Ten Ways to Build Strong Bones

6/11/2008

The skeleton you build as a child and young adult is basically the skeleton you have to work with for the rest of your life. The calcium they deposit by the time they’re in their late 20s is the calcium they will be drawing on for the rest of their lives. That’s why public-health experts often call osteoporosis a pediatric disease with a geriatric result.

As parents, it is important to make sure our children form good habits now—and avoid bad ones—to have strong and flexible bones for life. You have to start when they’re babies, and pay special attention when they’re teens, as about half your peak bone mass is built during adolescence.

On the positive side:

• 1. Do make sure your kids eat lots of foods rich in calcium. Calcium is an essential component of bone. Calcium-rich foods include dairy products, fortified orange juice, oily fish, figs, collards, kale, black beans, almonds, soy foods, and fortified cereals. The recommended daily intake of calcium varies by age, with 1,300 mg a day being the requirement for kids 9 to 18. For more on calcium click here.
• 2. Do make sure they get enough vitamin D, which is needed for calcium to be absorbed properly. In most parts of the country you can get all the vitamin D you need from exposure to the sun, but too much sun as a child has health costs as well as benefits. I agree with the American Academy of Pediatrics that for cancer prevention babies should be kept out of the sun and children should wear UVA/UVB sunblock whenever they’re outdoors.
• Your children can get their 400 IU per day of vitamin D from fortified foods and from supplements instead. Be especially sure that breastfed babies, dark-skinned children, vegans, and the lactose-intolerant get adequate levels of the bone-building vitamin. For more on vitamin D click here.
• 3. Do make sure they take time for regular exercise. Most important is weight-bearing exercise like walking, running, hopping, tennis, soccer, and any sport where feet meet the ground. And you’re never too young to start—even babies can increase their bone mineral density with exercise.
• 4. Do make sure they eat lots of deeply colored fruits and vegetables. Compounds called polyphenols in dark green, red, blue, or purple produce help build bone, as do essential trace minerals like magnesium, potassium, and zinc found in fruits, vegetables, and whole grains.
• 5. Do be especially careful that children taking steroid drugs meet the recommended daily intakes of calcium and vitamin D for their age. While steroids such as Nasonex or Pulmicort prescribed to children have low levels of absorption and very few long-term side effects, all steroids make it more difficult to build strong, dense bones.

As a precaution:

• 1. Don’t let your children start smoking. It can indeed stunt your growth as you age by increasing bone loss.
• 2. Don’t let them eat too much salt, which causes more calcium to be excreted unused. Keep sodium levels under 1,000 mg. a day for kids aged 1-3, under 1,200 mg. for ages 4-8, and under 1,500 for ages 9-18. The easiest way to do this is to avoid fast foods, prepared meals, and processed foods unless they are low in salt.
• 3. Don’t let them drink carbonated beverages, especially colas, on a regular basis. The phosphorous in them may interfere with the absorption of calcium.
• 4. Don’t let your young athletes over-train, especially the girls. Estrogen plays an important role in bone formation in young women, and exercising so much as to cause menstrual periods to stop can slow or reverse bone formation.
• 5. Don’t overdo the protein. Keep you child’s intake to the daily recommended intake (DRI) of 13 grams a day for toddlers, 19 grams for children ages 4-8, 34 grams for children ages 9-13, and either 46 (female) or 52 (male) grams a day for older teens. They’ll get 6-8 grams just in a cup of milk, an ounce of meat, an ounce of cheese, a half-cup of beans, or 2 tablespoons of peanut butter. Too much protein can also cause excessive excretion of calcium.

Resources:
Kids and Their Bones brochure from the National Institute of Arthritis and Musculoskeletal and Skin Diseases at www.niams.nih.gov/Health_Info/bone/Bone_Health/Juvenile/kids_and_their_bones.pdf

Powerful Bones, Powerful Girls website of the National Bone Health Campaign at www.girlshealth.gov/bones