Osteoporosis, a disease of increased bone fragility,
is often thought of as a disorder that primarily affects the elderly, but the
origins of this condition are established in early childhood and adolescence.
In a new clinical report, “Optimizing Bone Health in Children and Adolescents
in the October 2014 Pediatrics (published online Sept. 29), the American
Academy of Pediatrics (AAP) discusses strategies pediatricians can use in
health care visits to optimize children’s bone health. According to the AAP,
the primary source of nutrition for healthy infants should continue to be human
milk, or infant formula if human milk is not available. After the first year of
life, the main source of dietary calcium is milk and other dairy products,
which combined account for 70 to 80 percent of dietary calcium intake. The AAP
recommends that pediatricians encourage children and adolescents to increase
their daily intake of calcium and vitamin D-containing foods and beverages.
This can include nonfat milk and low-fat yogurts, both good sources of calcium.
The AAP supports the higher recommended dietary allowance for vitamin D
recommended by the Institute of Medicine but does not suggest universal
screening for vitamin D deficiency in healthy children. Screening for vitamin D
deficiency should be targeted at children and adolescents with recurrent
low-impact fractures or those with medical conditions associated with reduced
bone mineral density. Pediatricians should also ask about the type and amount
of exercise children are receiving, and encourage weight-bearing activities
such as walking, dancing and running to help optimize bone health throughout
childhood and adolescence.
The American Academy of Pediatrics is an
organization of 62,000 primary care pediatricians, pediatric medical
subspecialists and pediatric surgical specialists dedicated to the health,
safety and well-being of infants, children, adolescents and young adults. For
more information, visit www.aap.org