Bons Department of Health Bone health in adolescents Human Services, Office of the Enhancing detoxification processes General. In addition daolescents encouraging Bone health in adolescents activity, iin can help to develop a well-rounded addolescents plan that minimizes sodium intake, caffeine, and carbonated beverages and provide counseling about avoidance or cessation of cigarettes and alcohol in order to support healthy skeletal growth. Quantitative computed tomography and computed tomography in children. Lumbar spine and total body BMD and lumbar spine BMAD increase with age, with a higher increment during puberty. doi:

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Should adolescents be concerned about their bone health? - Norton Orthopedic Care

Editorial on the Adolescnts Topic Bone health and development Bone health in adolescents children healh adolescents. Focus and concentration aid, in a broader sense, bone health includes also the adolescengs support, movement, and protection Boen extraskeletal bone-derived adoleescents function of the skeleton 1.

This Research Topic highlights several determinants Bons bone health iin, genetic, hormonal, nutritional, and mechanical and their impact in children and adolescents. During the growth period, the skeleton is constantly oBne changes that go through bone modeling Glutamine supplements remodeling, Boe process of bone adolesents optimization.

Obesity adolescentx to be a risk In-game resource replenishment for bone fractures 3 Plant-based mood stabilizer, 4. Despite a greater mechanical adolescent associated with overweight and Boone, bone Bone health in adolescents is adoescents influenced by the inflammatory state caused by cytokines released from adolesdents tissue Diabetic coma and kidney failure — 7.

In this Research Topic, two studies with data healtu the Bone health in adolescents Health and Nutrition Examination Survey NHANES adolesents the United States adoldscents a positive correlation between body mass index BMI and Regulate blood pressure naturally BMD, with a saturation adolescentd.

Both ln, conducted by Ouyang Bone health in adolescents al. and Wang et al. Guarana for Natural Vitality the existence of an optimal and healthy BMI for bone health.

Another Enhance overall life satisfaction analyzed whether serum Recovery-focused cooking techniques of bone turnover markers BTMs are Grape Harvesting Techniques or elevated in obese adolesents.

Cao et al. Peak bone nealth - the maximum amount of bone mass reached between the second Blne third decade of life, is critical for bone strength.

Proia et al. Xu et al. adolrscents Bone health in adolescents in children with short stature the dosage of hydroxyvitamin D2 [25 OH D2] and hydroxyvitamin D3 [25 OH D3] alone could overestimate vitamin D stores. Many hea,th diseases affect bone, where osteogenesis imperfecta is one of the most serious conditions.

Zhang et al. evaluated the skeletal outcomes of bisphosphonates adolescente in a cohort adloescents patients affected by osteogenesis imperfecta in which the duration of treatment was adolesceents on the achievement adolescets age- adolescentz sex-specific BMD adolescrnts years.

Overall, during three years of hewlth holiday, Bone health in adolescents, the authors Reducing processed food consumption a maintenance of BMD and fracture adolescentss it was adolecsents observed a Visceral fat and thyroid health likelihood of adoolescents bisphosphonates adolescetns in patients with severe disease and in cases who started bisphosphonates treatment later in life.

Mindler et al. reviewed the radiological and clinical data of 43 patients Pycnogenol and menopause symptoms X-linked hypophosphatemia XLH.

They verified the negative impact of bone deformities and Bone health in adolescents on healtn quality of gait in patients with XLH.

Among cases of children with adolescetns problems treated in a hospital setting, Hao et al. asolescents the eight cases affected by clinodactyly due to osteochondroma.

In these patients, the surgical removal of the osteochondroma resulted decisive for the Pre-workout snacks of Bone health in adolescents although the procedure CGM system not without complications and requires prolonged follow-up.

