The promotion of good bone health in children and teenagers is exceptionally important as there is a limited window of development in your child’s life, where healthy bone is developed, laying the foundation for future bone health in adults. In fact, poor bone health development in children and teenagers may predispose adults to the development of osteoporosis, which is often described as a pediatric disease with geriatric consequences.
Osteoporosis can cause bones to become fragile and increase the risk of bone fractures as we age, which can be fatal in some instances. It is estimated that by the year 2020, that 50% of Americans over 50 years of age, will be at risk of osteoporotic fractures. This can cause an exceptionally high burden on economic resources and on quality of life. Therefore, the development of good bone health in younger years, remains a significant modifiable risk factor, for the development of osteoporosis in later life.
What Are the Windows For Peak Bone Development in Children?
Peak bone development in humans occurs in girls at age 12 and in boys at age 14. By 18 years of age, 90% of teenagers’ bone structure will have been developed. This time period allows for a ‘once off’ laying off good bone health. Hence during childhood and teenage years, it is important to ensure that they are getting enough calcium, Vitamin D, and physical activity, required to promote the development of optimum bone health, essential for later years when we are more prone to osteoporosis and bone fractures.
What Influences The Development of Healthy Bones in Children?
There are a number of factors which influence bone health and these include:
• Gender – Males generally acquire more bone density than females
• Ethnicity – Black women acquire higher bone densities than while females.
• Hormones – Girls who menstruate at an earlier age may have higher bone density
• Nutrition – Calcium, Vitamin D and a well-balanced diet are essential.
• Physical Activity – Weight bearing activities promotes the growth of healthy bones.
Some of the above factors are not modifiable, we cannot change them. These include gender, ethnicity, and hormones. However, nutrition and physical activity are two modifiable factors which can be promoted to ensure optimum bone health in children, and as we age.
Calcium is essential for the development of healthy bones and teeth. Calcium requirements are highest in young people aged 12–18 years, as this is when they go through peak growth spurts and bone development. In New Zealand, it is suggested that approximately 1/3 of young people aged 12-18 have an insufficient intake of calcium, which is higher in young females.
Dairy products such as milk (full or low fat), cheese and yogurt are good sources of calcium. It is recommended that young people (12-18) should have at least two to three servings of milk and milk products daily in order to meet their daily calcium requirements.
There are also non-dairy sources of calcium which include: canned fish with bones, green leafy vegetables, legumes, nuts, and seeds some and some breakfast cereals fortified with calcium (however these can contain high levels of added sugar). Vitamin D also plays an essential role in absorbing calcium in the diet.
Vitamin D and has an important role in bone health, as it enhances calcium absorption within our bodies. Exposure to sunlight is our main source of Vitamin D. Dietary sources alone will never provide sufficient sources of Vitamin D, in order to maintain optimal bone health.
It is interesting that until recently it was assumed that children in New Zealand get sufficient sun exposure, and hence have adequate levels of Vitamin D. However, there is now considerable evidence which suggests that some children and teenagers may not have sufficient levels of vitamin D, which can have adverse effects on bone quality, and this is more pronounced in the winter months, and on the South Island. As always we need to encourage the use of sun protection when the ultraviolet index (UVI) is 3 or higher to avoid skin and eye damage.
Physical activity and weight bearing exercises are very important in children and teenagers, as it encourages new bone to form and strengthens muscles, during this critical time where maximum bone is formed. Physical activity in children and teenagers is thus very important to reduce the risk of developing osteoporosis as we age.
Health Guidelines in New Zealand recommend that Children and teenagers aged 6 to 17 years should get a total of 60 minutes of moderate to vigorous physical activity every day. Younger children, aged 2 to 5 years, should play actively several times every day.
In summary, there is a short timeframe where we can really encourage optimum bone health in our children, which will serve them throughout the remainder of their lives. Calcium, Vitamin D and weight-bearing exercise are important factors to promoting healthy bones in children and teenagers, and in reducing the risk of osteoporosis as we age.
Lorraine Herity is the Clinic Director of Better Health Osteopathy in Christchurch, New Zealand. She previously worked in Osteopathic clinics in London and Ireland, before moving to New Zealand. Lorraine trained at the British School of Osteopathy in London, where she gained her Master of Osteopathy (M.Ost). Lorraine is a dedicated and passionate Osteopath. Her main aim is to help her patients regain their health, and to return her patients back to their everyday activities, in as quick a time as possible.