoporosis is often called the “silent disease” because there are usually no symptoms of the disease until a bone breaks. Everyone is susceptible to osteoporosis, but the following risk factors influence the chances of getting it:
- Gender—Women are more likely to get osteoporosis than men. This is because women's bones are naturally lighter and thinner. Women also experience increased bone loss after menopause .
- Age—The risk of osteoporosis increases with age.
- Genetics—People with a first-degree relative—a parent or sibling—with osteoporosis are at increased risk.
- Frame size—Small-boned, thin people have a higher risk.
- Ethnicity—White and Asian people are at higher risk.
- Diet—Consuming enough calcium and vitamin D can help build and maintain strong, healthy bones.
- Exercise—Physical activity, especially weight-bearing activity, helps keep bones strong.
- Smoking—Smoking can increase the chance of getting osteoporosis .
- Alcohol—Drinking alcohol can reduce bone density, leading to osteoporosis.
Though it is impossible to modify most of these risk factors, some—particularly diet and exercise—are within your control.
Why Do Kids and Teens Need to Worry About It?
Although osteoporosis is a disease that manifests in older adults, health professionals now suspect that its origins may occur in childhood. The peak years for bone formation are during adolescence—between ages 9-18—when more calcium is added to bone than is lost. For both boys and girls, most of this bone formation is complete by the age of 20. By getting enough calcium and weight-bearing activity in these critical years, it is thought that children can reduce their risk of developing osteoporosis later in life.
Getting Enough Calcium
Since their bones are soaking up more calcium now than they ever will, kids and teens have especially high calcium needs. Unfortunately, kids today are, for the most part, not getting what they need. The following table outlines the recommendations by the National Academy of Sciences for calcium intake in children:
Age
(years) |
Recommended Amount
(milligrams per day) |
---|---|
1-3 | 500 mg/d |
4-8 | 800 mg/d |
9-18 | 1,300 mg/d |
The National Institutes of Health (NIH) recommends that kids and teens eat a variety of calcium-rich foods. The table below lists some good calcium sources and the amount of calcium and calories that they contain:
Food | Serving Size |
Calcium Content
(mg/serving) |
Calories
(kcal/serving) |
---|---|---|---|
Low-fat yogurt, plain | 1 cup | 450 | 150 |
Tofu, prepared with calcium | ½ cup | 425 | 100 |
Skim milk | 1 cup | 350 | 100 |
Low-fat milk (1%) | 1 cup | 350 | 120 |
Reduced fat milk (2%) | 1 cup | 350 | 140 |
Whole milk | 1 cup | 300 | 150 |
Calcium-fortified orange juice | 1 cup | 350 | 110 |
Cheddar cheese | 1 ounce | 200 | 115 |
Ice cream | 1 cup | 100 | 150 |
Broccoli, cooked | 1 cup | 70 | 40 |
Almonds | 1 ounce | 70 | 165 |
Orange | 1 whole | 50 | 60 |
* Adapted from the US Department of Architecture Nutrient Database |
Getting Enough Vitamin D
While most people know that calcium is essential for building strong, healthy bones, many are not aware that vitamin D is also critical for bone health. Vitamin D can be obtained from the diet—mainly from vitamin D-fortified dairy products. Also, when exposed to the sun, skin makes vitamin D.
The body can store vitamin D for weeks or months, so it is not necessary to consume it or be in the sun every day. However, many kids and teenagers today probably do not spend enough time outdoors to get their needed vitamin D intake. Also, sunscreens, which are vital for protecting the skin from the sun’s harmful rays, may reduce the skin’s ability to produce vitamin D. For these reasons, it is important for kids and teens to eat food fortified with vitamin D. Supplements are also available. For people aged 1-50 years, the recommended daily dose is 200 International Units (IU).
The table below shows major food sources of vitamin D:
Food | Serving Size | Vitamin D Content (IU) |
---|---|---|
Cod liver oil | 1 Tbs. | 1,360 |
Salmon, cooked | 3-½ ounces | 360 |
Mackeral, cooked | 3-½ ounces | 345 |
Sardines, canned in oil | 3-½ ounces | 270 |
Milk, vitamin D-fortified | 1 cup | 98 |
Margarine, fortified | 1 Tbs. | 60 |
Liver, beef, cooked | 3-½ ounces | 30 |
Egg | 1 large | 25 |
Incorporating Weight-bearing Activities
Doing weight-bearing physical activities helps to build stronger, healthier bones by forcing your bones to work against gravity. The stress triggers bones to build more cells and become stronger. If you help your children find weight-bearing activities that they find enjoyable, then they will be more likely to do them regularly.
Some weight-bearing activities for kids and teens are:
- Running
- Jumping rope
- Gymnastics
- Tennis
- Dancing
- Tae kwon do
- Basketball
- Soccer
- Hopscotch
- Yoga
By learning bone-promoting behaviors during childhood, like eating right and staying active, not only will children build strong bones while they are young, but they will also adopt habits that will keep their bones strong and healthy as they age.
RESOURCES:
Centers for Disease Control and Prevention
http://www.cdc.gov/
National Institute of Child Health & Human Development
http://www.nichd.nih.gov/
CANADIAN RESOURCES:
About Kids Health
http://www.aboutkidshealth.ca/
Caring for Kids
http://www.caringforkids.cps.ca/
References:
Calcium. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=114. Updated April 2009. Accessed May 4, 2010.
Calvagna M. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81. Updated November 2009. Accessed May 4, 2010.
Disease statistics. National Osteoporosis Foundation website. Available at: http://www.nof.org/osteoporosis/stats.htm. Accessed June 2, 2003.
DRI: Dietary reference intakes. National Academy Press. National Academy of Sciences. Institute of Medicine website. Available at: http://search.nap.edu/html/dri_calcium/tables.html . Accessed June 2, 2003.
Frequently asked questions about what parents need to know about children's bone health. The National Women's Health Information Center website. Available at: http://www.4woman.gov/faq/bone.pdf . Accessed June 2, 2003.
Kleigman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics . 18th ed. Philadelphia PA: Saunders; 2007.
Vitamin D. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=114. Updated February 2010. Accessed May 4, 2010.
Last reviewed May 2010 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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