Bone health among children and adults

Tips on optimizing bone health among children and adolescents

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Bone health is affected by several factors including genetics, gender, and ethnicity. Other modifiable factors play very important role in bone health in children and adults including diet, exercise, lifestyle, and weight.

Approximately 90% of peak bone mass is accumulated by 18 years of age, making nutrition and healthy life style during childhood and adolescence critical determinants of bone health throughout life.

Calcium and vitamin D are considered the main dietary components that affects bone mass acquisition.

The amount of calcium required for healthy bone varies among age groups. In infants 200-300 mg per day of calcium is considered sufficient, while the need increases with age to reach 700 mg per day for pre-schoolers, 1000 mg per day for school age children, and around 1300 mg per day for teens.

The major source of dietary calcium is milk and other dairy products. Adequate milk intake during childhood and adolescence is associated with stronger bones and reduced fracture risk in adulthood. Furthermore, milk provides protein and a number of important nutrients other than calcium, including vitamin D, phosphorus, and magnesium, which are important in bone health.

Each cup (240ml) of milk or yogurt, or 1.5 oz of natural cheese, can provide 300 mg of calcium. The amount of milk that can provide the most calcium requirement is 2-3 cups per day for pre-schoolers and young children and 4 cups for adolescents. Green vegetables such as broccoli and spinach also provide smaller amounts of calcium.

Milk alternatives, such as soy- or almond-based beverages, have insufficient amount of calcium to meet the body needs. Similarly, calcium supplements cannot be used as replacement for dietary sources of calcium.

Vitamin D is necessary for calcium absorption and utilization. Without vitamin D, only 10% to 15% of dietary calcium is absorbed. Adequate vitamin D intake for infants younger than 1 year is 400 IU/d and 600 IU/d thereafter.

With decreased synthesis of vitamin D from reduced sun exposure, dietary sources of vitamin D become more important. Natural dietary sources of vitamin D are limited but include cod liver oil and fatty fish. Alternatively, vitamin D fortified foods should be preferred to non-fortified products.

For those who are unable to achieve adequate amounts of vitamin D in their diet or who have vitamin D deficiency, vitamin D supplements should be taken as prescribed by physician.

For healthy bones; it is essential for families to establish healthy dietary habits in their children, encourage physical activity and healthy weight, and keep regular check-ups by their physicians.