Health Library

What You Should Know About Your Child’s Bone Health

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Bones are important structures for your body. They provide support, allow for movement, protect organs, produce blood cells, and store minerals. If you take care of your bones, you should expect a lifetime of use from them. If you don't, you may have problems, such as osteoporosis. 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. Osteoporosis is generally associated with older women, but anyone can get it.

As your children grow into adulthood, certain habits and lifestyle factors will also play into their risk of increased loss of bone mass. These factors include smoking, lack of physical activity, and poor diet. Although genetics is not a risk factor that can be modified, others can be. It is important to maintain good bone health throughout life.

Why Do Children and Teens Need to Worry About It?

Osteoporosis is a disease that manifests in older adults, but health professionals now suspect that its origins may occur in childhood. The peak years for bone formation are during adolescence—between ages 9-18 years—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, children and teens have especially high calcium needs. Unfortunately, children today may not be 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
4-81,000 mg/d
9-181,300 mg/d

The National Institutes of Health (NIH) recommends that children 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:

FoodServing Size Calcium Content
(mg/serving)
Calories
(kcal/serving)
Low-fat yogurt, plain1 cup415150
Tofu, prepared with calcium½ cup253100
Skim milk1 cup300100
Low-fat milk (1%)1 cup305120
Reduced fat milk (2%)1 cup293140
Whole milk1 cup276150
Calcium-fortified orange juice6 ounces261110
Cheddar cheese1.5 ounces307115
Ice cream1 cup168150
Broccoli, cooked1 cup6240
Almonds1 ounce75165
Orange1 whole7260
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 your are exposed to the sun, your 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. In many cases, children and teenagers may not spend enough time outdoors to get their needed vitamin D intake. 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 children 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:

FoodServing Size Vitamin D Content (IU)
Cod liver oil1 Tablespoon1,360
Salmon (pink), cooked3 ounces447
Tuna fish, canned in water3 ounces154
Sardines, canned in oil and drained 2 sardines46
Milk vitamin D-fortified (nonfat, reduced fat, whole) 1 cup115-224
Soy milk, calcium-fortified1 cup120
Swiss cheese1 ounce6
Egg yolk 1 large41
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 children 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:

National Institute of Child Health & Human Development
http://www.nichd.nih.gov

NIH Osteoporosis and Related Bone Diseases National Resource Center
http://www.niams.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. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary. Updated August 22, 2013. Accessed February 6, 2014.

Calicium. National Institutes of Health Office of Dietary Supplements website. Available at: http://ods.od.nih.gov/factsheets/Calcium-HealthProfessional. Updated November 21, 2013. Accessed February 6, 2014.

Calcium. USDA national nutrient database for standard reference, release 25. USDA Agriculture Research Service website. Available at: https://www.ars.usda.gov/SP2UserFiles/Place/12354500/Data/SR25/nutrlist/sr25w301.pdf. Accessed February 6, 2014.

Calcium intake and supplementation. EBSCO DynaMed website. Available at: http://ebscohost.com/dynamed. Updated June 25, 2013. Accessed February 6, 2014.

The Surgeon General's report on bone health and osteoporosis: What it means to you. NIH Osteoporosis and Related Bone Diseases National Resource Center website. Available at: http://www.niams.nih.gov/Health_info/bone/SGR/surgeon_generals_report.asp. Published March 2012. Accessed February 6, 2014.

Vitamin D. EBSCO Natural and Alternative Treatments website. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary. Updated August 22, 2013. Accessed February 6, 2014.

Vitamin D. National Institutes of Health Office of Dietary Supplements website. Available at: http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional. Updated June 24, 2011. Accessed February 6, 2014.

Vitamin D intake and supplementation. EBSCO DynaMed website. Available at: http://ebscohost.com/dynamed. Updated February 4, 2013. Accessed February 6, 2014.



Last reviewed February 2014 by Michael Woods, 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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