Adolescent Bone Health

Abstract

Pediatric and adolescent care professionals have increasingly recognized the importance of understanding the skeletal health of their patients. Peak bone mass, the "bone bank" on which an individual will draw for their entire adult life, is likely achieved by late adolescence, with the critical window for accumulation occurring much earlier. This review outlines the known conditions that are associated with impaired bone mineral accrual and clinical settings in which the evaluation of "at-risk" adolescents should be considered. We describe the methods available to the health care professional for evaluating bone density, along with the limitations of each technology. Potential therapeutic options for patients identified to have a low bone mineral density are discussed. Finally, current recommendations regarding physical activity and nutrition, beneficial interventions for all adolescents, are presented.

Higher vitamin D intake is needed to achieve serum 25(OH)D levels greater than 50 nmol/l in Québec youth at high risk of obesity

“…Vitamin D status has been associated with the attainment of peak bone mass (Heaney et al, 2000;Loud and Gordon, 2006) and glucose homeostasis (Chiu et al, 2004), and is potentially protective of colorectal and breast cancer (Garland et al, 2006). Although important for health, vitamin D deficiency and 25-hydroxyvitamin D (25(OH)D) levels o75 nmol/l are prevalent among Canadian youth (Roth et al, 2005;Mark et al, 2008).…”

Cross-sectional evidence of suppressed bone mineral accrual among female adolescent runners

“…(2,3) Factors that may disrupt adequate bone mineral accumulation during adolescence in an otherwise healthy individual include a diet lacking adequate bone-building nutrients and extreme dietary restriction (as in anorexia nervosa). (1,(6)(7)(8)(9) Amenorrhea and a delayed onset of menarche are also associated with low bonemass gains. (1,(6)(7)(8)(9) In contrast, exercise has beneficial effects on bone mineral accumulation during childhood and early adolescence.…”

“…(1,(6)(7)(8)(9) Amenorrhea and a delayed onset of menarche are also associated with low bonemass gains. (1,(6)(7)(8)(9) In contrast, exercise has beneficial effects on bone mineral accumulation during childhood and early adolescence. (1,4,6,10,11) Studies have reported 10% to 40% higher bonemass gains in physically active adolescents compared with their sedentary controls.…”

Measurement properties of radial and tibial speed of sound for screening bone health and fragility in 10[ndash]12 years old boys and girls

“…Osteoporosis is however a disease that could have a slow and long progression starting in the period of growth associated with an insufficient acquisition of bone mineral. The screening of bone health around 10-14 years of age in girls and 12-16 years of age in boys seems to be particularly important in the prevention of osteoporosis because about 40% of peak bone mineral mass is acquired during the four year period surrounding peak height velocity, which is around the 12 nd and 14 th years of life in girls and boys, respectively [4][5][6]. Beyond DXA, other equipments have been applied in both pediatrics and adults to assess bone mineral status, as the quantitative ultrasonography (QUS), which quantifies the ultrasound velocity and attenuation parameters at the distal regions of the appendicular skeleton [7][8][9].…”