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  • What You Should Know About Your Child’s Bone Health

    Image for child bone health article 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 a “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 Institute of Medicine for calcium intake in children:
    Age
    (years)
    Recommended Amount
    (milligrams per day)
    1-3 700 mg/d
    4-8 1,000 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 children older than 1 year and adolescents, the recommended daily dose is 600 International Units (IU).
    The table below shows major food sources of vitamin D:
    Food Serving Size Vitamin D Content (IU)
    Cod liver oil 1 Tsp. 450
    Salmon (pink), canned 3 ounces 530
    Tuna fish (light), canned in oil 3 ounces 201
    Sardines, canned in oil 2 sardines 65
    Milk (low fat), vitamin D-fortified 1 cup 127
    Soy milk, calcium-fortified 1 cup 120
    Swiss cheese 1 ounce 12
    Egg yolk 1 large 18

    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
    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/healthLibrary/. Updated August 2011. Accessed May 21, 2012.

    Calcium intake and supplementation. EBSCO DynaMed website. Available at: http://ebscohost.com/dynamed. Updated November 22, 2011. Accessed May 21, 2012.

    Prevalence report. National Osteoporosis Foundation website. Available at: http://www.nof.org/advocacy/resources/prevalencereport Accessed May 21, 2012.

    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/healthLibrary/. Updated August 2011. Accessed May 21, 2012.

    Vitamin D intake and supplementation. EBSCO DynaMed website. Available at: http://ebscohost.com/dynamed. Updated April 24, 2012. Accessed May 21, 2012.

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