Abstract
The maximum rate of bone mass accumulation is during early adolescence. As such, a focus on optimizing mineral nutrition in school age children, defined here as approximately 5 to 15 years of age, is crucial to minimize the risk of bone loss that occurs later in life leading to osteoporosis and fractures. Optimizing bone mass in this age group requires attention to an overall healthy diet including adequate calcium, phosphorus, magnesium, and vitamin D. Special concerns may exist related to children who follow a restricted diet such as a vegan diet, those with intolerance or allergies to dairy, and those with chronic health conditions including young adolescents with eating disorders. Public policy messages should focus on positive aspects of bone health nutrition in this age group and avoid overly specific statements about the exact amounts of foods needed for healthy bones. In this regard, dietary recommendations for minerals vary between North America and Europe and these are higher than the values that may be necessary in other parts of the world. The management of many children with chronic illnesses includes the use of medications that may affect their bone mineral metabolism. Routine lab testing for bone mineral metabolism including the serum 25-hydroxyvitamin D level is not indicated, but is valuable for at-risk children, especially those with chronic illnesses.
Highlights
Bone Health in ChildrenTranslating these data into dietary intake guidance has relied upon data evaluating calcium bioavailability, including both absorptive and excretory factors
My research group evaluated whether adaptation would occur in diets commonly seen in the United States to very low calcium intake and found only partial adaptation with net calcium retention falling well below levels on higher intake [14]. This follows earlier work looking at population data suggesting that regions of a country with low calcium intakes had lower ultimate bone mass [15]
Adequacy of vitamin D status is usually assessed by measuring the serum 25-hydroxyvitamin D concentration (25-OHD) the principal physiologically active form is the 1, 25 dihydroxyvitamin D which is produced in the kidneys
Summary
Translating these data into dietary intake guidance has relied upon data evaluating calcium bioavailability, including both absorptive and excretory factors. My research group evaluated whether adaptation would occur in diets commonly seen in the United States to very low calcium intake and found only partial adaptation with net calcium retention falling well below levels on higher intake [14] This follows earlier work looking at population data suggesting that regions of a country with low calcium intakes had lower ultimate bone mass [15]. Dietary guidance needs to recognize this change and consider counseling specific to the use of calcium fortified non-dairy products (e.g., orange juice, soy, and vegetable milk-type products) and other dairy products including yogurt that are increasing popular with this age group Taken together, these data indicate the importance of calcium nutriture in school age children, especially during peak bone growth of puberty, typically about 9 to 14 years of age. They indicate caution in overinterpreting intake data both due to weakness in the available data, lack of data on populations with lower usual intake and relatively little long-term data clearly demonstrating benefits to high intakes in all populations
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
