Osteoporosis has been called a “pediatric disease with geriatric consequences” because the bone mass attained in childhood and adolescence determines lifelong skeletal health. Habits kids form now can make or “break” their bones as they age.

Up to 90% of peak bone mass is acquired by age 18 in girls and age 20 in boys so youth is the best time to invest in bone health. During the teen years, almost half of the adult skeleton is formed, yet less than half of all teens get enough calcium every day. For teenage girls it is even worse with only 15% getting enough calcium! Females are four times more likely than males to develop osteoporosis. After puberty, boys tend to acquire greater bone mass than girls.

• Not getting enough calcium.
• Drinking too much soda. Teens who drink soda drink less milk. Even water has some calcium in it and is better for you than drinking soft drinks.
• Too little physical activity.
• Smoking causes bone loss.
• Family history – do other people in the family have osteoporosis?
• Caucasian and Asian races are more at risk than African Americans. This is not well understood. Regardless of race, building bone early is protective later.
• Being below normal weight or if a female, having irregular periods. Sex hormones, estrogen and testosterone, are essential for development of bone mass. Girls who start to menstruate at an early age typically have greater bone density. Those who frequently miss their periods sometimes have lower bone density.
• Heavy intake of alcohol.

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• Eat lots of calcium-rich food like milk, yogurt and cheese; calcium-fortified orange juice and bread; green leafy vegetables such as collards and spinach; cheddar cheese, canned salmon and sardines or soybeans and tofu. Children and teenagers between 9 and 18 should aim for 1300 milligrams (mg) per day. This is equal to 4 high-calcium food servings a day. Each 8-ounce glass of milk (whether skim, 1%, 2%, or whole) and each cup of yogurt have about 300 mg. of calcium. A cup of Total Raisin Bran has 1000 mg! It is also important to get enough vitamin D, either from sunlight or in the diet to help the bones absorb the calcium. Sunscreens and more indoor activities today prevent many teens from getting enough vitamin D. Many calcium food lists are on the Internet. The NIH-NIAMS Osteoporosis site provides a good one.
• For those who don’t or can’t eat dairy products, a doctor’s or registered dietician’s advice about calcium supplements may be necessary. Calcium should come from food sources whenever possible. Non-dairy sources are soybeans, tofu, canned sardines, salmon, and legumes. For best absorption, no more than 500 mg. of calcium should be taken at one time. Most supplements have between 200-500 mg of calcium.
• Get weight-bearing physical activity every day. Walking, running, aerobics, tennis, gymnastics, weight lifting, basketball, soccer, skiing, volleyball, jumping rope, or dancing puts weight on bones and helps prevent osteoporosis. Occasionally, excessive exercising can lead to amenorrhea (absence of menstruation).
• Limit soft drink consumption to one or less a day. None is preferable. Soda might be called “osteoporosis in a can.” The typical formulations of carbonated soda, even carbonated water, contain carbonic acid or phosphoric acid. This causes calcium loss in the bones through a 3-stage process: 1) the carbonation irritates the stomach, 2) the stomach “cures” this by adding the only antacid at it disposal – calcium from the blood, 3) the blood, now low on calcium, replenishes its supply from the bones. If it did not do this, muscle and brain function would be severely impaired. More simply, carbonation leeches calcium from the bones making them weak and brittle.
• Do not smoke. As well as being bad for the heart and lungs, it also is harmful to bone tissue and leads to increase fracture risk. Tobacco lowers estrogen levels in women and may cause early menopause. In men, it lowers testosterone activity thus weakening bones. If teens finish high school as nonsmokers, they will probably stay that way for life. Make a bet with your friends that if they smoke that first cigarette, they owe you $100. And vice-versa! Smoking is the leading cause of most diseases and illnesses.
• Avoid alcohol. Alcohol reduces the ability of the body’s cells to make bone. Heavy drinking, particularly in adolescents and young adults years can compromise bone quality and increase osteoporosis risk later. Alcohol appears to affect bone-forming cells (osteoblasts) slowing bone turnover and cartilage proliferation, important precursors to bone development. Chronic alcohol exposure also may compromise bone elasticity, stiffness, load-carrying capacity, and toughness. Research shows that the effects of heavy alcohol use on bone cannot be reversed, even if alcohol consumption is stopped. A few epidemiological studies show that moderate drinking may have a beneficial effect, but this is not clearly understood. The recommended daily maximum is one glass of normal-strength beer or a very small glass of wine. The amount varies between men and women.
• Avoid drinks with caffeine. Coffee and many sodas (colas) have caffeine. Excessive caffeine contributes to bone breakdown and may cause osteoporosis. 5 ounces of coffee made by automatic drip contains 110-150 mgs of caffeine, Mountain Dew (12 oz.) has 54 mg., Pepsi, 38, Exedrin, an over-the-counter drug, 65, baking chocolate, 35. Even decaffeinated coffee has 2-6 mgs of caffeine.

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Try fortified soy milk or juice or Lactaid milk (the lactase enzyme you are missing has been added). Lactase enzyme tablets may also be taken before eating dairy products to help digest the lactose sugar in milk. Check with your doctor.

• Have a bowl of cereal with milk

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