Most people think osteoporosis is a disease of the elderly, because people lose bone mass as they age. But experts at the National Institutes of Health conference on Osteoporosis Prevention, Diagnosis and Therapy in March 2000 said bone growth during childhood and adolescence is as important as bone loss in the development of osteoporosis. Bones grow in size and strength during childhood. The degree of bone mass attained helps determine skeletal health throughout life. The more bone mass you have after adolescence, the more protection you have later in life against bone density loss. Childhood is also a critical time for developing lifestyle habits that support good bone health throughout life. Cigarette smoking, which usually starts in childhood, may have a deleterious effect on achieving bone mass. Good nutrition is vital for normal growth. All tissues, including bone, need a balanced diet, adequate calories, and appropriate nutrients to develop. Unfortunately, not everyone follows a diet that is optimal for bone health. For example, the Institute of Medicine recommends calcium intake for children ages 9 to 17 is 1,300 mg/day (800 mg/day for children ages 3 to 8). But only about 25 percent of boys and 10 percent of girls ages 9 to 17 have a diet that meets these recommendations. Calcium is the specific nutrient most important for attaining peak bone mass and for preventing and treating osteoporosis. Vitamin D is required for the body to absorb calcium effectively and is important for bone health. Most infants and young children in the United States get enough vitamin D from fortified milk. But adolescents don’t consume as many dairy products, and may not get an adequate level of vitamin D. In particular, diets and fasting in pursuit of thinness may impact adequate nutrition and bone health. They may need to take calcium and vitamin D supplements. Many more studies are needed on ways to maximize peak bone mass in girls and boys. But parents and children alike can benefit from following these suggestions: 1. Make sure you get adequate calcium and vitamin D throughout your life. You can find a listing of recommended doses and major food sources on the Calcium Fact Sheet on this web site. 2. Exercise regularly, using resistance and high-impact activities. 3. Eat a healthy diet and follow a healthy lifestyle. Other risk factors Several groups of children and adolescents may be at risk for poor bone health. They include: Premature and low birthweight infants who have lower-than-expected bone mass in the first few months of life. Children who take medications such as systemic or inhaled steroids to treat chronic inflammatory or respiratory diseases such as asthma Children who have cystic fibrosis, celiac disease, and inflammatory bowel disease because these conditions make it difficult for the body to absorb nutrients appropriately Adolescent girls who have minimal, delayed or irregular menstrual cycles because of strenuous athletic training, emotional stress, or low body weight (The primary sponsors of the NIH conference were the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the NIH Office of Medical Applications of Research.)

Osteoporosis causes bones to thin and weaken. With osteoporosis, bone minerals—mainly calcium—are lost, causing bones to become so brittle that they could result in a wrist, hip or spine fracture. No matter what your age, you can take steps to prevent bone loss. Here are some preventative tips developed by the American Academy of Orthopaedic Surgeons that you should follow during the stages of your life. 10 and 20 years old: Start preventing osteoporosis now by putting calcium deposits in your "bone bank." To make your bones as strong and healthy as possible, you need 1,300 mg of calcium each day. Instead of soft drinks, choose milk-at least three 8-oz. glasses each day. You also can choose other foods-dairy products like cheese or green leafy vegetables are other great sources of calcium. For females, remember that having regular menstrual periods is important to prevent osteoporosis. See a physician if you are older than 16 and have never menstruated or if you have begun to menstruate but have noticed changes in your cycle. 20 and 35 years old: Though you are not forming new bone as readily as before, your bones will reach their peak strength during these years. It is important to get adequate calcium and exercise to help achieve peak bone density. You will need at least 1,000 mg of calcium each day. Engaging in weight-bearing exercises like jogging or walking also will help make your bones stronger. 35 and 50 years old: You may have begun to gradually lose bone. At this stage in your life, getting enough calcium (1,000 mg each day) and exercise are crucial to keep bone loss to a minimum. Most women enter menopause between the ages of 42 and 55. If your period becomes irregular or if you develop signs of menopause, talk with your physician. You also might want to ask about bone density screening examinations. Over 50 years old: For women who have gone through menopause, they may be losing bone at a rate of 1 to 6 percent per year. Ask your physician about the various therapies on the market, and if it is appropriate for you. Adequate calcium intake and exercise still are important. You should be getting 1,000 mg of calcium each day. If you rarely get out in the sun, vitamin D also may be recommended. Try to walk, jog or perform a resistance workout for at least 20 minutes, three times a week.

Preparing the body for exercise is important for persons at any age and fitness level. The key to preventing injuries before exercising is to warm up. One of the best ways to warm up is to do flexibility or stretching exercises. The key to proper stretching lies in the way you perform the exercise. When you are stretching certain parts of your body, you should not feel pain. Staying relaxed is very important to stretching properly. Make sure your body is not tight. Your shoulders, hands and feet should be kept relaxed as you stretch. Breathe slowly. Here are some exercises developed by the American Academy of Orthopaedic Surgeons. The exercises will help warm up various parts of your body. Lower back Tighten your hip muscles and at the same time, tighten your abdominal muscles to flatten your lower back. Hold for 5 to 8 seconds, then relax. Repeat two or three times. Pull your right leg toward your chest. If possible, keep the back of your head on the floor. Try to keep your lower back flat. Hold for 30 seconds. Repeat with your left leg. Hip and groin With arms supplying slight resistance on inside of legs, slowly push down your knees. Hold for 5 to 8 seconds. Place one leg forward, while your knee of the other leg is resting on the floor. Without changing the position of the knee on the floor or the forward leg, lower the front of your hip downward. Hold for 30 seconds. Knee and calf Hold the top of your left foot with right hand and gently pull heel toward buttocks. Hold for 30 seconds. Repeat with other leg. Stand close to a solid support, and lean on it with your forearms, head resting on hands. Bend one leg and place your foot on the ground in front of you, with the other leg straight behind. Slowly move your hips forward, keeping your lower back flat. Hold for 15 to 30 seconds. Do not bounce. Shoulder In a standing or sitting position, interlace your fingers. With your palms facing upward, push your arms slightly back and up. Hold for 15 seconds. With your arms overhead, hold the elbow of one arm with the hand of your other arm. Gently pull the elbow behind your arm. Do slowly. Hold for 15 seconds. Stretch both arms. Gently pull your elbow across your chest toward your opposite shoulder. Hold for 10 seconds. Repeat with other elbow. Hamstring Sit down and straighten your left leg. The sole of your right foot should rest next to the inside of your straightened leg. Lean slightly forward and touch your foot with your fingers. Keep your left foot upright with the ankle and toes relaxed. Hold for 30 seconds. Repeat with right leg.