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Bone health in children & adolescents

Bone health starts early in life – in fact it begins at the foetal stage, when good maternal nutrition helps optimize the development of the baby’s skeleton.

Childhood and adolescence is a critical time for bone building. It is during this period that both the size and strength of our bones increases significantly. Approximately half of our bone mass is accumulated during adolescence, with a quarter being built up during the two-year period of fastest growth. The process continues until our mid 20s.

Although genetics will determine up to 80% of the variability in individual peak bone mass, factors such as nutritional intake and physical activity will help a child achieve optimal bone strength. This is beneficial in late adulthood as there is more bone in reserve from which to draw; unlike in their younger years adults cannot replace bone tissue as quickly as they lose it. It is believed that a 10% increase in peak bone mineral density (BMD) – one measure of bone strength – could delay the development of osteoporosis by 13 years.

Calcium and protein-rich nutrition boosts bone development

Young people aged between 9–18 years have higher calcium and protein requirements, with the peak age for bone building being 14 years in boys and 12.5 years in girls.

Milk and other dairy products provide up to 80% of dietary calcium intake for children from the second year of life onwards. Although calcium is a vital nutrient for bone development during this stage of life, children are consuming less milk than they did 10 years ago and are instead turning to sweetened beverages. This trend needs to be reversed and children encouraged to drink more milk.

Young people also need enough protein to achieve their genetic potential for peak bone mass. Studies have shown a positive link between children who were given extra servings of milk in their diets – which is high in protein – and increases in a growth factor that enhances bone formation.

Getting enough of the sunshine vitamin

Young people often don’t get enough vitamin D. This is partly due to their increasingly indoor lifestyles. By ensuring that children spend more time participating in sports and outdoor physical activity – and less time indoors in front of their computers or televisions – parents can help them maintain a healthy level of this key vitamin.

Recommended daily intake of key nutrients


Calcium RDA

Vitamin D RDA

Protein RDA

1-3 years

700 mg

600 IU

13 g

4-8 years

1200 mg

600 IU

46 g

9-13 years

1200 mg

600 IU

46 g

14-18 years

1300 mg

600 IU

girls 46 g

boys 52 g

Based on the Institute of Medicine (IOM) USA recommendations, RDA: Recommended Dietary Allowances

Exercise and lifestyle matter

Nutrition and physical activity work hand in hand to enhance bone development in people of all ages, and at no stage in life is this more important than in youth. Young people who exercise regularly show a significant increase in bone mass.

A healthy body weight during childhood and adolescence – being neither too thin nor overweight – contributes to optimal bone health. Anorexia has a serious and negative impact on BMD and skeletal strength in adolescents, while obese children are more likely to sustain fractures at the wrist.

Bone-building tips for kids

Snack on cheese, yoghurt, nuts and dried fruit

Drink milk-based beverages, fruit smoothies and mineral waters

Eat balanced meals that contain calcium and protein, as well as fruits and vegetables

Move spend time outdoors on physical activities that involve running and jumping