| SMART CHOICES
IN CHILDHOOD CAN LAY THE FOUNDATION FOR
STRONG BONES TO LAST A LIFETIME. If
a child comes to Childrens Hospital Los Angeles
with a bone problem, the shout immediately goes
out: "Call Dr. Duke!" That is the nickname
for Pisit Pitukcheewanont, M.D., assistant professor
of pediatrics at the Keck School of Medicine of
USC and clinical director of the pediatric bone
program in CHLN’s endocrinology division.
These
days, many are getting to know "Dr. Duke"
because of his talks in the community on behalf
of kids' bone health. Pitukcheewanont wants to
spread the word: Lifestyle habits that children
have today can either strengthen or hinder the
bones they end up with in adulthood.
But
with a little effort and smart choices, kids'
bones can grow to be all they can be.
Bone
bank
Children's
bones grow in stages. As children grow up, from
babyhood to just before puberty, their bones grow
longer, wider and thicker, with boys' bones growing
bigger than girls' bones.
In
puberty, hormones surge and influence bone growth.
During these teen years, bones not only keep growing
larger, but they also grow denser.
Bone
growth peaks in the late teens and early 20s,
when bones are at their very strongest. It levels
out until the early 30s, when bones start losing
mass and density.
"If
anything interferes with bone growth during childhood,
you're going to have a problem," he says.
For some children, diseases and medications are
to blame for bone problems; but others have no
such underlying causes.
"About
a third of children will suffer a fracture of
some kind between birth and age 16," Pitukcheewanont
says, "and a third of these fractures are
not related to a high impact trauma."
If
a seemingly innocuous tap fractures a bone,
that indicates a weakness in the bones themselves,
he explains. "That suggests to us that the
child has low bone mass or an increased risk of
osteoporosis later in life."
Studies
show that healthy children who have the smallest
and least dense bones when they start puberty,
at about age 10, will still have the smallest
and least dense bones when they stop growing at
age 18. And those who have the biggest bones as
10-year-olds also end up with the biggest bones
at 18.
Bone
built up by the late teens or early adulthood
forms a sort of lifetime "bone bank."
During adulthood, the body slowly withdraws bone
from the bank. The less bone to start with, the
likelier bone will become porous and vulnerable
to fracture.
Genetics
accounts for as much as 60 to 80 percent of bone
structure. The other 20 to 40 percent is where
actions can make a difference.
Got
calcium?
Because
bones are mostly made of calcium, the body needs
calcium to build bones. But all other cells in
the body need the mineral to function, too, so
when the body does not get enough calcium through
food, it takes calcium out of bones.
Kids
ages 9 to 17 need about 1,300 milligrams (mg)
of calcium a day, and those between ages 3 and
8 need 800 mg a day, according to the Institute
of Medicine.
Milk
is the best dietary calcium source, Pitukcheewanont
says. Eight ounces of milk-a cup-contains about
300 mg of calcium.
For
kids who have difficulty digesting lactose, good
options include tofu, some cheeses and yogurt,
as well as soy and rice milk.
‘Vegetarians
can get calcium from green, leafy vegetables,
too," he adds. "But to make up the same
amount that you'd get from a cup of milk, you'd
need a whole lot of vegetables." It takes
eight cups of spinach, for example, to get the
same calcium as one cup of milk. |
