How to Help Kids Have Healthy Bones

You may not think much about your kids' bones, but it's important to. A new report by the American Academy of Pediatrics (AAP), published in Pediatrics suggests that a few simple steps taken during childhood (both literal and figurative) can make all the difference in the world when it comes to your kids having healthy bones when they're grown.

To prevent the risk of brittle bones and osteoporosis, the AAP report encourages kids to start with their diets. It recommends that kids routinely consume adequate amounts of calcium and vitamin D from milk and other foods (including fortified ones). It also recommends that kids engage in regular exercise—something not only great for their bones, but for their bodies and minds. And when it comes to strengthening bones, simply playing and incorporating weight-bearing activities like walking, dancing and running are especially effective. And they're so easy for kids to incoporate, even in short bursts, throughout each day.

According to the Institute of Medicine's (IOM) Dietary Reference Intakes, daily calcium (expressed in milligrams) and vitamin D (expressed in International Units) recommendations are as follows:

*Infants up to six months of age: 200 mg calcium; 400 IU vitamin D.

*Infants six- to 12-months of age: 260 mg calcium; 400 IU vitamin D.

*One- to three-year-olds: 700 mg calcium; 600 IU vitamin D.

*Four- to eight-year-olds: 1,000 mg calcium; 600 IU vitamin D.

*Nine- to 18-year-olds: 1,300 mg calcium; 600 IU vitamin D.

Some calcium-rich foods kids can enjoy include:

*low-fat or nonfat yogurt (~300 to 400 mg per 8-ounce cup)

*low-fat or nonfat milk (~300 mg per 8-ounce cup)

*cheese—Swiss, cheddar, muenster etc. (~200 mg per ounce)

*fortified ready-to-eat cereal—preferably whole grain, low sugar, high fiber varieties (check labels since amounts vary)

*calcium-fortified soy beverage (~350 mg per cup)

*oatmeal, plain, instant—preferably with no sugar added (~100 mg per packet)

*tofu, firm (~250 mg per half cup)

Fish, beans, and greens (like spinach) also provide calcium. Here's a more complete list of calcium-rich foods and the amounts each provides from Harvard University Health Services.

Although kids can get some vitamin D from the sun, it's wise to seek this nutrient, vital for the absorption of calcium, from food sources. Eating vitamin D-rich foods not only helps them keep their bones strong, but it protects their skin from overexposure that can lead to sunburn.

Here are some foods rich in vitamin D that kids can enjoy:

*salmon, cooked (360 IU per 3.5 ounces)

*tuna fish, canned in oil (200 IU per 3 ounces)

*low-fat or nonfat milk (~100 per 8-ounce cup)

Fortified ready-to-eat cereal, eggs, and Swiss cheese also contain some vitamin D.

If your child follows current dietary guidelines—though let's face it, most don't—he or she should be able to meet current calcium and vitamin D intake recommendations. But if your child follows a diet that excludes or minimizes foods like milk, yogurt, or fish, or if he or she doesn't have a varied diet that includes green vegetables, beans or other calcium-rich plant foods, be sure to consult with a registered dietitian nutritionist (RDN) for ideas to get more of these vital nutrients into meals and snacks. An RDN and a pediatrician can also help you figure out if your child needs or would benefit from supplementation of either calcium or vitamin D. Although it's prudent to follow IOM current recommended intakes for calcium and vitamin D, many experts believe more vitamin D (mainly through supplementation) would be beneficial for kids. But again, speak with your dietitian or a pediatrician to discuss what's best for your child in the context of his or her diet and nutrition status.

Although the AAP does not recommend routine calcium supplementation for healthy children and adolescents, it does support testing children for vitamin D deficiency if they have conditions associated with increased bone fragility.

It's key when kids are young to help them set the stage for optimal health in adulthood. Helping them keep their bones strong with three key strategies—eating enough calcium-rich foods, meeting vitamin D needs, and exercising—can go a long way in helping them ward off brittle bones and osteoporosis (not to mention the mental and physical debilitation they contribute to) down the road.

How do you help your kids achieve and maintain strong bones?

Image of cute little girl and boy are drinking milk using straw via shutterstock.

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