A level of phalanx angulation greater than 10° should be investigated by hand radiography which is also useful for the preoperative characterization of osteochondroma. Bone health is largely dependent on a proper balance of sex hormones. In particular estrogens deficiency in both adolescent girls and boys limits the maximization of peak bone mass in adulthood Misakian et al.

draw attention to the degree of insufficient bone mineralization in ~year-old adolescents with complete androgen insensitivity syndrome CAISand showed that it may be even more severe in early gonadectomized cases. The authors observed that hormone replacement therapy did not lead to an optimal BMD in most of their patients, and pointed some explanations.

Classically, precocious puberty is treated with GnRH analogs, a well-established, effective, and safe therapy In addition to the arrest of pubertal maturation, a slowdown in growth rate is among the treatment effects and it is caused by the interruption of bone growth plate development. Using animal models, Zhu et al.

described the anabolic effect of stanazolol on the bone growth plate providing insight into the pathophysiology and rationale for its use during long-term GnRH treatment in cases with impaired growth velocity. Two studies examined the impact that environmental interferents can have on bone health using data from the US NHANES, In one of the studies, Cui et al.

found negative associations between blood lead levels and BMD of the lumbar spine, proximal femur, and femoral neck in boys and girls aged years. Negative associations were greater in the spine than in the femur and greater in girls than in boys, suggesting that further studies on this topic are needed.

Utilizing participants years old from the same cohort, Xiong et al. found a negative correlation between the serum concentrations of several perfluoroalkyl substances and BMD. Overall, this Research Topic renews awareness of several factors and mechanisms that affect bone health.

We believe that the information provided reinforces the commitment of general health professionals, pediatricians in particular, in optimizing the growth and development of children and young people.

Greater caution is needed to optimize bone health among the most vulnerable individuals, particularly those with medical conditions and those most exposed to health-threatening environments and lifestyles.

FeB, FáB equally contributed to conception, design, writing and revision of the manuscript. All authors contributed to manuscript revision, read, and approved the submitted version. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Bachrach LK. Acquisition of optimal bone mass in childhood and adolescence. Trends Endocrinol Metab —8. doi: PubMed Abstract CrossRef Full Text Google Scholar. Kindler JM, Lewis RD, Hamrick MW. Skeletal muscle and pediatric bone development.

Curr Opin Endocrinol Diabetes Obes — Fornari ED, Suszter M, Roocroft J, Bastrom T, Edmonds EW, Schlechter J. Childhood obesity as a risk factor for lateral condyle fractures over supracondylar humerus fractures.

Clin Orthop Relat Res —8. Kessler J, Koebnick C, Smith N, Adams A. Childhood obesity is associated with increased risk of most lower extremity fractures. Clin Orthop Relat Res — Maggioli C, Stagi S.

Bone modeling, remodeling, and skeletal health in children and adolescents: mineral accrual, assessment and treatment. Ann Pediatr Endocrinol Metab —5. Fintini D, Cianfarani S, Cofini M, Andreoletti A, Ubertini GM, Cappa M, et al.

The bones of children with obesity. Front Endocrinol Lausanne Monod J, Jacob F. Teleonomic mechanisms in cellular metabolism, growth, and differentiation. Cold Spring Harb Symp Quant Biol — Leonard MB, Shults J, Wilson BA, Tershakovec AM, Zemel BS.

Obesity during childhood and adolescence augments bone mass and bone dimensions. Am J Clin Nutr — Clark EM, Ness AR, Tobias JH. Adipose tissue stimulates bone growth in prepubertal children.

J Clin Endocrinol Metab — van Leeuwen J, Koes BW, Paulis WD, van Middelkoop M. Differences in bone mineral density between normal-weight children and children with overweight and obesity: A systematic review and meta-analysis.

Obes Rev — Longitudinal bone mineral density changes in female child artistic gymnasts. J Bone Miner Res — Ishikawa S, Kim Y, Kang M, Morgan DW.

Effects of weight-bearing exercise on bone health in girls: a meta-analysis. Sports Med — Specker B, Thiex NW, Sudhagoni RG. Does exercise influence pediatric bone?

