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2019 Feb

Strong, Healthy Bones

Find out why building healthy bones in childhood matters!

Typically, when parents think about their children’s health, they don’t think about their bones. But building strong bones by adopting healthy nutritional and lifestyle habits in childhood is very important to help prevent osteoporosis and fractures later in life.

Osteoporosis, the disease that causes bones to become less dense and prone to fractures, has been called “a pediatric disease with geriatric consequences,” because the bone mass attained in childhood and adolescence is a very important determinant of lifelong skeletal health. The health habits your kids are forming now can make—or literally, break—their bones as they age.

Here are a few questions and answers to help you know how to take care of your children’s bones.

Q. Why is childhood such an important time for bone development?
A. Bones are the framework for your child’s growing body. Bones are living tissue that changes constantly, with bits of old bone being removed and replaced by new bone. You can think of bone as a bank account, where (with your help) your kids make “deposits” and “withdrawals” of bone tissue. During childhood and adolescence, much more bone is deposited than withdrawn as the skeleton grows in both size and density.

The amount of bone tissue in the skeleton (known as bone mass) can continue to increase until your child reaches his/her mid-twenties. At that point, bones have reached their maximum strength and density, or peak bone mass. Up to ninety percent of peak bone mass is acquired by age eighteen in girls and age twenty in boys, which makes youth the best time for your kids to “invest” in their bone health.

Building your children’s “bone bank” account is a lot like saving for their education: the more they can put away when they’re young, the longer it will last as they get older.

Q. How can I help keep my kids’ bones healthy?
A. The same healthy habits that keep your kids going—and growing—will also benefit their bones. One of the best ways to encourage healthy habits in your children is to be a good role model yourself. Believe it or not, your kids are watching, and your habits—both good and bad—have a strong influence on theirs.

Q. What are the two most important bone health habits to encourage now?
A. Encourage proper nutrition and plenty of physical activity. Eating for healthy bones means getting plenty of foods rich in calcium and vitamin D. Most kids get enough vitamin D from sunlight (or from foods like egg yolks or fortified milk), but most do not get enough calcium in their diets. Younger kids (ages 2-8) are more likely to get adequate calcium, but among older kids (ages 9-19), only 19 percent of girls and 52 percent of boys get enough calcium to ensure optimal peak bone mass.

Calcium is found in many foods, but the most common source is milk and other dairy products. Drinking one 8-oz glass of milk provides 300 mg of calcium, which is about one-third of the recommended intake for younger children and about one-fourth of the recommended intake for teens.

Q. How can I persuade my daughter to drink milk instead of diet soda? She thinks milk will make her fat.
A. Soft drinks tend to displace calcium-rich beverages in the diets of many children and adolescents. Research has shown that children who drink soft drinks consume much less calcium than those who do not.

It’s important for your daughter to know that good sources of calcium don’t have to be fattening. Skim milk, low-fat cheeses and yogurt, calcium-fortified juices and cereals, and green leafy vegetables can all fit easily into a healthy, low-fat diet. Replacing even one soda each day with milk or a milk-based fruit smoothie can significantly increase her calcium intake.

Q. What if my kids don’t like milk?
A. Sources of calcium also include an ounce or two of cheese on pizza or a cheeseburger, a cup of calcium-enriched orange juice, or a small carton of yogurt. Your kids can also get calcium from dark green, leafy vegetables like kale or bok choy, or foods such as broccoli, almonds, tortillas, or tofu made with calcium. Many popular foods—cereals, breads, juices—now have calcium added, too.

Q. My daughter is constantly dieting. Should I be concerned?
A. Maintaining proper weight is important to overall health, but so is good nutrition. If your daughter is avoiding all milk and dairy products and severely restricting her food intake, she is probably not getting enough calcium. She needs a more balanced diet that includes low-fat milk products and other calcium-rich foods. Calcium supplements may also be helpful to ensure that she gets enough of this essential nutrient.

