Nutrition and Bone Health in Kids

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More often than not when parents ponder over their child’s physical well-being they tend to skip over ‘bone health’ altogether. It is because we do not link bone issues with childhood and assume it is something that will happen gradually. However, what your child eats and the amount of nutrition he/she consumes directly affects their bone density, ability to prevent osteoporosis and fractures later in life. Osteoporosis has been termed as a ‘childhood disease with adulthood symptoms’ which means the onset of osteoporosis depends on the bone mass your children attain during their childhood and adolescent years. The habits that your children are imparting in their lives right now can eventually make or break their bones with time in future.

Bone development in childhood:

Bones are the building blocks of your child’s growing body. Not many people are aware of this but bone is a living tissue that changes constantly; bits of old bone gets replaced by new one’s frequently. During childhood and adolescence, much more bone is deposited than withdrawn as the skeleton grows in both size and density.

Bone mass (amount of bone tissue in the skeleton) usually peaks in the late 20s; which means bones reach their maximum strength and density by then. Around 90% of bone mass is acquired in girls by the age of 18 whereas; the same is acquired among guys in their early 20s. This makes the youth phase the best time to invest in the bone health.

Factors affecting peak bone mass:

  • Gender: gender plays a very vital role in determining bone density as men have higher bone mass as compared to women. Before puberty it is same for both girls and boys however, after puberty boys tend to acquire greater bone mass than girls.
  • Hormonal factors: Sex hormones, including oestrogen and testosterone, are essential for the development of bone mass. Girls who start to menstruate at an early age typically have greater bone density. Those who frequently miss their menstrual periods sometimes have lower bone density.
  • Nutritional status: a well-balanced diet that consists of everything especially calcium, magnesium, zinc and Vitamin D is very important. Kids who do not eat good food are likely to develop bone and other health related issues in the future.
  • Physical activity: being physically active is a must for healthy bones. It provides a lot of benefits especially when it comes to hips, arms and thighs.

Influence of macronutrients and micronutrients in bone health:

Calcium: calcium is vital for bones since it is the structural component of the bone and is built into bone as a mineral complex. Skeleton’s house as good as 99% of our total body’s calcium. Calcium built into the bones also tends to act like calcium reservoirs for maintaining calcium levels in blood. It is further used by the small intestine by passive diffusion and also plays an important role when it comes to nerve and muscle functions. It is important for your child to consume healthy food that is rich in calcium. Dairy is the main source of calcium in diet, apart from that broccoli, kale, fish and nuts can also be a great addition in your child’s diet.

What if my child is lactose intolerant?

There are some calcium fortified food products available in the market; such as breads, fruit juices, almond milk, soy beverages and cereal. Recently certain brands of mineral water have also started diffusing calcium in them. These food alternatives can be a great source for people who are vegan or lactose-intolerant.

Calcium Supplements:

Experts believe that one should avoid taking calcium supplements and try hard enough to eat healthy food that can help them attain that amount. However, if you believe that your child isn’t getting enough calcium through his/her diet then supplements might be beneficial. They should be taken after the guidance of a doctor and shouldn’t exceed 500-600 mg per day. Calcium is often combined with Vitamin D for best results.

Protein and other nutrients:

  • Protein:

Protein plays a key role in bone mass acquisition. Under nutrition including less protein intake can severely affect the bone development. Action and production of insulin is also dependent upon protein intake and can hamper growth factor (IGF-1) that focuses on enhancing bone formation. During growth and pubertal maturation, impaired production and action of IGF-1 due to low protein intake may result in reduced bone development.

  • Magnesium:

Just like calcium, our skeleton’s house nearly 99% of the body’s magnesium. While the lack of magnesium isn’t a common phenomenon and happens only with undernourished population, it is important to note that with time our body stops absorbing magnesium and this can put adults at the risk of magnesium deficiency. It is important to include things like green vegetables, nuts, fruits and legumes from a young age to prevent any complications with time.

  • Zinc:

When it comes to bone tissue renewal mineralization zinc is a necessity. Severe deficiency is usually associated with calorie and protein malnutrition and has been reported to be common in community-dwelling older people. Sources of zinc include lean red meat, poultry, whole grain cereals, pulses, legumes and dried fruit. 

Other Nutritional Factors:

  • Caffeine:

Youth these days is highly dependent of caffeine. Caffeine leads to urinary and faecal loss of calcium which can severely affect your health if you are already consuming a low calcium diet which is why it is important for you to cut down on your caffeine intake. This is not limited to the consumption of coffee but other things such as caffeinated drinks, chocolate, green tea, energy drinks, cola etc.

  • Low BMI:

A lot of children especially female are below the prescribed Body Mass Index. A BMI below 19 is not only dangerous for your child’s health but also puts your child at a risk of developing bone problems such as osteoporosis at a later stage in life.

  • Effects of steroid:

There are a lot of kids out there who have medical complications (such as asthma) that compels them to take certain medications that can possibly hinder the absorption of calcium in food. Such kids need to take extra care of their bones and the parents should positively talk to the doctor to find out if they can give their child calcium supplements.

Dr. Ratnav Ratan
Dr. Ratnav Ratan
Pediatric Orthopedist and Sports Medicine specialist​

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