Health: A weekly column prepared by Dr Balwant Singh’s Hospital Inc.

By Dr Suhel Kotwal, MS (Orth)

Typically, when parents think of their child’s health, they don’t think about their bones. Building healthy bones by adopting healthy nutritional and lifestyle habits in childhood is important to help prevent osteoporosis and fractures later in life.

Why is childhood such an important time for bone development?
Bones are the framework of your child’s growing body. Bone is living tissue that changes constantly, with bits of old bone being removed and replaced by new bone. You can think of bone as a bank account, where (with your help) your kids make ‘deposits’ and ‘withdrawals’ from their ‘bone account.’ During childhood and adolescence, much more bone is deposited than withdrawn, as the skeleton grows both in size and density.

For most people, the amount of bone tissue in the skeleton (known as bone mass) peaks by the late twenties. At that point, bones have reached their maximum strength and density. Up to 90 per cent of peak bone mass is acquired by the age of 18 in girls and 20 in boys, which makes youth the best time for your kids to ‘invest’ in their bone health.

What is osteoporosis? Isn’t it something old people get?
Osteoporosis, the disease that causes bones to become less dense and more prone to fractures, has been called “a childhood disease with old age consequences,” because the bone mass attained in childhood and adolescence is an important determinant of lifelong skeletal health.

Osteoporosis is common in older people, but can also occur in young and middle-aged adults. Optimizing peak bone mass and developing lifelong healthy bone behaviour during youth are important ways to help prevent or minimize osteoporosis risk as an adult.

How can I help keep my kids’ bones healthy?
The same healthy habits that keep your kids going and growing will also benefit their bones. One of the best ways to encourage healthy habits in your children is to be a good role model yourself. Believe it or not, your kids are watching, and your habits, both good and bad, have a strong influence on them.
The two most important lifelong bone health habits to encourage now are proper nutrition and plenty of physical activity.

Eating for healthy bones means getting food rich in calcium and vitamin D.

Recommended Calcium Intakes*

Age                               Amount of calcium
Birth – 6 months                  210 mg
6 months – 1 year                270 mg
Children/Young Adults
1 – 3 years                           500 mg
4 – 8 years                           800 mg
9 – 18 years                         1,300 mg
Adult Women and Men
19 – 50 years                       1,000 mg
50+                                      1,200 mg
Pregnant or Lactating Women
18 years or younger             1,300 mg
19 – 50 years                       1,000 mg

Calcium is found in many foods, but the most common source is milk and other dairy products. Drinking one 8-oz glass of milk provides 300 mg (milligrams) of calcium, which is about one-third of that recommended. In addition, milk supplies other minerals and vitamins needed by the body.

But my kids don’t like milk!
Drinking milk isn’t the only way to enjoy its benefits. For example, try making oatmeal or other hot cereals with milk instead of water. Pour milk over cold cereal for breakfast or a snack. Incorporate milk into a fruit milkshake. Chocolate milk and cocoa made with milk are also ways to increase the milk in your child’s diet.
Sources of calcium also might include an ounce or two of cheese on pizza or a cheeseburger, a cup of calcium-enriched orange juice, or a small carton of yogurt. Your kids can also get calcium from dark green, leafy vegetables like pakchoy, or foods such as broccoli, almonds or tofu made with calcium. Many popular foods such as cereals, breads, and juices now have calcium added too.

Should I give my kids calcium supplements?
Experts believe calcium should come from food sources whenever possible. However, if you think your children are not getting adequate calcium from their diet, you may want to consider a calcium supplement.

How does physical activity help my kids’ bones?
Muscles get stronger when we use them. The same idea applies to bones: the more work they do, the stronger they get. Any kind of physical exercise is great for your kids, but the best ones for their bones are weight-bearing activities like walking, running, hiking, dancing, tennis, basketball and soccer. Children who tend to play outside will also have higher vitamin D levels.

The most important thing is for your kids to spend less time sitting and more time on their feet and moving. Alone or with friends, at home or at the park, one of the best gifts you can give your kids is a lifelong love for physical activity.

Bone-building activities
Field hockey
In-line skating
Lifting Weights
Jumping rope

How can I get through to my kids?
The best way to help your kids develop healthy habits for life is to be a good role model. Research suggests that active children have active parents. If you make physical activity a priority and try hard to maintain a healthy diet, including plenty of calcium, chances are your positive lifestyle will ‘rub’ on them along the way. Here are some things you can do:

  • Be a role model. Drink milk with meals, eat calcium-rich snacks, and get plenty of weight-bearing exercise.
  • Incorporate calcium-rich foods into family meals.
  • Serve fat-free or low-fat milk with meals and snacks.
  • Stock up on calcium-rich snacks that are easy for hungry children to find, such as:

Cereal with milk
Calcium-fortified orange juice

  • Limit access to soft drinks by not keeping them in the house.
  • Help your kids to find a variety of physical activities or sports.
  • Establish a firm time limit for sedentary activities such as TV, computers, and video games.
  • Teach your kids to never start smoking, as it is highly addictive and toxic.
  • Look for signs of eating disorders especially in teenage girls.
  • Talk to your child’s paediatrician about their bone health.
  • Talk to your children about their bone health, and let them know it is a priority for you.

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