Osteoporosis, a disease that causes bones to become less dense and more prone to fractures, is often thought of as an older person's disease. But experts are beginning to refer to this degenerative condition as a pediatric disease with geriatric consequences. This is because the bone mass attained in childhood and adolescence is a very important determinant of lifelong skeletal health. The health habits your kids are forming now can literally make or break their bones as they age.

Childhood and Bone Development

Bones are living tissue that change constantly, with bits of old bone being removed and replaced by new bone. You can think of bone as a bank account, where (with your help) your kids make "deposits" and "withdrawals" of bone tissue. During childhood and adolescence, much more bone is deposited than withdrawn as the skeleton grows in both size and density.

The amount of bone tissue in the skeleton (known as bone mass) can continue to increase until your child reaches his or her mid-twenties. At that point, bones have reached their maximum strength and density, or peak bone mass. Up to 90 percent of peak bone mass is acquired by age 18 in girls and age 20 in boys, which makes youth the best time for your kids to "invest" in their bone health, according to the Centers for Disease Control and Prevention (CDC). Building your children's "bone bank account" is a lot like saving for their education: The more they can put away when they're young, the longer it will last as they get older.

Factors That Affect Bone Mass

Peak bone mass is influenced by a variety of factors; some you can't change, such as gender and race, and some you can, like nutrition and physical activity.


Bone mass or density is generally higher in men than in women. Before puberty, boys and girls develop bone mass at similar rates. After puberty, however, boys tend to acquire greater bone mass than girls. In fact, women are four times more likely to develop osteoporosis than men, according to the National Osteoporosis Foundation.


For reasons still not well understood, African-American girls tend to achieve higher peak bone mass than Caucasian girls, and African-American women are at lower risk for osteoporosis later in life. More research is needed to understand the differences in bone density between various racial and ethnic groups. However, because all women, regardless of race, are at significant risk for osteoporosis, all girls need to build as much bone mass as possible to protect themselves.


Sex hormones, including estrogen and testosterone, are essential for the development of bone mass. Girls who start menstruating at an early age typically have greater bone density, according to the National Institutes of Health (NIH). Those who frequently miss their menstrual periods sometimes have lower bone density, putting them at increased risk for osteoporosis.


Calcium is an essential nutrient for bone health. In fact, calcium deficiencies in young people can account for a 5 to 10 percent lower peak bone mass and may increase the risk for bone fractures in later life, according to the National Osteoporosis Foundation. For a girl between the ages of 9 and 13, the Office of Dietary Supplements recommends 1,300 mg of calcium and 200 IU of vitamin D daily. Low-fat dairy products are great sources of calcium, while milk and certain types of fish are rich in vitamin D.

Physical activity.

Fitness is extremely important for building healthy bones. The benefits of activity are most pronounced in those areas of the skeleton that bear the most weight, such as the hips during walking and running and the arms during gymnastics and upper-body weightlifting.