A bone-healthy lifestyle in the teenage years pays off

teenage girls playing football
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Parents take note: building up the ‘bone bank’ during adolescence helps prevent osteoporosis in later life.

Did you know that teens may be putting themselves at greater risk of osteoporosis in later life by not optimizing their bone health during the critical years of bone development? It’s a fact, and it’s one reason why osteoporosis has been called ‘a paediatric disease with geriatric consequences’.

The period of greatest bone growth is during puberty and adolescence: maximum bone development takes place in girls and boys roughly between the ages of 11 to 17 years. In girls, as much bone is built in the two years surrounding the first menstrual cycle as is lost in the last four decades of life.1 After around 26 years of age bone mass reaches a plateau and then, at around 35 years of age, bone mass begins to decline progressively. Adopting bone-healthy habits early in life thus optimizes the bone-building process and ensures that young people are achieving their maximum bone mass potential during their adolescence – in order to be less susceptible to osteoporosis in the future.

An excellent analogy is that of the ‘bone bank’– the more bone you save up in the bank during youth, the more bone you have to draw from later in life.

peak bone mass in men

Parents take charge – encourage a bone healthy environment

Osteoporosis is seen as an old person’s disease, so it’s not surprising that bone health is not a priority for young people – after all, when you’re 14 years old, fifty or sixty seems a long way off. Studies have shown that even young adult women who are aware of the risks and the consequences of the disease see osteoporosis as something ‘distant and not concrete’. 2

While educating young people about bone health is important, parents do really need to take the lead in promoting the kind of bone healthy lifestyle that will improve their children’s chances of enjoying a fracture-free future without osteoporosis. It’s important to note that many factors can weaken bones, some of which are out of our control, including family history and some medical conditions and treatments. However, there are many everyday lifestyle choices that can be controlled. Here are the basics parents should look for:

Getting enough calcium and vitamin D: boys and girls aged 9-18 years need 1,300 mg of calcium a day and 200 IU (5 micrograms) per day of Vitamin D. Start by serving calcium rich meals. There are easy ways to ‘sneak in’ that calcium – for example, provide cream cheese on wholegrain crackers instead of chips, or offer milk-based drinks instead of sodas. Very few foods contain vitamin D, so make sure your teens spend time outdoors getting safe exposure to sunshine.

Being physically active: children and adolescents should get at least one hour of physical activity a day. Sports which involve running and jumping are great ways to build strong bones and muscles. Many parents find that facilitating participation in competitive team sports is the easiest way to ensure regular exercise.

Maintaining a healthy weight: a normal body weight is not just good for self-esteem, it’s also good for bone health. Being both underweight (for example, anorexia) and overweight (obesity) can increase the risk of osteoporosis. Many young girls may try to lose weight to look slim, but extreme body thinness in young women can lead to estrogen deficiency and amenorrhea (cessation of menstruation). Estrogen deficiency in younger women contributes to bone loss in much the same way estrogen deficiency does after menopause.

Avoiding tobacco: studies have shown that if an adolescent is smoking, he or she will not develop maximum bone mass and will end up with a smaller skeleton and less bone mass, compared to a non-smoker1. And, although not really an issue in this age group, it should be noted that excessive alcohol use is also a danger for bone health.

Teenagers who adopt healthy diets, engage in regular physical activity and avoid bad habits won’t just reap the benefits of ‘more bone in the bone bank’, they’re hopefully learning bone-healthy behaviours that will be maintained throughout life.

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  1.  Dorn, Beal et al. (2012) Longitudinal Impact of Substance Use and Depressive Symptoms on Bone Accrual Among Girls Aged 11–19 Years. Journal of Adolescent Health, Vol. 52, Issue 4, p393–399
  2. Kasper, Peterson et al. (1994). Knowledge, Beliefs, and Behaviors Among College Women Concerning the Prevention of Osteoporosis. Arch Fam Med, 3, pp. 696-702

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