CC BY-NC-ND 4.0 · Journal of Child Science 2018; 08(01): e67-e74
DOI: 10.1055/s-0038-1669402
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Child Nutrition and Bone Health

Lucía Redondo-Cuevas
1   Department of Pediatrics, Obstetrics, and Gynecology, University of Valencia, Valencia, Spain
,
Jesús Sanchis-Chordà
1   Department of Pediatrics, Obstetrics, and Gynecology, University of Valencia, Valencia, Spain
,
Pilar Codoñer-Franch
1   Department of Pediatrics, Obstetrics, and Gynecology, University of Valencia, Valencia, Spain
2   Department of Pediatrics, Dr. Peset University Hospital, Valencia, Spain
› Author Affiliations
Further Information

Publication History

29 June 2018

01 July 2018

Publication Date:
26 September 2018 (online)

Abstract

Nutrition is one of the modifiable factors that contributes to bone accrual during childhood and adolescence, a critical period to prevent adult osteoporosis. Calcium and vitamin D seem to be the most important nutrients for optimal bone growth. Requirements for calcium intake are different among countries and organizations, and exact recommendations are difficult to determine since other dietary factors directly affect calcium metabolism, such as salt intake and vitamin D levels. Some scientists have suggested that the actual calcium requirements are overestimated and that increased dairy intake does not necessarily translate to better bone health in adults. Moreover, calcium can be obtained from other natural foods, such as cruciferous vegetables (turnip greens, broccoli rabe, kale, broccoli, and cabbage), endive, sesame seeds, legumes, almonds, calcium-fortified vegetable beverages, and canned sardines. Vitamin D should be obtained from food combined with appropriate sun exposure, and if that is not enough, vitamin D supplements can be used. Diets comprised a complex combination of nutrients and foods, and dietary patterns in children and adolescents play a key role in bone formation. A dietary pattern that is high in vegetables and fruits and low in processed foods (containing large amounts of added sugar and salt) is necessary to achieve optimal bone formation. Finally, physical activity, particularly activities that apply large forces, is even more important than dietary factors to contribute to bone accrual.

