Building Strong Bones in Kids

On a recent holiday road trip, my husband and I listened to Dr. Radio and an interview with a pediatric bone expert. I researched further and decided the topic would make a good blog article.

Picture of a human skeleton waving.

I have written a couple of times about vitamin D:

https://www.feedfuturehealth.com/post/the-latest-vitamin-d-guidelines

https://www.feedfuturehealth.com/post/vitamin-d-deficiency-why-is-it-so-prevalent

But vitamin D is only part of the story. Read on…

A few interesting facts:

1. Peak bone mass (95%) is set by age 20.

2. During the pubertal growth spurt, we acquire 57% of our bone mass due to bone lengthening.

3. Estimates indicate that about 85% of teen girls don’t get enough calcium.

4. Three out of four teens don’t get enough vitamin D. This vitamin helps absorb calcium.

5. Additional vitamins important for bone health and vitamin D absorption include vitamins C and K2.

6. Breast milk does not provide enough vitamin D for infants. The American Academy of Pediatrics recommends 400 IU (10 mcg) of vitamin D drops for breastfed babies. For ages 1 to 2 years, 600 IU of vitamin D is recommended.

7. If you don’t get enough calcium in your diet, the body takes calcium out of the bones, leading to osteopenia and osteoporosis. 

8. Exercise is critical in building and maintaining bone strength, especially weight-bearing exercises. These exercises work against gravity, such as walking, running, and jumping. Muscle-strengthening exercises are also useful. Aim for an hour a day.

9. Adequate protein intake is required to build the framework for bones.

10. Excessive soda intake, especially dark colas (regular and diet), with their high acidity due to phosphoric acid and caffeine content, can interfere with calcium absorption, especially in females. Stick with milk and water as the primary beverages. 

The growing years are critical for bone development, and this is the time to ensure your child receives all they can to build strong bones.

X-ray of the lower arm and hand showing healthy, fully developed bones.

Calcium needs by age:

Birth to 1: 200 - 250 mg 

(supplied by breast milk or infant formula)

1-3:     700 mg

4-8:    1,000 mg

9-18:  1,300 mg

Vitamin D needs:

Birth to 1: 400 IU (International units)

1-18: 600-800 IU, some may need more

Vitamin D3 is the active form of this vitamin.

What foods are highest in calcium?

Yogurt

Milk

Cheese

Calcium-fortified orange juice

Calcium-fortified cereal

Calcium-fortified tofu

Salmon

Kale

Spinach

Tums antacid is a good source of calcium, ranging from 500 to 1000 mg. These are chewable and now come in Tums Naturals, which claims to be free of artificial dyes or flavors. 

Young child drinking a glass of milk and showing his muscles. Without milk and dairy in your diet, getting enough calcium and vitamin D can be challenging.

What foods are highest in Vitamin D?

There are not many foods with naturally occurring vitamin D; most foods are fortified except,

salmon, mackerel, tuna, and trout which have the highest amount.

Egg yolks, cheese, cod liver oil, and beef liver have smaller amounts. Mushrooms contain vitamin D2.

Fortified sources include

• Dairy and non-dairy milks

• Cheeses

• Yogurt

• Cereals

• Orange juice

Almost all milk is vitamin D-fortified, but many foods made from milk products, such as ice cream, are not.

When supplementing vitamin D, look for one combined with vitamin K2.

Vitamins D and K are fat-soluble vitamins, meaning they can be stored in fat tissue. Too much of a fat-soluble vitamin can lead to toxicity, so stay within the upper limit guidelines. 

Vitamin D levels can be easily measured with a blood test. If one measures low, they may initially need a higher dose for supplementation. Levels should be measured after 2-3 months, since it takes that long to reach a steady state. 

Do what you can now to ensure strong bones later.