Our knowledge of orthopaedics. Your best health.

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 and Vitamin D. But not everyone's diet is best for bone health.

For example, the Institute of Medicine recommends: 

• A calcium intake of 1,300 mg/day for children ages 9 to 18 years, and 1,000 mg/day for children ages 4 to 8 years.
• A Vitamin D intake of at least 400IU/day for children from birth to 1 years, and 600IU/day for children older than 1 year.

Many children, however, have diets that do not meet these recommendations.

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 U.S. get enough Vitamin D from fortified milk.
• Infants who are breastfed must be supplemented with Vitamin D because breastmilk does not contain Vitamin D.
• Children and adolescents who do not do not consume dairy products may also need supplementation since few foods contain high enough levels of the vitamin.
• Exposure to sunlight can help our bodies make Vitamin D; however, it is not always a practical solution, especially in areas that experience a winter climate. (To reduce the risk for skin cancer, it is important for children to wear sunscreen when playing outdoors; research has shown that sunscreen does not lead to lower Vitamin D levels in the body.)
• Dieting and fasting can 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 are needed.

Exercise

Sports and exercise are healthy activities for people of all ages. 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.

Occasionally, female athletes who focus 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.