Building Strong Bones

Alvin N. Eden, M.D.

To build strong bones and prevent serious trouble in the future, your child must consume an adequate amount of calcium each and every day. Milk and dairy products are by far the best sources of calcium and usually provide most of the calcium in your child’s diet.

A recent national survey showed that many children in the United States today do not get enough calcium. The survey demonstrated that 50% of children under the age of five, 65% of teenage boys and 86% of teenage girls, consumed less than the recommended daily calcium requirements. This is extremely bad news. These children are increasing their risk for weakened bones, which can lead to frequent fractures (especially of the hip) later in life. Calcium deficiency in bones causes osteoporosis (sometimes called brittle bone disease). Although osteoporosis is a major public health problem in older adults, it begins during childhood. Not only is calcium essential for building strong bones, it has also been shown to benefit the heart. Calcium may help lower blood pressure in many people with high blood pressure. Calcium helps lower LDL cholesterol (bad cholesterol) and raises HDL cholesterol (good cholesterol). Calcium has also been shown to protect against some forms of intestinal cancer.

Why are so many children calcium deficient? The main reason is that most children, especially after age three, do not consume enough foods that are high in calcium (such as milk or dairy products like cheese and yogurt) every day. It is difficult to meet the body’s calcium needs with foods that are not milk-based. Unfortunately, many parents allow their children to fill up on fruit drinks and soda instead of milk or milk-based drinks. Schools aren’t helping. The fact of the matter is that many schools allow soda-dispensing vending machines in or near the cafeteria. If this is the case in your child’s school, be sure to present your concerns and rationale to the school principal and Parents' Association.

It is important that children of all ages consume the right amount of calcium. The teenage years are crucial for helping build strong bones that will remain strong throughout life. Remember that girls accumulate 95% of their total body calcium content by age 17. This means that any girl who has not absorbed enough calcium by age 17 is destined to become a woman with less than the normal amount of calcium in her bones. This will obviously make her more vulnerable to osteoporosis in the future. It is too late to try to catch up on calcium after the teenage years. Parents must take a more active role in guaranteeing their teenagers consume adequate amounts of calcium every day. This means making sure they drink milk or other milk products and eat other calcium-rich foods, daily.

How much calcium do children require on a daily basis? It depends on his/her age. The following are the recommended daily calcium requirements according to age:

• 1-3 years: 500 mg of calcium per day
• 4-8 years: 800 mg of calcium per day
• 9-18 years: 1300 mg of calcium per day
  

As you can see, teenagers require the largest daily calcium intake. The following is a list of calcium-rich foods you can encourage your child to eat:

Calcium

1 cup milk: 300 mg
8 oz yogurt: 270 mg
8 oz calcium-fortified orange juice: 300 mg
1 oz Swiss cheese: 270 mg
1 oz cheddar cheese: 200 mg
½ cup collard greens: 180 mg
1 cup white beans: 100 mg
3 oz sardines: 325 mg
3 oz canned salmon: 180 mg

You can figure out what your child needs to eat to meet his/her calcium requirements by referring to this list. A toddler only needs two cups of milk daily. A school-age child only needs two cups of milk and 1 oz cheese to meet the needed requirements. Teenagers need more. An adolescent needs at least four daily servings of calcium-rich foods. It is important to keep track of what your child eats so you know if they are getting enough. If he/she does not meet the requirements, a calcium supplement may be necessary. Discuss this with your child’s doctor if this is the case.

Adequate calcium intake is rarely a problem for infants and toddlers who drink large quantities of milk every day. The problem with low-calcium intake usually begins at around age four, when many children begin refusing to drink milk. Inadequate calcium intake is most severe among teenagers, who are notoriously poor milk drinkers. For example, a teenager would have to eat 2 ¼ cups of broccoli to equal the amount of calcium in just one cup of milk. Without a calcium supplement, teenagers who refuse to drink milk rarely meet their calcium requirements

Parents should encourage their children to eat a diet that contains plenty of calcium. This is the best insurance policy against the severe problems related to osteoporosis. Without adequate calcium intake during childhood, your children are more likely to develop osteoporosis and other medical problems associated with calcium deficiency.