Increase Bone Health and Prevent Osteoporosis

Osteoporosis occurs when bone is weakened and vulnerable to fracture due to an imbalance between loss and bone formation. Losing bone mass is a fact of life. On average, men will lose 20-30% of their bone mineral, while women may lose up to 50% of their bone mineral.

Childhood is the only time where bones gain mineral and become stronger. That’s why it is crucial to maximize your child’s ability to gain bone mineral and decrease the chance of developing osteoporosis as an adult.

Children's Healthcare of Atlanta is focused on optimizing our young patients' bone health.

How to build strong bones

Understanding bone structure and function
Bone is made of the soft, organic portion (collagen) and the hard, inorganic portion (minerals). Collagen is a strong protein material whose fibers are woven together to provide bone its tensile strength. The inorganic portion is principally made of calcium and phosphate, which provides strength.

Bones store 99% of the body’s calcium. It maintains a variety of normal functions like those in the cardiovascular and musculoskeletal systems. If the body does not have enough calcium from the diet, then the body will take calcium from the bone to continue functioning normally.

Vitamin D is a hormone that enables the intestines to absorb calcium from the diet into the bloodstream. Like skin, bone is continually refreshing its cells. During childhood, bone formation occurs at a rate faster than bone loss. Between the ages of 20 to 60, bone is essentially at a steady state where bone formation and bone breakdown are occurring at equal rates. As you become older, bone loss occurs faster than the body can generate new bone.

Control over bone health
Approximately 60 to 80% of our bone mineral density is determined by our genes. Despite this, we only control only a small portion of our bone mineral makeup.

  • Diet: It is crucial that children eat the recommended daily allowance of these essential nutrients, especially Vitamin D. For adolescents, 1300 mg of calcium and 600 IU of vitamin D is recommended daily. For overall general health, a well-balanced diet is also recommended. Tables 2 and 3 list examples of foods rich in calcium and vitamin D. Keep in mind that very few foods naturally contain vitamin D.
  • Exercise: Numerous studies have demonstrated the importance of physical activity on bone health. High impact, short burst activity, such as jumping, have the greatest positive influence. Mechanically, bone that endures physical stress will adapt to its load and become stronger. For reasons not completely known, this appears to be especially true in the prepubescent child. In addition, exercise also appears to improve the body’s ability to absorb calcium.
  • Chronic illness: There are numerous reasons why ill children are at risk for weak bones. This risk depends on the illness itself. For example, a child with leukemia may have weak bones because of malnourishment due to chemotherapy, lack of exercise, and medications such as steroids which are known to be toxic to bones. A child with cerebral palsy, on the other hand, may be wheelchair dependent and at risk for weak bones due to lack of weight-bearing exercises. There are numerous other disease processes that put children at similar risks of compromised bone health.
  • Smoking: Smoking has been shown to compromise the strength of bone and should be discouraged.

Table 1 


Milligrams of calcium

Plain yogurt, 8oz


Calcium-fortified orange Juice


Mozzarella, part skin, 1.5 oz


Sardines in oil, 3 oz


Milk, 8 oz


½ cup tofu, made with calcium sulfate


Salmon, pink, canned, 3 oz


Cottage cheese, 1 cup


Table 2

Vitamin-D Rich Foods

International Units (IU) per serving

Cod liver oil, 1 tbsp


Swordfish, cooked 3 oz


Salmon, cooked, 3 oz


Tuna fish, canned, 3 oz


Orange juice, fortified, 8 oz


Milk, fortified, 8 oz


Yogurt, fortified, 6 oz