Adolescence: Springboard to Lifelong Bone Health

Encourage Calcium-Rich Foods and Bone-Building Activities

A calcium-rich diet and bone-building activity (weight-bearing exercise) are two essential factors for healthy bones. Yet many adolescents, particularly pre-teen and teen girls, fall short in both areas.

Diet

• Most American girls over age 11 consume barely half the 1300 mg of daily calcium recommended by the National Institute of Health.
• About one-third of boys also fail to hit that target.
• Declining consumption of dairy products during adolescence is a major factor in the teen calcium deficit. Dairy products provide 75 percent of the calcium in the American diet.

Activity

• Active children may have 5-10 percent greater bone mass at the end of adolescence than inactive ones.
• Activity levels decline as children pass through adolescence: 70 percent of 12-year-olds say they participate in vigorous physical activity, while only 30 percent of women and 42 percent of men do so by age 21.
• "Couch potatoes" grow bones strong enough only to sustain their low activity levels.
• At the other extreme are teens who overexercise in combination with strict dieting. This can delay both puberty and menstruation, increasing the risk for weak bones and fractures now and later in life. Young athletes need to maintain a healthy body weight and eat a well-rounded diet.

Reinforce Positive Health Habits

Developmentally, adolescents are just beginning to recognize the connection between actions and consequences. Effective intervention combines skills, knowledge and motivation to establish lifelong healthy habits.

• Make goals and strategies to overcome obstacles realistic and relevant. Help students think through changes in eating and activity choices that work for them.
• Get families involved. Reinforcing goals at home helps ensure student success.
• Emphasize the short-term benefits: Students will be stronger, more fit and feel better about themselves NOW.
• Discuss the long-term benefits as well: Students can look forward to a healthier, more active lifestyle throughout adulthood.
• Discuss other lifestyle habits: Smoking and alcohol consumption potentially interfere with the body's ability to maximize peak bone mass.

Eat Bone-Building Foods!

• Consume at least three 8 ounce glasses of milk every day.
• Dairy foods, such as milk, yogurt and hard cheese are an easy, convenient way to get calcium as well as a complete "package" of nutrients essential to bone growth and development: vitamins D, A, B6, folate, riboflavin, magnesium and potassium.
• Other foods also help meet adolescent calcium needs, if eaten in large enough amounts. For example, 3 cups of broccoli, 3 cups of kale or 4.5 oz of canned salmon (with bones) provide the amount of calcium in one glass of milk.
• Calcium-fortified foods or supplements can enhance a healthy diet. Relying on such foods, however, potentially shortchanges the body of other important nutrients found in foods that naturally contain calcium.

• Make a lifelong commitment to daily physical activity. Include activities that put weight on the bones, such as running, jumping or dancing. Activities that work all large muscle groups help bones store calcium.
• While daily activity is important and desirable, be aware that excessive exercise can actually endanger growth and bone development. Moderation is the key.

Adolescents may face real or perceived obstacles to getting the calcium they need. If your students retort with comments such as these, here are some strategies to help redirect them.

• "I'm not a little kid anymore. I don't need milk."
  
  Just when they most need a calcium-rich diet, adolescents drop their calcium consumption. Reinforce the "window of opportunity." This is the most critical time to support growing bones by eating plenty of calcium-rich foods.

• "My life is so busy, I don't have time to exercise!"
  
  Bone-building activities can readily fit into most any lifestyle. Simply walking to school or to a friend's house, instead of riding in a car can make a difference.

• "No one in my family drinks milk. It's never in the house, so I don't drink it at home."
  
  Be aware of possible obstacles to consuming some calcium-rich foods, such as ethnicity, dietary customs and lactose intolerance. Encourage students to make small, realistic changes in eating that they can see themselves carrying out. For example, have lowfat milk for lunch at school, instead of a soft drink; or try yogurt, cheese and other calcium-rich foods.

• "I can't eat dairy products. They're too high in fat and calories and I don't want to gain weight."
  
  Dairy foods offer a wide range of options, including nonfat and lowfat milk and yogurt and reduced fat cheeses. Taking out the fat does not remove or lower the amount of calcium and other important nutrients these products provide. Calcium-rich diets don't have to be calorie-rich as well. A cup of nonfat yogurt or 3 cups of broccoli have no fat, are low in calories and pack a big punch of calcium and other nutrients.

• "Osteoporosis is something my grandmother worries about. My bones are fine."
  
  If students can't relate to the long-term consequences of poor bone health, make bone health relevant by discussing the short-term benefits: good nutrition, weight-bearing exercise and appropriate body weight will make them strong and fit NOW.