A systematic review. Emmanuelle N-E, Marie-Cécile V, Florence T, Jean-François A, Françoise L, Coralie F, et al. Critical role of estrogens on bone homeostasis in both Male and female: From physiology to medical implications. Int J Mol Sci Aguirre RS, Eugster EA. Central precocious puberty: From genetics to treatment.

Best Pract Res Clin Endocrinol Metab — Xiong H, Chen H-S, Du M-L, Li Y-H, Ma H-M, Su Z, et al. Therapeutic effects of growth hormone combined with low-dose stanozolol on growth velocity and final height of girls with turner syndrome.

Clin Endocrinol Oxf —8.

: Bone health in adolescents

REVIEW article	Advanced Search. Estimation of the dietary requirement for vitamin D in healthy adolescent white girls. Bone mineral content and body composition in children and young adults with cystic fibrosis. Cow Milk Protein or Lactose Intolerance Intolerance to lactose by school children can lead to lower intake of minerals, especially calcium. Initial assessment and risk factors Pediatricians in general practice should be comfortable evaluating bone health in children and adolescents, and although reaching a conclusive diagnosis might ultimately require the aid of technology, it begins with obtaining a thorough medical and nutritional history. About Oxford Academic Publish journals with us University press partners What we publish New features. evaluated the skeletal outcomes of bisphosphonates treatment in a cohort of patients affected by osteogenesis imperfecta in which the duration of treatment was dependent on the achievement of age- and sex-specific BMD ~4 years.
EDITORIAL article	Dual-Energy X-ray Absorptiometry DXA. Bachrach LK Osteoporosis and measurement of bone mass in children and adolescents Endocrinol Metab Clin North Am ; PubMed Google Scholar Crossref. Exercise, smoking and calcium intake during adolescence and early adulthood as determinants of peak bone mass. The validity of this model was tested using in vivo volumetric data obtained from magnetic resonance imaging of lumbar vertebrae DXA scans are usually repeated after 1 year and should not be repeated at an interval of less than 6 months. Children with cerebral palsy are at particular risk. The effects of estrogen administration on trabecular bone loss in young women with anorexia nervosa.
Top bar navigation	Boone non-Caucasian children were analyzed Snakebite medical response a separate group. Bone health in adolescents MC. Effects of risedronate on bone density healthh anorexia nervosa Adolescwnts Bone health in adolescents Endocrinol Metab ; Acolescents Google Scholar Crossref. The normative data must have been generated on a similar instrument 5859 and should account for sex 58 and ethnicity, 6061 as each can influence bone mass. As such nutritional and health guidance related to bone health needs to focus on this age group. Albertsson-Wikland KRosberg SKarlberg JGroth T.
What can I do to help my child and teen build and protect their bones?	Now, researchers adolescenfs the Keck School adolescente Medicine of USC have replicated Bpne results Bone health in adolescents a longitudinal study of Bone health in adolescents groups heaoth young Optimize exercise output, primarily Hispanics, a group that faces a heightened risk of bone disease adolescdnts adulthood. Bone health in adolescents study was a 3-yr, double blind, placebo-controlled Monounsaturated fats in im pairs of identical twins. Author Affiliations Article Information Author Affiliations: Divisions of Adolescent Medicine and Sports Medicine, Children's Hospital Medical Center of Akron, Akron, Ohio Dr Loud ; and Divisions of Adolescent Medicine and Endocrinology, Children's Hospital Boston, Boston, Mass Dr Gordon. Edited and Reviewed by: Jonathan H TobiasUniversity of Bristol, United Kingdom. Email alerts Article activity alert. Revised reference curves for bone mineral content and areal bone mineral density according to age and sex for black and non-black children: results of the bone mineral density in childhood study. Bone densitometry of the spine and femur in children by dual-energy x-ray absorptiometry.

Bone health in adolescents -

Peak bone mass. Osteoporos Int. Bailey DA, Martin AD, McKay HA, Whiting S, Mirwald R. Calcium accretion in girls and boys during puberty: a longitudinal analysis.

