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Optimizing Peak Bone Mass in Children

Between the ages of 9–14, children will develop more bone then they will ever lose in their lifetime. They need help focusing on their bone health and most importantly, their bone development. Making the most of a peak bone mass may help reduce the risk of fractures and osteoporosis in early adulthood.

By age 18, kids have developed 90% of their lifetime bone mass. By age 30, most have reached peak bone mass, a maximum threshold that may protect them for several years but will require constant attention throughout mid and late life. Many factors affect peak bone mass, some of which can be changed and some of which cannot.

Family history: Heredity accounts for about 65% of bone health. If osteoporosis or fractures run in the family, take special note of bone development in your children.

Gender: Though boys and girls develop bone mass at the same rate before puberty, boys tend to gain greater bone mass at a greater speed after age 10. Girls have a shorter window of time to gain their optimum peak bone mass.

Hormone: Estrogen and testosterone are necessary for bone mass development. Girls who begin their menstrual cycle early can build greater bone density than those who start at a later age or frequently miss their periods.

Nutrition: Calcium, vitamin D, magnesium, and zinc are the most important nutrients for building bone mass. Of these, calcium and vitamin D deficiencies tend to be the most prominent. Young children who have a calcium deficiency can have 5-10% percent lower peak bone mass than children with sufficient calcium intake. The Institute of Medicine suggests that kids age 9-18 get 1,300 mg of calcium and 600 IUs of vitamin D per day.

Exercise: Sports and physical activity, particularly those that include jumping, are extremely important for bone development because stress sends electrical impulses through the marrow of the bone that stimulate the bone formation cells. BEWARE: It is possible to overdo it. Without sufficient nutrition, an energy imbalance can lead to Athletic Energy Deficit and repetitive hyperextension activities can lead to PARS stress fractures.

What to do

If your children don’t drink three glasses of milk or eat three servings of dairy or fortified juices a day, they may need a supplement. Most children will need a vitamin D supplement.

If your daughter has not started her period by age 15 or misses three consecutive periods, she may be at risk for poor bone development. Talk to your pediatrician about potential causes for the delay or irregularity — including Athletic Energy Deficit.

Make sure your children are mixing it up and that they lay off a sport or activity that is causing pain. A short time of rest helps the bones and muscles repair. Be sure to include activities that strengthen abdominal and gluteal muscle groups. These powerhouse muscles can help protect the spine. The hip flexor, quadriceps and hamstring muscles often get tight in growing kids and need to be properly stretched.

Reviewed: 5/14/19

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