Without proper attention, our bones may grow more fragile which could lead to osteoporosis if not taken care of properly throughout the years. No matter your age, it is important to pay attention to bone health, however, the way we do so depends on what stage of life we are in. Continue reading to learn how to have healthy bones at all ages and why each age range requires slightly different attention.
Bone health is important at every age and stage of life. The skeleton is our body’s storage bank for calcium — a mineral that is necessary for our bodies to function. Calcium is especially important as a building block for bone. We must get calcium from the foods we eat. If we do not have enough calcium in our diets to keep our bodies functioning, calcium is removed from where it is stored in our bones. Over time, this causes our bones to grow weaker. Loss of bone strength can lead to osteoporosis — a disorder in which bones become very fragile and more likely to break. Older adults with osteoporosis are most vulnerable to breaks in the wrist, hip, and spine. These fractures can seriously limit mobility and independence. Fortunately, there are many things we can do at every age to keep our bones strong and healthy.
Our maximum bone size and strength is called peak bone mass. Genes play a large role in how much peak bone we have. For example, the actual size and structure of a person’s skeleton is determined by genetic factors. Although peak bone mass is largely determined by our genes, there are lifestyle factors — such as diet and exercise — that can influence whether we reach our full bone mass potential.
There is a limited time that we can influence our peak bone mass. The best time to build bone density is during years of rapid growth. Childhood, adolescence, and early adulthood are the times when we can significantly increase our peak bone mass through diet and exercise. Not surprisingly, we can also make choices that decrease peak bone mass, such as smoking, poor nutrition, inactivity, and excessive alcohol intake.
Most people will reach their peak bone mass between the ages of 25 and 30. By the time we reach age 40, we slowly begin to lose bone mass. We can, however, take steps to avoid severe bone loss over time. For most of us, bone loss can be significantly slowed through proper nutrition and regular exercise.
Although everyone will lose bone with age, people who developed a higher peak bone mass when young are better protected against osteoporosis and related fractures later in life. Some people, however, are at higher risk for bone loss and osteoporosis because of problems with the way their bodies remodel bone (the continual process of removing old bone and replacing it with new bone). A healthy diet and exercise can help, but bone will still be lost at a faster rate. The good news is that in recent years, medications have been developed to treat this metabolic problem. In severe cases, bone loss may even be reversed with newer, bone-forming medications.
Gender and Peak Bone Mass
Men have a higher peak bone mass than women. Men accumulate more skeletal mass than women do during growth, and their bone width and size is greater. Because women have smaller bones with a thinner cortex and smaller diameter, they are more vulnerable to developing osteoporosis. Although men have a higher peak bone mass, they also are at risk for osteoporosis, especially after age 70 when bone loss and fracture risk increase significantly.
There are things we can do at every stage of life to ensure good bone health. Especially important is making sure we get enough calcium and Vitamin D. The sections below provide guidelines from the Food and Nutrition Board (FNB) at the Institute of Medicine of the National Academies on calcium and Vitamin D daily intake at every age for the general public.
Please note that some people may require different dosages of these supplements. For example, people who live in areas with little sun, those with darker skin, and people who are obese may need more Vitamin D than the recommended daily amount. The upper safe limit of daily vitamin D for people older than 9 years is 4000 International Units (IU), but talk to your doctor about the best dose for you. Also, be aware that taking calcium and Vitamin D at higher than recommended levels may cause adverse side effects.
Birth to Age 9
Calcium is an essential mineral for babies and young children to ensure they are able to grow strong bones and teeth. Because our bodies need Vitamin D to absorb calcium from our diets, getting enough Vitamin D goes hand-in-hand with getting enough calcium. Young children who do not get enough Vitamin D are at risk for rickets, a disease that can cause bone weakness, bowed legs, and other skeletal deformities.
First year
According to the FNB, infants, age birth to 6 months, need 200 milligrams (mg) of calcium each day, and infants, ages 7 to 12 months, 260 mg. During this first year, both breast milk and infant formula provide sufficient calcium.
The FNB daily recommendation of Vitamin D for infants from birth to 12 months is 400 IU. Although Vitamin D can be found in breast milk and infant formula, it is not in sufficient amounts. The American Academy of Pediatrics now recommends that babies take daily Vitamin D supplement drops, unless they are drinking 32 oz. of infant formula each day.
Ages 1 to 3 years
The amount of calcium and Vitamin D that a young child needs increases with age.
For children ages 1 to 3, the FNB recommended dietary allowances (RDAs) are 700 mg of calcium and 600 IU of Vitamin D. Milk is one of the best sources of calcium for children — plus a cup of milk is fortified with 100 IU of Vitamin D. Doctors recommend whole milk for children between the ages of 1 and 2 years. Lowfat and skim milk are good options after age 2.
Between 10 and 20 Years of Age
This is the stage of life when peak bone mass is established.
Puberty
Puberty is a very important time in the development of the skeleton and peak bone mass. Half of total body calcium stores in women and up to 2/3 of calcium stores in men are made during puberty. At the end of puberty, men have about 50% more body calcium than women.
On average, girls begin puberty at age 10 and start having menstrual periods at about age 12. Having a regular period is important to girls’ and women’s bone health because it indicates that sufficient estrogen is being produced. Estrogen is a hormone that improves calcium absorption in the kidneys and intestines.
The average girl grows the fastest in height between the ages of 11 and 12, and stops growing between the ages of 14 and 15. About 95% of a young woman’s peak bone mass is present by age 20, and some overall gains in mass often continue until age 30. The average boy has his fastest rate of growth in height between ages 13 and 14, and stops growing between ages 17 and 18. Peak bone mass occurs 9 to 12 months after the peak rate in height growth.
Early or late onset of puberty affects peak bone mass. Boys with late puberty generally have less bone mass for life than those who start puberty at the typical time, about age 11 1/2. Obesity delays the start of puberty in boys and, therefore, may have a negative effect on peak bone mass.
Obesity in girls, however, accelerates the onset of puberty. The effect that obesity and early puberty have on the peak bone mass is variable in girls.
Nutritional requirements
Many adolescents and young adults do not get enough calcium. Both boys and girls ages 10 to 20 need at least 1,300 mg of calcium each day, the equivalent of:
- One cup of orange juice with added calcium
- Two cups of milk
- One cup of yogurt
Other dairy products, green leafy vegetables, fish, and tofu are also good sources of calcium.
A Vitamin D supplement is necessary to ensure the calcium that adolescents do take in is absorbed in the intestines. Sodas and carbonated beverages should be avoided for many nutritional reasons, including for bone health and to prevent obesity. Sodas decrease calcium absorption in the intestines and contain empty calories. Milk, calcium-fortified juices, and water are better beverage alternatives for all age groups.
Adolescent pregnancy.
Like other adolescents, young women who are pregnant and/or breastfeeding between the ages of 14 and 18 should have 1,300 mg of calcium each day. The RDA for Vitamin D remains 600 IU, although as mentioned above, recent research supports a daily dosage of 1000 IU for better bone health.
Exercise
Weightbearing exercise during the teen years is essential to reach maximum bone strength. Examples of weightbearing exercise include walking and running, as well as team sports like soccer and basketball.
Young women who exercise excessively can lose enough weight to cause hormonal changes that stop menstrual periods (amenorrhea). This loss of estrogen can cause bone loss at a time when young women should be adding to their peak bone mass. It is important to see a doctor if there have been any menstrual cycle changes or interruptions.
Because very few foods contain substantial levels of Vitamin D, the American Academy of Pediatrics recommends that all children — from infancy through adolescence — take Vitamin D supplements.
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Original and complete article published on orthoinfo.aaos.org.
