Help Your Teen Build Strong Bones

Brittni Reum’s first broken bone happened in her right heel at age 10. She suffered four more fractures over the next three years in her arms and knee — all from seemingly minor mishaps while playing on the monkey bars or shooting hoops in gym class. “Brittni seemed so fragile that I was afraid to let her go outside or play sports,” says her mom, Michelle, an accounting manager in Jacksonville, Fla.

Enrolling in a bone-density study at nearby Nemours Children’s Clinic revealed that Brittni had osteoporosis. Doctors prescribed calcium supplements and told her to load up on dairy products. Michelle hadn’t been including much dairy in her daughter’s diet since Brittni developed a milk allergy as an infant (most kids outgrow the allergy by age 5). Fortunately, the damage wasn’t permanent. Today, at 17, Brittni’s bone density is normal, and she hasn’t broken any bones in several years.

While her case might sound extreme, Brittni is far from the only teen who needs to be paying attention to bone health. In fact, according to the USDA, 81 percent of teen girls and 48 percent of teen boys fail to get the recommended amounts of calcium — 1300 mg/day until age 18; 1,000 mgs after that. The shortfall comes at a pivotal time because from age 9 to 18, hormones, such as estrogen and insulin-like growth factor-1 kick in, prompting the body to store calcium and absorb more of it from food.

“The teen years are when you acquire nearly half of all the bone you’re going to have for the rest of your life,” says Susan Coupey, M.D., chief of adolescent medicine at the Children’s Hospital at Montefiore in New York City. Your child draws from this “bone bank account” throughout adulthood, especially after age 50, when bone mass naturally starts to decline. If your kid doesn’t build bone now, she may not reach her peak bone density. The good news: Research shows that boosting bone density by as little as 5 percent during the teen years lowers the risk of fractures later by 40 percent. Help your kids maximize their bone-building window of opportunity with this action plan.

Keep Dairy Handy
A recent study reveals that teens ages 14 to 18 typically down 18 ounces of soft drinks daily, which is more than double their milk intake. To help your teen boost her calcium quota, encourage her to have at least four 1-cup servings of dairy a day. Stock up on yogurt, yogurt smoothies, low-fat string cheese and calcium-fortified cereal bars. Besides providing a healthy dose of calcium and vitamin D, dairy products offer a package of nutrients — including riboflavin, phosphorus, potassium, protein, zinc and essential amino acids — that aid bone development.

If your teen is lactose intolerant, try having her build up her tolerance by consuming small amounts of milk with food, such as a half-cup of milk on cereal, then gradually increasing amounts. According to the American Academy of Pediatrics, teens with lactose intolerance should still drink as much milk as they can tolerate. “Drinking milk fosters good bacteria in the intestine that digests lactose,” explains Robert P. Heaney, M.D., professor of medicine at Creighton University in Omaha. Lactose-free milk is also an option, as are dairy products with low levels of lactose, such as cheddar and Swiss cheeses and yogurt containing active cultures.

Set a Good Example
Make soft drinks a rare treat for you and your teens. “Don’t bring them into the house,” suggests Stephanie Smith, R.D., a spokesperson for the National Dairy Council, in Thornton, Colo. That way, your teens won’t be tempted. Also, push nonfat milk at meals, and drink it yourself. It’s important to be a good role model. And try to eat together as often as you can. “Getting calcium into your child’s diet is a family affair,” Smith says. In fact, studies show that families who eat together tend to be major milk consumers.

Seek Out a Supplement
In addition to calcium, teens also need 200 daily IUs of vitamin D, which helps the body utilize the bone-building mineral. Have your teens take a daily supplement as extra health insurance, recommends Dr. Coupey. A multivitamin also offers some other nutrients teens may be missing, such as folic acid.

Give Team Sports a Go
Bones also need regular weight-bearing exercise, such as walking, running and jumping, to get stronger. Unfortunately, many teens aren’t getting the recommended 60 minutes of daily physical activity their bodies need. But a recent study found that teens who participated in team sports such as soccer, basketball, ultimate Frisbee, baseball and rugby had higher bone mass than those who didn’t. Team sports also offer the chance to build bone mass through weight training, a key component of many organized sports programs.

Pay Attention to Her Period
If your daughter hasn’t gotten her first period by age 14, or if she misses her period anytime for three to six months in a row, see a doctor. Delayed puberty and missed periods may be the result of excessive dieting or overexercising, and can trigger the fall of estrogen levels, compromising peak bone mass, explains Saralyn Mark, M.D., associate professor of medicine and ob-gyn at Yale University and Georgetown University School of Medicine.

Sandra Gordon is a journalist and author whose most recent book is “Consumer Reports Best Baby Products.”