 
  • References

  • 1 Word Health Organization. WHO scientific group on the assessment of osteoporosis at primary health care level. Summary Meeting Report Brussels, Belgium, 2004 . Available at: http://www.who.int/chp/topics/Osteoporosis.pdf . Accessed April, 2018
  • 2 Stagi S, Cavalli L, Iurato C, Seminara S, Brandi ML, de Martino M. Bone metabolism in children and adolescents: main characteristics of the determinants of peak bone mass. Clin Cases Miner Bone Metab 2013; 10 (03) 172-179
  • 3 Gordon CM, Zemel BS, Wren TA. , et al. The determinants of peak bone mass. J Pediatr 2017; 180: 261-269
  • 4 Weaver CM, Gordon CM, Janz KF. , et al. The National Osteoporosis Foundation's position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int 2016; 27 (04) 1281-1386
  • 5 Gunter KB, Almstedt HC, Janz KF. Physical activity in childhood may be the key to optimizing lifespan skeletal health. Exerc Sport Sci Rev 2012; 40 (01) 13-21
  • 6 Faibish D, Ott SM, Boskey AL. Mineral changes in osteoporosis: a review. Clin Orthop Relat Res 2006; 443 (443) 28-38
  • 7 Pietschmann P, Mechtcheriakova D, Meshcheryakova A, Föger-Samwald U, Ellinger I. Immunology of osteoporosis: a mini-review. Gerontology 2016; 62 (02) 128-137
  • 8 Rocha-Braz MG, Ferraz-de-Souza B. Genetics of osteoporosis: searching for candidate genes for bone fragility. Arch Endocrinol Metab 2016; 60 (04) 391-401
  • 9 Alswat KA. Gender disparities in osteoporosis. J Clin Med Res 2017; 9 (05) 382-387
  • 10 Walker MD, Novotny R, Bilezikian JP, Weaver CM. Race and diet interactions in the acquisition, maintenance, and loss of bone. J Nutr 2008; 138 (06) 1256S-1260S
  • 11 Cooper C, Westlake S, Harvey N, Javaid K, Dennison E, Hanson M. Review: developmental origins of osteoporotic fracture. Osteoporos Int 2006; 17 (03) 337-347
  • 12 Golden NH, Abrams SA. Committee on Nutrition. Optimizing bone health in children and adolescents. Pediatrics 2014; 134 (04) e1229-e1243
  • 13 Going SB, Farr JN. Exercise and bone macro-architecture: is childhood a window of opportunity for osteoporosis prevention?. Int J Body Compos Res 2010; 8: 1-9
  • 14 Zulfarina MS, Sharkawi AM, Aqilah-S N ZS, Mokhtar SA, Nazrun SA, Naina-Mohamed I. Influence of adolescents' physical activity on bone mineral acquisition: a systematic review article. Iran J Public Health 2016; 45 (12) 1545-1557
  • 15 McCabe L, Britton RA, Parameswaran N. Prebiotic and probiotic regulation of bone health: role of the intestine and its microbiome. Curr Osteoporos Rep 2015; 13 (06) 363-371
  • 16 Heaney RP, Abrams S, Dawson-Hughes B. , et al. Peak bone mass. Osteoporos Int 2000; 11 (12) 985-1009
  • 17 Maggioli C, Stagi S. Bone modeling, remodeling, and skeletal health in children and adolescents: mineral accrual, assessment and treatment. Ann Pediatr Endocrinol Metab 2017; 22 (01) 1-5
  • 18 Food and Agriculture Organization of the United Nations. Milk and dairy products in human nutrition. Rome (Italy), 2013 . Available at: http://www.fao.org/docrep/018/i3396e/i3396e.pdf . Accessed April, 2018
  • 19 Hegsted DM. Fractures, calcium, and the modern diet. Am J Clin Nutr 2001; 74 (05) 571-573
  • 20 Nieves JW, Lindsay R. Calcium and fracture risk. Am J Clin Nutr 2007; 86 (06) 1579-1580
  • 21 Looker AC. Dietary calcium: recommendation and intakes around the world. In: Weaver CM, Heaney RP. , eds. Calcium in the Human Health, 1st ed. Totowa, NJ: Humana Press; 2006: 105-127
  • 22 Food and Agriculture Organization. Human vitamin and mineral requirements. Report of a joint FAO/WHO expert consultation, Bangkok, Thailand. World Health Organization, Rome, 2002 . Available at: http://www.fao.org/docrep/004/y2809e/y2809e00.htm . Accessed April, 2018
  • 23 Ross AC, Manson JE, Abrams SA. , et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 2011; 96 (01) 53-58
  • 24 European Food Safety Authority. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Scientific Opinion on Dietary Reference Values for calcium. EFSA J 2015; 13: 4101 Available at www.efsa.europa.eu/efsajournal . Accessed April, 2018
  • 25 Federación Española de Sociedades de Nutrición. Alimentación y Dietética. Ingestas Dietéticas de Referencia (IDR) para la Población Española. Act Diet 2010; 14: 196-197