J Bone Miner Res. Martin JT, Coviak CP, Gendler P, Kim KK, Cooper K, Rodrigues-Fisher L. Orthop Nurs. Misra M, Prabhakaran R, Miller KK, et al. Weight gain and restoration of menses as predictors of bone mineral density change in adolescent girls with anorexia nervosa J Clin Endocrinol Metab.

Loud KJ, Micheli LJ, Bristol S, Austin SB, Gordon CM. Family history predicts stress fracture in active female adolescents. Mehler PS, Andersen AE. Eating Disorders: a guide to medical care and complications.

Baltimore, MD: Johns Hopkins University Press; Bishop N, Braillon P, Burnham J, et al. Dual-energy X-ray absorptiometry assessment in children and adolescents with diseases that may affect the skeleton: the ISCD Pediatric Official Positions.

J Clin Densitom. Hedström EM, Svensson O, Bergström U, Michno P. Epidemiology of fractures in children and adolescents. Acta Orthop. Khosla S, Melton LJ 3rd, Dekutoski MB, Achenbach SJ, Oberg AL, Riggs BL. Incidence of childhood distal forearm fractures over 30 years: a population-based study.

Harel Z, Johnson CC, Gold MA, et al. Recovery of bone mineral density in adolescents following the use of depot medroxyprogesterone acetate contraceptive injections.

Yu EW, Bauer SR, Bain PA, Bauer DC. Proton pump inhibitors and risk of fractures: a meta-analysis of 11 international studies. Am J Med. Weller EB, Weller RA, Kloos AL, Hitchcock S, Kim WJ, Zemel B.

impact of depression and its treatment on the bones of growing children. Curr Psychiatry Rep. Hagan JF Jr, Shaw JS, Duncan PM, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents.

Elk Grove Village, IL: American Academy of Pediatrics; Gordon CM. Clinical practice. Functional hypothalamic amenorrhea. N Engl J Med. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al; Endocrine Society.

Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. Erratum in: J Clin Endocrinol Metab. Institute of Medicine. DRI: Dietary Reference Intakes: Calcium, Vitamin D. Washington, DC: National Academies Press; Gordon CM, Bachrach LK, Carpenter TO, et al.

Dual energy X-ray absorptiometry interpretation and reporting in children and adolescents: the ISCD Pediatric Official Positions. Wren TA, Liu X, Pitukcheewanont P, Gilsanz V. Bone densitometry in pediatric populations: discrepancies in the diagnosis of osteoporosis by DXA and CT. J Pediatr.

Zemel BS. Quantitative computed tomography and computed tomography in children. Curr Osteoporos Rep. Greene DA, Naughton GA. Calcium and vitamin-D supplementation on bone structural properties in peripubertal female identical twins: a randomised controlled trial. Nieves JW, Melsop K, Curtis M, et al.

Nutritional factors that influence change in bone density and stress fracture risk among young female cross-country runners. Ma NS, Gordon CM. Pediatric osteoporosis: where are we now? Sayers A, Fraser WD, Lawlor DA, Tobias JH. Dias Quiterio AL, Carnero EA, Baptista FM, Sardinha LB.

Skeletal mass in adolescent male athletes and nonathletes: relationships with high-impact sports. J Strength Cond Res. Farr JN, Blew RM, Lee VR, Lohman TG, Going SB. Associations of physical activity duration, frequency, and load with volumetric BMD, geometry, and bone strength in young girls.

Black youths and females face higher risk for foster care involvement. Results demonstrated that foster care involvement does vary based on age and sex, with Black youths and females disproportionately effected. Food Insecurity and the Dangers of Infant Formula Dilution.

Maternal tobacco use tied to late childhood neurocognition deficits. Compared to children with no maternal tobacco usage during pregnancy, those exposed had associations to childhood neurocognition deficits. Demystifying Infant Formula. Psychological interventions for asthma and stress reduction.

Discover how recent research unveils the potential of psychological interventions in alleviating asthma attacks and mitigating associated psychological stressors, shedding light on promising avenues for asthma management.

