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Early Prevention of Osteoporosis 

The only cure for osteoporosis is prevention. Most people think osteoporosis is a disease of the elderly because people lose bone mass as they age. Bones grow in size and strength during childhood and are the framework for a growing body. Bones are living tissue that change constantly, with bits of old bone being removed and replaced by new bone. Think of bone as a bank account, where "deposits" and "withdrawals" of bone tissue are made. During childhood and adolescence, much more bone is deposited than withdrawn as the skeleton grows in both size and density. 

Peak bone mass is a major determinant for the risk of osteoporosis.  The amount of bone mass in the skeleton can continue to increase until a child reaches his/her mid-20s. At that point, bones have reached their maximum strength and density, or peak bone mass. The amount of bone mass attained during this early period helps determine skeletal health throughout life. Up to 90 percent of peak bone mass is acquired by age 18 in girls and age 20 in boys, which makes youth the best time for kids to "invest" in their bone health. 

Factors Affecting Peak Bone Mass

Bone mass is influenced by a variety of factors--some that you can't change, like gender and race, and some that you can, like nutrition, physical activity and avoidance of certain bad habits.

Gender: Bone mass or density is generally higher in men than in women. Before puberty, boys and girls develop bone mass at similar rates. After puberty, however, boys tend to acquire greater bone mass than girls. 

Race: For reasons still not well understood, African American girls tend to achieve higher peak bone mass than Caucasian girls, and African American women are at lower risk for osteoporosis later in life. However, because all women, regardless of race, are at significant risk for osteoporosis, girls of all races need to build as much bone as possible to protect against this disease. 

Hormonal Factors: Sex hormones, including estrogen 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: Development of healthy eating habits during childhood will translate into healthy eating habits during adulthood. All tissues, including bone, need a balanced diet, adequate calories, and appropriate nutrients to develop. Calcium is an essential nutrient for bone health. In fact, calcium deficiencies in young people can account for a 5-10% lower peak bone mass and may increase the risk for bone fracture in later life. 

Calcium: is the specific nutrient most important for attaining peak bone mass and for preventing and treating osteoporosis. Vitamin D is required for the body to absorb calcium effectively and is also important for bone health. Most infants and young children in the United States get enough vitamin D from fortified milk. But adolescents don’t consume as many dairy products, and may not get an adequate level of vitamin D. In particular, diets and fasting in pursuit of thinness may impact adequate nutrition and bone health, especially among girls. 

Physical Activity: Weight bearing physical activity is important for building healthy bones. The benefits of activity are most pronounced in the areas of the skeleton that bear the most weight, such as the hips during walking and running, the arms during gymnastics and the upper-body during weightlifting. Weight bearing exercise helps remodel the bone, enabling it to support added stresses. Physical activity must be continued throughout ones life in order to maintain the remodeling process. 

Cigarette Smoking: Avoidance of cigarette smoking, which usually starts during late childhood or early adolescence, is of utmost importance. Cigarette smoke can have a deleterious effect on achieving bone mass. Cigarette smoking was first identified as a risk factor for osteoporosis more than 20 years ago. A relationship between cigarette smoking and low bone density in adolescence and early adulthood has been identified.

Avoidance of Soft Drinks: Soft drinks, such as soda, tend to displace calcium-rich beverages in the diets of many children and adolescents. Those who drink soft drinks consume much less calcium than those who do not. Recent research showed that soda is replacing milk as the drink of choice.

Falling Short

According to many experts, a “calcium crisis” is affecting American youth. Only 13.5 % of girls and 36.3 % of boys ages 12 to 19 get the recommended intake of calcium from their diets. Kids aged 5-8 require 800 mg of calcium daily and that amount jumps to 1300 mg for those aged 9-19. 

In addition to calcium, many children and adolescents are not receiving the recommended amount of vitamin D. It is estimated that 30% or more may be deficient. Vitamin D deficiency may be caused in part by a lack of Ultraviolet rays. Ultraviolet rays interact with chemicals in the skin to produce vitamin D. Kids today tend to favor indoor activities such as video games and television, and many shun vitamin D-fortified milk in favor of soda. When they do venture out, they are often slathered with sunscreen.

Kids are loading up on foods relatively low in nutrients, placing them at risk for deficiencies in other vitamins and minerals important for not only bone health, but for their overall health. Other vitamins and minerals important for bone health include:

Vitamin A is necessary for normal bone remodeling. In people with a vitamin A deficiency, new bone forms faster than old bone can be removed and abnormal bone formation occurs. Milk, eggs and liver are good sources of vitamin A.

Vitamin B12 combines with folic acid, iron, copper and vitamin C to improve hematopoiesis (production of red blood cells) in the bone marrow. 

Vitamin C promotes the formation of collagen, which is used in organic bone matrix formation, and aids in the synthesis of structural proteins found in bone. It is an antioxidant that acts to prevent free radical formation and cell damage. Well-known sources of vitamin C are citrus fruits; other sources include deep green leafy vegetables and potatoes.

Vitamin K plays a key role in the synthesis of a key bone protein, osteocalcin. Osteocalcin improves the attachment of bone-resorbing cells to bone and supports bone remodeling. Vitamin K is found in green leafy vegetables (also good calcium sources), and many other foods. 

Vitamin E is an antioxidant that preserves essential cellular constituents. 

Folic acid is important for tissue growth and proper cell division and replication. Folic acid works in tandem with vitamins B12 and C in several metabolic processes, including production of blood cells in the bone marrow. 

Iron is an essential part of red blood cell production.

Magnesium is necessary for calcium metabolism into bone and essential in muscle function.

Zinc is required for proper functioning of enzyme systems in the body and important for tissue renewal and skeletal development. Zinc levels tend to be low in menopausal women.

Copper is part of proteins and enzymes linked with red blood cell function. Plays a role in helping form the connective structures of bones and enhances the effectiveness of vitamin D. Copper levels tend to be low in menopausal women.

Healthy Bones….A Lifelong Commitment

Beginning a lifelong commitment to exercise and healthy nutrition while you are still young will reduce your risk of developing osteoporosis later in life. While proper nutrition and exercise are important during the bone building years, it is no less important as you get older. It may be necessary to take a supplement increase your intake of certain vitamins and minerals important for bone health.

Healthy lifestyle behaviors learned during childhood and adolescence will follow through into adulthood making way for healthier bones and a decreased risk for osteoporosis.

Note: All information on this website is intended for your general knowledge only and is not a substitute for medical advice or treatment for a specific medical condition. Please consult your physician if you have questions or concerns regarding your health.
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