  • 26 Dietary reference values for food energy and nutrients for the United Kingdom. Report of the Panel on Dietary Reference Values of the Committee on Medical Aspects of Food Policy. Rep Health Soc Subj (Lond) 1991; 41: 1-210
  • 27 The Japan Dietetic Association. Dietary Reference Intakes for Japanese, 2015 . Available at: http://www.mhlw.go.jp/file/06-Seisakujouhou-10900000-Kenkoukyoku/Overview.pdf . Accessed April, 2018
  • 28 Ludwig DS, Willett WC. Three daily servings of reduced-fat milk: an evidence-based recommendation?. JAMA Pediatr 2013; 167 (09) 788-789
  • 29 Word Health Organization. Diet, nutrition, and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation. WHO Technical Report Series, No. 916 (TRS 916), Geneva, 2003 . Available at: http://apps.who.int/iris/bitstream/handle/10665/42665/WHO_TRS_916.pdf;jsessionid=CA68047B8489AC043623D73CC7E6882C?sequence=1 . Accessed April, 2018
  • 30 Pettifor JM. Calcium and vitamin D metabolism in children in developing countries. Ann Nutr Metab 2014; 64 (Suppl 2): 15-22
  • 31 Fleet JC. The role of vitamin D in the endocrinology controlling calcium homeostasis. Mol Cell Endocrinol 2017; 453: 36-45
  • 32 Wikoff D, Welsh BT, Henderson R. , et al. Systematic review of the potential adverse effects of caffeine consumption in healthy adults, pregnant women, adolescents, and children. Food Chem Toxicol 2017; 109 (Pt 1): 585-648
  • 33 Areco V, Rivoira MA, Rodriguez V, Marchionatti AM, Carpentieri A, Tolosa de Talamoni N. Dietary and pharmacological compounds altering intestinal calcium absorption in humans and animals. Nutr Res Rev 2015; 28 (02) 83-99
  • 34 Food and Agriculture Organization of the United Nations. Human vitamin and mineral requirements. Report of a joint FAO/WHO expert consultation Bangkok, Thailand, 2001 . Available at: http://www.fao.org/3/a-y2809e.pdf . Accessed April, 2018
  • 35 Tai V, Leung W, Grey A, Reid IR, Bolland MJ. Calcium intake and bone mineral density: systematic review and meta-analysis. BMJ 2015; 351: h4183
  • 36 Bolland MJ, Leung W, Tai V. , et al. Calcium intake and risk of fracture: systematic review. BMJ 2015; 351: h4580
  • 37 Ward KA, Cole TJ, Laskey MA. , et al. The effect of prepubertal calcium carbonate supplementation on skeletal development in Gambian boys-a 12-year follow-up study. J Clin Endocrinol Metab 2014; 99 (09) 3169-3176
  • 38 Lambert HL, Eastell R, Karnik K, Russell JM, Barker ME. Calcium supplementation and bone mineral accretion in adolescent girls: an 18-mo randomized controlled trial with 2-y follow-up. Am J Clin Nutr 2008; 87 (02) 455-462
  • 39 Du X, Zhu K, Trube A. , et al. School-milk intervention trial enhances growth and bone mineral accretion in Chinese girls aged 10-12 years in Beijing. Br J Nutr 2004; 92 (01) 159-168
  • 40 Cheng S, Lyytikäinen A, Kröger H. , et al. Effects of calcium, dairy product, and vitamin D supplementation on bone mass accrual and body composition in 10-12-y-old girls: a 2-y randomized trial. Am J Clin Nutr 2005; 82 (05) 1115-1126 , quiz 1147–1148
  • 41 Merrilees MJ, Smart EJ, Gilchrist NL. , et al. Effects of diary food supplements on bone mineral density in teenage girls. Eur J Nutr 2000; 39 (06) 256-262
  • 42 Lappe JM, Begley MA, Des Mangles JC, Laughlin A, McMahon DJ, Schawartz MC. Clinical trial of dairy in adolescent girls: effect on bone accrual. In: Weaver CM, Daly R, Bischoff-Ferrari H. , eds. Nutritional Influences of Bone Health. Montreal, Canada: Springer; 2016: 261-267
  • 43 Vogel KA, Martin BR, McCabe LD. , et al. The effect of dairy intake on bone mass and body composition in early pubertal girls and boys: a randomized controlled trial. Am J Clin Nutr 2017; 105 (05) 1214-1229
  • 44 Weber DR, Stark LJ, Ittenbach RF, Stallings VA, Zemel BS. Building better bones in childhood: a randomized controlled study to test the efficacy of a dietary intervention program to increase calcium intake. Eur J Clin Nutr 2017; 71 (06) 788-794
  • 45 Feskanich D, Bischoff-Ferrari HA, Frazier AL, Willett WC. Milk consumption during teenage years and risk of hip fractures in older adults. JAMA Pediatr 2014; 168 (01) 54-60
  • 46 Melnik BC. Evidence for acne-promoting effects of milk and other insulinotropic dairy products. Nestle Nutr Workshop Ser Pediatr Program 2011; 67: 131-145