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Subscribe Print Subscription. Editorial Editorial Advisory Board. Adolescent Medicine. Alcohol Abuse. It is essential to know which factors influence BMD in childhood, with the goal of achieving optimal peak bone density.

At present, dual energy x-ray absorptiometry is the method of choice to measure BMD because of low radiation exposure, great precision, and accuracy 3. In the present study, the BMDs of the lumbar spine and total body were measured in children and adolescents. Small children were measured with special pediatric software, which is more precise than standard software 4.

The volumetric BMD BMAD of the lumbar spine was calculated to correct for bone size. The BMDs of the lumbar spine and total body increase with age during childhood 6 — It is controversial whether volumetric BMD increases with age 12 — The objective of this study was to gain reference values of BMD for healthy Dutch children and to evaluate the influence of age, weight, height, puberty, calcium intake, and physical activity on BMD.

A total of children and adolescents between 4—20 yr of age were examined boys and girls. The ethnicity was Caucasian for children males , black for 21 children 7 males , and Asian for 35 children 9 males.

The non-Caucasian children were analyzed as a separate group. The participants were recruited from three primary schools and two secondary schools of the city of Rotterdam in cooperation with the Organization of Child and Adolescent Welfare of Rotterdam. The study protocol was approved by the ethics committee of the University Hospital Rotterdam.

Written informed consent was obtained from parents or from subjects older than 16 yr of age. A questionnaire was administered to all subjects to determine calcium intake, physical activity, vitamin and fluoride use, medical history, smoking, prematurity at birth, low birth weight, previous fractures, menarche, regularity of menstrual periods, use of oral contraceptives, and country of birth of both parents during an interview.

The questions were asked of one of the parents and in the older children also of themselves. Calcium intake was determined by a detailed food frequency questionnaire of dairy products Habitual physical activity included physical education classes, organized sports, recreational activity, and habitual walking and cycling and was measured in minutes per week Height was measured with a fixed stadiometer.

Weight was measured without shoes on a standard clinical balance. As validated previously 18 , pubertal development was evaluated by self-assessment of breast and pubic hair stage in girls and genitalia and pubic hair stage in boys, according to the method of Tanner Subjects were given pictures and written descriptions, and selected the picture that most accurately reflected their appearance.

When there were discrepancies between the two variables, greater emphasis was placed on the degree of breast development in girls and of genital development in boys for the determinations of Tanner stage.

Pediatric software was used for children with a weight below 30 kg. During measurement of the lumbar spine, the child was supine, and the physiological lumbar lordosis was flattened by elevation of the knees. All measurements were performed and analyzed by the same person A. Quality assurance was performed daily.

The coefficient of variation has been reported to be 1. The coefficient of variation was not determined, because it was considered unethical to measure a child several times.

Of 43 children only, the BMD of the lumbar spine was measured. The BMD grams per cm 2 from this measurement is an areal density that varies with bone size.

The lumbar body was assumed to have a cylindrical shape. The validity of this model was tested using in vivo volumetric data obtained from magnetic resonance imaging of lumbar vertebrae The best model for adjustment for age was chosen by multiple regression analysis.

Multiple regression analysis was used to determine the association of various factors with BMD. Dummy variables were used for categorical variables that had more than two categories. Two sample t tests were used to test differences in calcium intake and physical activity between boys and girls.

The BMD of lumbar spine and total body and lumbar spine BMAD increased with age Fig. Due to the small number of subjects between 18—20 yr of age, they were combined in one group in Table 1. During puberty, the increment was higher than before puberty.

The accumulation started to increase at the age of 11 yr in girls and at the age of 13 yr in boys. The variance increased during puberty. After the age of 16 yr, the age-dependent increase in BMD leveled off in girls, whereas in boys it continued.

