Preventing Osteoporosis Begins in Childhood

Osteoporosis or ‘brittle bones’ is a disease that women are particularly prone to after menopause.  It is more prevalent in women with smaller frames and less body mass. With age bones become progressively more porous and vulnerable to fracture, sometimes with as little provocation as a sneeze.

Fortunately it is a disease that seems to be largely preventable.  Three things are key to preventing osteoporosis:

  1. Adequate calcium intake in the diet throughout life.
  2. Getting enough vitamin D – either through sunshine or supplements.
  3. Exercise at least 3 times a week that begins in childhood and continues throughout life.

Growing girls should be getting about 1,000 to 1300 mg of calcium per day which is easily achieved in a healthy diet.  Calcium is found in a variety of foods – not just dairy products but also cooked green leafy vegetables such as spinach and beet greens, almonds and almond butter, tofu and sardines.  Explain the benefits of a healthy diet to children at a young age.  Involve them in shopping, meal planning and cooking so they learn from a very young age the importance of a healthy balanced diet.  If your child is a really picky eater and you want to make sure they get adequate calcium, consider a supplement.  There are a variety of good tasting chewable and liquid forms available.

Getting enough sunshine on your body for 20 minutes per day would provide you with adequate amounts of Vitamin D as your body manufactures it from the natural oils on your skin in the presence of ultraviolet light.  Sunscreens inhibit this process, as does clothing – making getting Vitamin D from the sun very tricky in this part of the world.  So supplementing with Vitamin D is fairly important.  While there is still some debate over adequate doses of Vitamin D, it is recommended that children under 10 should be getting at least 400 IU of vitamin D per day and after age 10 it should be 1,000 IU per day.  Check with your health care provider for appropriate dosages for your child.

Exercise is one of the most important ways of preventing osteoporosis and it should begin in childhood in order to maximize its effect.  Most people think of bones as being static and unchanging.  The truth is that new bone is constantly being formed as old bone is broken down.  During childhood new bone growth is greater than bone resorption or breakdown.  This happens to the greatest extent during growth periods.  The process of bone building peaks between the late 20’s and early 30’s.  After this age bone building gradually diminishes and is eventually surpassed by bone breakdown.  Bone loss is accelerated significantly after menopause unless steps are taken to halt the process.  Bone mass will remain the same if bone building and bone loss processes are equal

The best type of exercise for bone building is weight bearing exercise. That is walking, running, jumping, dancing, skating, hiking, tennis, stair climbing, soccer etc.  Any exercise that accentuates the effects of gravity on the body will increase bone density and bone strength.  While non weight bearing exercises such as cycling and swimming are of great benefit to us in other ways, they do not benefit bone density significantly.

Exercise that begins in childhood is considered to be very important because we can maximize the increase in bone mass that naturally occurs during childhood growth periods.  Think of the skeleton as a form of a bone ‘bank’ where the input of exercise and nutrients yields the highest results during childhood.  You will have more bone mass ‘accrued’ so that later in life it will provide you with more stability as you begin to lose bone tissue.

With budget cutbacks in schools, gym programmes often suffer the most.  Boys are much more likely to exercise outside of school than girls and indeed there seems to be more after school sports programmes available for boys than for girls.  It is important therefore to encourage girls get involved with exercise programmes year round.

Girls who learn to exercise regularly at a young age will be more likely to carry on this healthy habit throughout their lives. Educate your daughters at an early age about the benefits of regular exercise.  Encourage them to join you in walking, hiking, skiing, skating or at the gym. Children are more likely to exercise if the whole family is involved. For reluctant teens offering incentives such as a new bike or clothing they want may just get them off that couch and away from the computer.

Maintaining a certain frequency of exercise is essential.  Somewhat vigorous weight bearing exercise such as gymnastics, skipping, folk dancing, volleyball etc. should be done for a minimum of 30 minutes 3 times per week.  Less vigorous exercise such as walking, hiking and gentler forms of dance should be done 4 to 5 times per week.

Regular exercise benefits all children in so many ways.  They have better focus and attention during school; they sleep better at night; they generally have more self esteem and less problems with mood swings.  They are more flexible and have greater cardiovascular fitness.  And in the case of girls, they will grow up to have greater bone strength and fewer problems with bone loss as they age.

Dr. Mary Welch

Dr. Mary Welch


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