  • 47 Bartley J, McGlashan SR. Does milk increase mucus production?. Med Hypotheses 2010; 74 (04) 732-734
  • 48 Deth R, Clarke A, Ni J, Trivedi M. Clinical evaluation of glutathione concentrations after consumption of milk containing different subtypes of β-casein: results from a randomized, cross-over clinical trial. Nutr J 2016; 15 (01) 82
  • 49 Lu W, Chen H, Niu Y, Wu H, Xia D, Wu Y. Dairy products intake and cancer mortality risk: a meta-analysis of 11 population-based cohort studies. Nutr J 2016; 15 (01) 91
  • 50 Aune D, Navarro Rosenblatt DA, Chan DS. , et al. Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies. Am J Clin Nutr 2015; 101 (01) 87-117
  • 51 Turner KM, Keogh JB, Clifton PM. Red meat, dairy, and insulin sensitivity: a randomized crossover intervention study. Am J Clin Nutr 2015; 101 (06) 1173-1179
  • 52 Melnik BC. Milk--the promoter of chronic Western diseases. Med Hypotheses 2009; 72 (06) 631-639
  • 53 Cashman KD. Calcium intake, calcium bioavailability and bone health. Br J Nutr 2002; 87 (Suppl 2): S169-S177
  • 54 European Food Safety Authority. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Scientific Opinion on the substantiation of health claims related to lactose and increase in calcium absorption leading to an increase in calcium retention (ID 668) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA J 2011; 9: 2234 Available at https://efsa.onlinelibrary.wiley.com/doi/epdf/10.2903/j.efsa.2011.2234 . Accessed April, 2018
  • 55 Gupta RK, Gangoliya SS, Singh NK. Reduction of phytic acid and enhancement of bioavailable micronutrients in food grains. J Food Sci Technol 2015; 52 (02) 676-684
  • 56 Embaby H. Effect of heat treatments on certain antinutrients and in vitro protein digestibility of peanut and sesame seeds. Food Sci Technol Res 2011; 17: 31-38
  • 57 Weaver CM, Proulx WR, Heaney R. Choices for achieving adequate dietary calcium with a vegetarian diet. Am J Clin Nutr 1999; 70 (3, Suppl): 543S-548S
  • 58 Weaver CM, Plawecki KL. Dietary calcium: adequacy of a vegetarian diet. Am J Clin Nutr 1994; 59 (5, Suppl): 1238S-1241S
  • 59 US Department of Agriculture, Agricultural Research Service, Nutrient Data Laboratory. USDA National Nutrient Database for Standard Reference, Release 28. Version Current: September 2015, slightly revised May 2016 . Available at: https://ndb.nal.usda.gov/ndb/ . Accessed April, 2018
  • 60 Göring H, Koshuchowa S. Vitamin D — the sun hormone. Life in environmental mismatch. Biochemistry (Mosc) 2015; 80 (01) 8-20
  • 61 Wacker M, Holick MF. Sunlight and vitamin D: a global perspective for health. Dermatoendocrinol 2013; 5 (01) 51-108
  • 62 Serrano MA, Cañada J, Moreno JC, Gurrea G. Solar ultraviolet doses and vitamin D in a northern mid-latitude. Sci Total Environ 2017; 574: 744-750
  • 63 Bouillon R. Comparative analysis of nutritional guidelines for vitamin D. Nat Rev Endocrinol 2017; 13 (08) 466-479
  • 64 Shams-White MM, Chung M, Du M. , et al. Dietary protein and bone health: a systematic review and meta-analysis from the National Osteoporosis Foundation. Am J Clin Nutr 2017; 105 (06) 1528-1543
  • 65 Zofkova I, Davis M, Blahos J. Trace elements have beneficial, as well as detrimental effects on bone homeostasis. Physiol Res 2017; 66 (03) 391-402
  • 66 Movassagh EZ, Vatanparast H. Current evidence on the association of dietary patterns and bone health: a scoping review. Adv Nutr 2017; 8 (01) 1-16
  • 67 Seiquer I, Mesías M, Hoyos AM, Galdó G, Navarro MP. A Mediterranean dietary style improves calcium utilization in healthy male adolescents. J Am Coll Nutr 2008; 27 (04) 454-462
  • 68 Høstmark AT, Søgaard AJ, Alvær K, Meyer HE. The Oslo Health Study: A dietary index estimating frequent intake of soft drinks and rare intake of fruit and vegetables is negatively associated with bone mineral density. J Osteoporos 2011 . doi: http://dx.doi.org/10.4061/2011/102686
  • 69 Anderson JJ. Calcium requirements during adolescence to maximize bone health. J Am Coll Nutr 2001; 20 (2, Suppl): 186S-191S
  • 70 Word Health Organization. Adolescents: health risks and solutions, 2018 . Available at: http://www.who.int/mediacentre/factsheets/fs345/en/ . Accessed April, 2018