Girls had higher lumbar BMD and BMAD than boys at all ages. There was no difference in total body BMD between boys and girls. Relation between age and BMD of the lumbar spine BMDL; grams per cm 2 , total body BMD BMDTB; grams per cm 2 , and BMAD of the lumbar spine grams per cm 3 in boys and girls.

The line shows the best-fitted function with the factors age, age 2 , and age 3 for girls and age and age 2 for boys. Mean BMD values of lumbar spine BMDL; grams per cm 2 , BMAD of lumbar spine grams per cm 3 , BMD of total body BMDTB; grams per cm 2 , and sd s in boys and girls.

The best model for adjustment for age resulted in a model for girls with the factors age, age 2 , and age 3 and for boys with the factors age and age 2 , for BMD as well as for BMAD.

Adjustment for age was performed in this way unless reported otherwise. The associations of the various factors with BMD and BMAD adjusted for age are listed in Table 2.

Association of various factors with lumbar spine BMD BMDL; grams per cm 2 , total body BMD BMDTB; grams per cm 2 , and lumbar spine BMAD grams per cm 3 after adjustment for age.

After adjustment for age, height had a significant positive association with lumbar spine and total body BMD in boys and with lumbar spine BMD in girls. Height had no significant association with BMAD in both sexes after adjustment for age. Weight correlated significantly with all three BMD variables after adjustment for age.

Tanner stage had a significant positive association with BMD and BMAD of the lumbar spine and with total body BMD in boys and girls. The increases between the Tanner stages are shown in Table 3. Mean BMD ± sd of lumbar spine BMDL and total body BMDTB and BMAD per Tanner stage.

The increases between Tanner stage III to IV and IV to V were significant in girls for all three BMD variables adjusted for age. One hundred and forty-three girls had experienced menarche. Girls of the same age who had experienced menarche had higher lumbar spine and total body BMD and spinal BMAD than girls who had not.

To evaluate whether the age at menarche influenced BMD, an analysis was performed of the girls who had experienced menarche with adjustment for age. There was no significant association for BMAD.

There was no significant difference in calcium intake between boys and girls and no significant correlation with age. Calcium intake had no significant association with BMD in girls. Calcium intake had no significant association with lumbar spine BMAD in either sex.

Physical activity was significantly higher in boys than in girls[ mean, 9. Physical activity had no significant association with BMD and BMAD in girls. Ethnicity had no significant association with BMD or BMAD in boys. In girls, ethnicity had a significant influence on total body BMD.

The girls of Asian ethnicity had a lower total body BMD than the Caucasian girls. The BMD and BMAD of the children with black ethnicity did not differ from those of the other children. The children with Asian ethnicity had a significantly lower calcium intake than the Caucasian children vs.

The Asian girls had a significantly lower physical activity 4. The physical activity of the Asian boys was not significantly different. The calcium intake and physical activity of black children were not significantly different from those of Caucasian children.

In this study determinants of BMD were evaluated in healthy children and adolescents. Weight in boys and Tanner stage in girls had a significant and independent correlation with all three BMD variables.

Determinants of BMD in healthy persons are genetic-ethnic factors, hormonal status, calcium intake, physical activity, and weight. This might be an overestimation as a result of more common lifestyle factors. Bone density is higher in black than in white subjects and lower in Chinese and Japanese 25 , We found a lower total body BMD of girls of Asian ethnicity than of Caucasian girls.

The lower bone density in Asians might be attributed to low calcium intake Calcium supplementation increased the bone mineral content of Chinese children with habitually low calcium intakes Our values for lumbar spine BMD are higher than published values of Finnish children 13 and comparable to those of Spanish children 6 measured using DXA equipment from the same manufacturer.

There may be geographical differences in BMD. A study in adults found higher incidence rates of hip fractures in the northern part of Europe compared to the rest of Europe During puberty, there was a large increase in BMD and BMAD.

Lumbar spine BMD and BMAD and total body BMD increased significantly with higher Tanner stages, as was previously found for lumbar spine BMD 6 , 10 , 29 and total body BMD 7. During puberty, GH as well as sex steroid levels increase, and both have a positive influence on BMD 30 , The influence of puberty on BMD was higher in girls than in boys.

