Timothy Woods, MD
In recognition of National Osteoporosis month Dr. Timothy Woods from Bitterroot
Orthopedics and Sports Medicine wanted to share an article from the American
Academy of Orthopaedic Surgeons on how to help prevent osteoporosis before
As people age, their bones may become very weak and fragile - a condition
called osteoporosis. It often develops unnoticed over many years, with
no symptoms or discomfort until a bone breaks.
Fortunately, there are many things that people at all stages of life can
do to build strong, healthy bones. Childhood and adolescence are especially
important times for building bones and developing habits that support
good bone health for life.
Healthy Bones Begin in Childhood
Bones grow in size during childhood, gaining mass and strength. The amount
of bone mass you obtain while you are young determines your skeletal health
for the rest of your life. The more bone mass you have after adolescence,
the more protection you have against losing bone mass later.
Calcium and Nutrition
Good nutrition is vital for normal growth. Like all tissues, bone needs
a balanced diet, enough calories, and appropriate nutrients, such as calcium.
But not everyone follows a diet that is best for bone health. For example,
the Institute of Medicine recommends a calcium intake for children ages
9 to 18 years of 1,300 mg/day (1,000 mg/day for children ages 4 to 8 years).
Many children, however, have diets that do not meet this recommendation.
Calcium is the most important nutrient for reaching peak bone mass. It
prevents and treats osteoporosis. Calcium is not made in the body - it
must be absorbed from the foods we eat. To effectively absorb calcium
from food, our bodies need Vitamin D.
Vitamin D can come from diet or exposure to sunlight. Before the development
of fortified milk, lack of dietary Vitamin D caused rickets-a softening
of the bones. Although rare in Western societies today, some children
still develop rickets.
Most infants and young children in the United States get enough Vitamin
D from fortified milk, but adolescents typically do not consume as many
dairy products, and few foods contain substantial levels of the vitamin.
Although exposure to sunlight can help our bodies make Vitamin D, it is
not a practical or safe way for children to obtain the vitamin. To reduce
the risk for skin cancer, it is important for children to wear sunscreen
when playing outdoors. Because sunscreen blocks the absorption of Vitamin
D, even children who spend a great deal of time outdoors may not meet
their Vitamin D needs.
In addition, dieting and fasting to be thin may also harm nutrition and
bone health. As a result, many children - especially adolescents - may
not get adequate levels of Vitamin D. For children and teens to safely
get the Vitamin D their bodies need, it may be helpful to take Vitamin
D supplements. Talk to your doctor about whether Vitamin D supplements
Sports and exercise are healthy activities for people of all ages. Weight-bearing
exercise during the teen years is essential to reach maximum bone strength.
Examples of weight-bearing exercise include walking and running, as well
as team sports like soccer and basketball.
Occasionally, a female athlete who focuses on being thin or lightweight
may eat too little or exercise too much. 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.
Risk Factors for Poor Bone Health
Several groups of children and adolescents are at greater risk for poor
bone health, including:
- Premature infants and infants with low birth weight who have lower than
expected bone mass in the first few months of life.
- Children who take medications, such as steroids, to treat respiratory diseases
- Children who have cystic fibrosis, celiac disease, and inflammatory bowel
disease. These conditions make it difficult for the body to absorb nutrients
- Adolescent girls who have minimal, delayed, or irregular menstrual cycles
because of strenuous athletic training, emotional stress, or low body weight.
- Children with cerebral palsy and other conditions that place limits on
physical activity, especially those who take chronic medications for seizure control.
- Children and adolescents who lead inactive, sedentary lifestyles.
Childhood obesity may also play a role in reducing bone density, but more
research is needed to separate the roles of other factors including diet,
race, ethnicity, lifestyle, and sun exposure.
Research is currently being done on ways to maximize peak bone mass in
children but, for now, parents and children alike can benefit from the
- Make sure you get enough calcium and Vitamin D throughout your life.
- Exercise regularly and choose weight-bearing activities like walking and running.
- Eat a healthy diet and lead a healthy lifestyle.
- Do not smoke. Cigarette smoking often starts in childhood and has a harmful
effect on reaching peak bone mass.
Reference: from the American Academy of Orthopaedic Surgeons -
Join us at Marcus Daly Memorial Hospital for a free Cholesterol Screening
and Health Fair on Saturday, May 9, 2015 from 7:00am to Noon. For more
Questions and or comments regarding this week's health column please
contact Timothy Woods, MD at Bitterroot Orthopedics and Sports Medicine,
1200 Westwood Drive, Hamilton, MT 59840. Working together to build a healthier