Q. Should I give my kids calcium supplements?
A. Experts believe calcium should come from food sources whenever possible. However, if you think your children are not getting adequate calcium from their diet, you may want to consider a calcium supplement. For optimal absorption, no more than 500 mg of calcium should be taken at one time.

Q. How does physical activity help my kids’ bones?
A. Muscles get stronger when we use them. The same idea applies to bones: the more work they do, the stronger they get. Any kind of physical exercise is great for your kids, but the best ones for their bones are weight-bearing activities like walking, running, hiking, dancing, tennis, basketball, gymnastics, and soccer.

Swimming and bicycling promote your kids’ general health but are not weight-bearing exercises and will not help build bone density. Organized sports can be fun and build confidence, but they are not the only way to build healthy bones.

The most important thing is for your kids to spend less time sitting and more time on their feet and moving. Alone or with friends, at home or at the park—one of the best gifts you can give your kids is a lifelong love of physical activity.

Q. So, my kids need to eat foods that are rich in calcium and get plenty of weight-bearing exercise. Is there anything else they can do to keep their bones healthy?
A. Yes. They should avoid smoking. You probably know that smoking is bad for the heart and lungs, but you may not know that it’s harmful to bone tissue.

Tobacco, nicotine, and other chemicals found in cigarettes may be directly toxic to bone, or they may inhibit absorption of calcium and other nutrients needed for bone health. The many dangers associated with smoking make it a habit to be avoided.

You may think it’ s too early to worry about smoking, but the habit typically starts during childhood. In fact, most people who use tobacco products start before they finish high school. The good news? If your kids finish high school as nonsmokers, they will probably stay that way for life.

Q. My 8-year-old son is a daredevil and has already broken several bones. Could he have a problem like osteoporosis at this young age?
A. Osteoporosis is rare among children and adolescents. When it occurs, it is usually caused by an underlying medical disorder or by medications used to treat such disorders. This is called secondary osteoporosis. It may also be the result of a genetic disorder such as osteogenesis imperfecta, in which bones break easily from little or no apparent cause. Sometimes there is no identifiable cause of juvenile osteoporosis. This is known as idiopathic juvenile osteoporosis.                         Two or more low-impact fractures may be a sign of one of these disorders. If you are concerned about your son’s fractures, talk to his doctor for more information.

Q. How can I get through to my kids? They sure don’t think about their bones.
A. You are absolutely right. Research has shown that children and adolescents do not tend to think much about their health. Their decisions about diet and exercise, for example, are rarely made based on “what’s good for them.”

But we also know that you have a much greater influence on your kids’ decisions and behaviors than you may believe. When asked who has been the greatest influence in their lives, many teenagers name parents before friends, siblings, grandparents, and romantic partners.

The best way to help your kids develop healthy habits for life is to be a good role model yourself. Research suggests that active children have active parents.

If you make physical activity a priority and try hard to maintain a healthy diet, chances are your positive lifestyle will “rub off” on them along the way. Here are some things you can do.

• Be a role model. Drink milk with meals, eat calcium-rich snacks, and get plenty of weight-bearing exercise. Don’t smoke.

• Incorporate calcium-rich foods into family meals.

• Serve fat-free or low-fat milk with meals and snacks.

• Stock up on calcium-rich snacks that are easy for hungry children to find, such as cheese cubes and string cheese; calcium-fortified orange juice; single-serving puddings; individual cheese pizzas; yogurt and frozen yogurt; tortillas; cereal with low-fat milk; almonds; broccoli with yogurt dip

• Limit access to soft drinks and other snacks that don’t provide calcium by not keeping them in the house.

• Help your kids find a variety of physical activities or sports they enjoy participating in.

• Establish a firm time limit for sedentary activities such as TV, computers, and video games.

• Teach your kids to never start smoking, as it is highly addictive and toxic.

• Talk to your children about their bone health and let them know it’s a priority. Your kids may not think much about health, but they are probably attracted to such health benefits as energy, confidence, good looks, and strength.

(Source: National Institute of Health)

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