In multiple regression analysis, Tanner stage did not correlate significantly with BMD in boys, whereas in girls it was the major determinant.

Animals studies showed a more important role of estrogen than of androgen in mineralization of the skeleton Estrogen is an important determinant of BMD in girls during puberty. This is illustrated by our results showing that girls who had an early menarche or regular periods had higher BMD.

Other studies showed that late menarche and amenorrhea in ballet dancers and patients with anorexia nervosa were related to a reduced BMD and fractures 33 — Late puberty and amenorrhea are risk factors for low BMD in girls.

A few studies showed that persons who consume greater quantities of calcium early in life have greater bone mass later 37 , Peak bone mass is optimal when the threshold calcium balance is met The threshold is the level of calcium intake below which skeletal accumulation of calcium varies with intake and above which it remains constant.

According to Matkovic et al. Johnston et al. This study was a 3-yr, double blind, placebo-controlled trial in 70 pairs of identical twins.

The increase in BMD was twice as high at the radius cortical bone as at the lumbar spine trabecular bone. We also found a higher correlation between calcium intake and total body BMD, which mainly consists of cortical bone, than between calcium intake and lumbar spine BMD in boys. An adequate calcium intake during childhood is important for optimal mineralization of the skeleton.

Slemenda et al. Other studies found a positive correlation between physical activity and lumbar spine BMD 42 or femoral neck BMD 13 in children. In a prospective study it was found that the men and women with the highest levels of exercise at the age of 9—18 yr had higher femoral BMD at the age of 20—29 yr than those with the lowest levels; only the men with the highest levels of exercise had also higher BMD of the lumbar spine In our study, physical activity had a positive association with BMD in boys only.

The low variance in physical activity in girls may be the reason why no association was found between physical activity and BMD in girls. The effect of weight on BMD is due to load on weight-bearing bones 44 , comparable to the influence of physical activity.

Children who are underweight and inactive are at risk of developing low BMD. DXA measures bone mineral content within the projected area; the correction for area removes some, but not all, of the dependence on bone size. To correct completely for bone size, we calculated volumetric density for the lumbar spine; this was not possible for the total body measurement.

Bone size might be an independent determinant of bone strength 45 , Studies showed the relation between areal BMD and both strength 47 and fracture risk 48 , which justifies the use of areal BMD. Diagnostic sensitivity was higher, and precision error was lower for BMD than for BMAD in postmenopausal women Data for the true volumetric density of children are scarce, because of the high radiation dose of quantitative computed tomography.

A study of true volumetric spinal bone density measured by quantitative computed tomography showed no increase between 2 and 12 yr in girls Kröger et al. Our results also showed an increase in BMAD with age. Height, calcium intake, and physical activity had no significant influence on spinal BMAD; therefore, the influence of these variables on spinal BMD could be due to an increase in bone size.

This cross-sectional study provides reference values for lumbar spine and total body BMD of children and adolescents of a West-European country. Lumbar spine and total body BMD and lumbar spine BMAD increase with age, with a higher increment during puberty. Determinants of BMD are age, sex, genetic-ethnic factors, hormonal status, calcium intake, physical activity, and weight.

The major determinant of BMD during childhood appeared to be weight in boys and pubertal development in girls. The authors thank Peter P. Kooy and Jopie Hensen of the Department of Nuclear Medicine for their cooperation; Gijs Willem van Omme, Hein Raat, and Alice A. Hazebroek-Kampschreur of the Child and Adolescent Welfare Organization of Rotterdam for assistance with the recruiting of the children, and medical students Gerwin Wildeboer and Jeroen van Essen for their assistance.

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Annemieke M. Boot, Maria A. de Ridder, Huibert A. Bone health in adolescents, Eric P. Krenning, Sabine M. On association of height, weight, pubertal stage, calcium intake, and physical activity with bone mineral density BMD was evaluated in children and adolescents boys and girlsaged 4—20 yr.

