When we think of osteoporosis, we typically think of it as increased bone fragility that affects older individuals. But according to the American Academy of Pediatrics, the foundation for this condition is laid in early childhood and adolescence. As such, the organization places emphasis on the importance of bone health during childhood.

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The AAP researchers recommend that children participate in weight-bearing activities – such as running or dancing – and increase dietary intake of calcium to optimize bone strength.

Researchers from the American Academy of Pediatrics (AAP) publish their report in the journal Pediatrics, where they outline strategies pediatricians can use to aid children’s bone health.

According to the researchers, osteoporosis is a major cause of morbidity and economic burden around the world. By the year 2020, it is estimated that half of Americans 50 years of age or older will be at risk for osteoporotic fractures.

Though the condition was previously thought to be a feature of aging, medical experts now say its roots lie in childhood, when preventative measures can be taken.

Additionally, the team says attaining substantial bone mass early in life is considered to be “the most important modifiable determinant of lifelong skeletal health.”

Though bone mineral deposition starts during pregnancy, bone mineral content (BMC) increases 40-fold from birth through adulthood, with peak bone mass occurring near the end of the second decade of life.

Around 70% of variance in bone mass is down to genetic factors, but the researchers note that nutritional intake of calcium, vitamin D, protein, sodium and carbonated beverages are modifiable factors, as well as exercise, lifestyle, keeping a healthy body weight and hormonal status.

Childhood milk consumption is linked with higher BMC and lower fracture risk in adulthood, note the researchers, and around 99% of total body calcium is located in the skeleton.

To further investigate the importance of bone health in childhood, the AAP researchers reviewed bone acquisition in infancy, childhood and adolescence, in order to advise pediatricians on bone health strategies for their patients.

Fast facts about osteoporosis
  • Osteoporosis is a disease of the skeletal system, characterized by low bone mass
  • The condition leads to increased risk of bone fractures
  • Risk factors include being female, white, older, small in body size and eating a low-calcium diet.

Learn more about osteoporosis

The team states that the primary nutrition source for infants should be human milk – or infant formula, if human milk is not feasible. The main source of dietary calcium after the first year of life is milk and other dairy products, which account for 70-80% of nutritional calcium intake.

Based on their report, the researchers recommend that pediatricians advise children and adolescents to increase daily consumption of calcium and foods and beverages containing vitamin D, which includes nonfat milk and low-fat yogurts.

The Institute of Medicine have suggested a higher recommended dietary allowance for vitamin D, and the AAP support this, however, the organization does not support universal screening for vitamin D deficiency in healthy children.

Instead, they say such screening should be targeted at children and adolescents with recurring fractures or with medical conditions that are linked with reduced bone mineral density.

Additionally, the researchers say pediatricians should enquire about the exercise children are receiving and should recommend weight-bearing activities – including walking, dancing and running – which encourage bone health.

As part of their report, they say routine calcium supplementation is not advised for healthy children but that increased dietary intake is strongly encouraged.

Last year, Medical News Today reported on a study in The Lancet that found vitamin D supplements do not prevent osteoporosis.