Osteoporosis has been billed by health professionals as “a pediatric disease with geriatric consequences.” The National Osteoporosis Foundation estimates that by next year, about 12 million people over age 50 will have osteoporosis.
When you’re older isn’t the time to think about avoiding the disease. Preventing osteoporosis, a condition in which bones become less dense and more prone to fractures, begins in childhood, with ages 9 to 18 as the most critical years.
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, girls accumulate up to 90 percent of their peak bone mass by age 18 and boys by age 20. “By 18, the growing ends of the bone tend to fuse and stop growing,” said Dr. Salimah Dhanani, assistant professor in pediatrics at Albany Medical Center. “When bones are growing, that’s when they get mineralized best.”
In an effort to improve bone health and to educate parents and their children about the subject, the U.S. Department of Health and Human Services just launched a new campaign, “Best Bones Forever!” Because osteoporosis is four times more common in women than in men, the campaign targets girls ages 9 to 14, encouraging them to consume at least 1,300 milligrams of calcium per day and take part in bone-strengthening activities at least three days a week.
Ulster County is one of three locations chosen to pilot a community program for parents and girls. “The tag line of this whole campaign is ‘If you’re older than 9, now’s the time,’ ” said Laurie Mozian, project coordinator for the Community Heart Health Coalition for Ulster County, who will be managing the Best Bones Forever! program.
Osteoporosis is not the only reason to be concerned about strong bones. A 30-year study showed that there has been a significant increase in the number of forearm fractures in children and adolescents.
Bones build mineral content through the intake of calcium and then store the calcium that blood and cells need. Calcium absorption is enhanced during puberty, which is why diet and exercise are so important for children. “Parents should know that their children should get two to three servings of calcium [per day],” Dhanani said. One 8-ounce glass of milk provides 300 milligrams of calcium, which is one-third to one-quarter of the recommended calcium intake, depending on a child’s age.
The irony is that at the age when it is most critical, many children stop consuming as much calcium, preferring soda and juice to milk. According to the U.S. Department of Health & Human Services, fewer than one in 10 girls actually get enough calcium in their diets. Studies have shown that by the teen years, girls have doubled or tripled their soft drink consumption and cut milk drinking by over 40 percent.
Encouraging kids to eat calcium-rich foods can be helped by making it convenient, such as having cheese sticks and individual yogurts on hand for a quick snack. If a child isn’t a milk drinker, parents can add milk to the diet by preparing other foods, such as oatmeal or soups, with milk in place of water. Other sources of calcium include tofu, almonds, calcium-fortified orange juice, tortillas, fortified cereals, soy beverages and broccoli.
Equally as important as calcium is Vitamin D, which helps the body to absorb calcium. Vitamin D is added to foods like milk, orange juice, yogurt and cereal, and it is present in canned tuna and salmon.
Sunlight is another source of Vitamin D. With concerns about skin cancer, people are less likely to hang out in the sun unprotected, but sunlight exposure can be as little as 10 minutes, and this helps the body make its own Vitamin D. Supplements can also help with calcium absorption, Dhanani said.
A calcium-rich diet works in tandem with exercise to strengthen bones. The exercise should be weight-bearing, but this does not mean lifting weights. Kids can take part in bone-strengthening activities that have the bones working against gravity to strengthen them.
Physical education teachers are helping with this effort in schools. “For the kids, we don’t do weight training,” said Kim Ferrie, a physical education teacher at Pashley Elementary School in Glenville and a field hockey coach for Burnt Hills-Ballston Lake Central Schools. “We use their own body strength for exercises, like pull-ups and push-ups.”
But beyond those traditional P.E. class staples, teachers seek to make the exercise fun. Ferrie and her colleagues set up stations, like a rock-climbing wall and a cargo net for kids to climb. “We have a lot of different ways to get the kids to work on their upper body strength,” she said.
Activities like running, jumping, gymnastics, dancing, tennis and other sports where bones have to work against gravity are also bone-strengthening. Mozian advocates giving kids as much exposure as possible to different forms of activities so that they can find ones that they enjoy and will be more likely to do.
Kids used to get this much-needed physical activity by playing outside. Nowadays, it seems that with structured activities, they have less time for playing than they did in generations past. Also, the lure of electronics — video games, computers, television and the like — also contributes to less outside playtime.
“It doesn’t take a lot — it could be a jump rope or kicking a ball in the yard,” said Ferrie, who gets outside and plays with her own kids at home. “We clean up after dinner and get outside — that’s how we finish our day,” she said. “Whether it’s running or jumping, those are all very good things for their bone density.”
NIAMS encourages parents to be role models with healthy eating and exercise in order to prevent osteoporosis later.
“It’s a disease with a long tail,” Mozian said. “You don’t see it until many, many years later. You can do something about it between the ages of 9 and 18.”