Bone health in adolescents -

In , the American Academy of Pediatrics adopted the National Academy of Sciences recommendation that all children from infancy to adolescence receive IU of vitamin D supplementation daily, a policy that has been met with some controversy.

Provision of larger doses eg, IU may be needed for these groups, especially during winter. There is a critical need to reconvene an expert panel to evaluate the dietary reference intake for vitamin D for young patients.

Adolescence is the most critical period across the life span for bone health because more than half of PBM is accumulated during the teenage years. Recent and ongoing studies have highlighted the increasing number of clinical settings in which an adolescent may potentially lose bone density and are beginning to fill gaps in knowledge regarding the roles of physical activity and calcium and vitamin D intake in healthy adolescents, as well as the appropriate use of pharmacologic skeletal agents in those with chronic illness.

Unfortunately, research has not yet generated evidence to identify appropriate candidates for both baseline bone density screening and continued monitoring.

Nonetheless, although there still seem to be more questions than answers in this new field, adolescent health care professionals are on the cusp of an exciting era in which they can have a major role in improving the skeletal health of our nation.

Correspondence: Catherine M. Gordon, MD, MSc, Children's Hospital Bone Health Program, Children's Hospital Boston, Longwood Ave, Boston, MA catherine. gordon childrens. Author Contributions: Study concept and design : Loud and Gordon. Drafting of the manuscript : Loud and Gordon. Critical revision of the manuscript for important intellectual content : Loud and Gordon.

Administrative, technical, and material support : Loud. Study supervision : Gordon. full text icon Full Text. Download PDF Top of Article Abstract Bone acquisition in adolescence Which patients are at risk for poor skeletal health?

How to evaluate skeletal status When should one consider a bone density measurement? Use of skeletal agents in adolescents Potentially beneficial interventions for all adolescents Conclusions Article Information References.

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Clin Endocrinol Oxf —8. Keywords: androgen, diet, hypophosphatemia, puberty, perfluoroalkyl, obesity, osteogenesis imperfecta, vitamin D.

Citation: Baronio F and Baptista F Editorial: Bone health and development in children and adolescents. Received: 17 November ; Accepted: 28 November ; Published: 12 December Copyright © Baronio and Baptista.

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Per- and polyfluoroalkyl B vitamins for skin health PFASmanufactured chemicals Bone health in adolescents in products such as Bone health in adolescents packaging and cosmetics, can lead qdolescents reproductive problems, increased cancer risk and Adolrscents health issues. Adolescnets growing body of research has also linked the chemicals to axolescents bone mineral density, which can daolescents to osteoporosis adolesxents other Exercise performance nutrition diseases. But most of those studies have focused on older, non-Hispanic white participants and only collected data at a single point in time. Now, researchers from the Keck School of Medicine of USC have replicated those results in a longitudinal study of two groups of young participants, primarily Hispanics, a group that faces a heightened risk of bone disease in adulthood. In a group of adolescents, exposure to PFAS was linked to a decrease in bone mineral density over time. In a group of young adults, PFAS exposure was also linked to lower baseline bone density, but no differences were observed over time. Osteoporosis occurs during childhood and adolescence as a heritable condition such as OI, with acquired disease eg, IBDBne iatrogenically healtn Bone health in adolescents result of high-dose glucocorticoid therapy. However, the number of children Bome by osteoporosis during youth is small Bone health in adolescents Prebiotics in food the numbers who adolesccents develop osteoporosis in adulthood. Prevention of adult osteoporosis requires that an optimal environment for the achievement of peak bone mass be established during the growing years. Detection of low BMD can be achieved using modalities such as DXA and pQCT. Standard radiologic studies, especially vertebral radiography, may also be helpful in children and adolescents at high risk for osteoporosis. It is critical to the development of healthy bones that adolescents have proper nutrition with adequate calcium and vitamin D intake and that they participate in regular physical activity especially weight-bearing exercise.