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Compound Factors in Rising Rates of Childhood Fractures

Simple Lifestyle Changes May Help Reduce Fractures, Future Osteoporosis Risk

SACRAMENTO, CA—October 16, 2007 – Research corroborates the clinician’s hunch. Children and adolescents today are more likely to break a bone than their parents were, and experts have found that low dairy intake, overweight, inactivity and early fractures predict an increased risk of future fractures. Because early lifestyle choices can have serious health consequences now and later in life, experts are urging parents to make adequate calcium, vitamin D and physical activity a priority in their children’s lives.

"We know that children who avoid dairy products tend to have lower bone mass and more risk of fracture, but we’re seeing other factors like weight come into play,” said Laura K. Bachrach, M.D., Professor of Pediatrics at Stanford Medical Center. “Fractures put further bone growth and strengthening on hold. What’s more, they may create a vicious cycle for more fracture. Children are less active after breaking a bone, which in turn can further weaken the bones and set the stage for more fractures. If we don’t focus our efforts on improving bone health and maintaining a healthy weight from an early age, our children are likely to miss out on a chance to build the strongest bones they can."

Studies from the U.S., Sweden and Japan have shown that fractures are on the rise over the past four decades1,2,3,4. American boys are 32 percent and girls are 56 percent more likely to experience bone fracture than children were 40 years ago4. Changing eating patterns and obesity rates correlate with this increase. In 1945, Americans drank four times more milk than carbonated soft drinks; in 2001, they consumed nearly two and a half times more soft drinks than milk5. As a result, only a fraction of children—12 percent of females and 32 percent of males—get the calcium they need to optimize bone health during childhood and adolescence6, putting them at risk for fractures now and later in life7. Research also found that overweight children reported more fractures than nonoverweight children8. Additionally, early fracture increases the risk of repeat injury9, further impeding growth and bone-mass accrual.

"The good news is that we can suggest ways to build stronger bones. The window for building strong bones lasts until early adulthood, but it’s never too late to make bone health a priority,” said Bachrach. “Parents play a critical role in reducing fracture risk by ensuring their children get adequate calcium and vitamin D, cutting out extras and getting active with their children. Small changes made now can yield benefits—for you and your children—for years to come."

Bachrach recommends that parents try to provide adequate calcium and vitamin D through nutrient-rich foods whenever possible, rather than turn to supplements. A daily multivitamin can provide adequate vitamin D for most children to absorb the calcium they need for bone health, but ideally, the calcium should come from real food, not pills. Children and adolescents need two to three servings of dairy and 30 minutes of exercise a day for optimal bone-building gains. Because adolescence is typically when teens forgo milk and dairy products for sodas and other snack foods, early family reinforcement and lifestyle adoption is very important. Dairy Council of California offers simple steps to building a lifetime of strong bones:

  • Play soccer or go for a walk, because weight-bearing exercise helps build strong bones and maintain a healthy weight.
  • Encourage milk as the beverage of choice at lunch. Many schools offer low-fat or fat-free flavored milks that children love.
  • Offer cheese and yogurt as bone-building meal components and snack foods. Dairy foods work well as ingredients in many recipes you cook.
  • Include other calcium-rich foods in your diet, like beans, nuts and dark green leafy vegetables. Add slivered almonds and broccoli florets to a salad. Fat-free refried beans and corn tortillas make a great calcium-rich snack.
  • Be sure to include milk and dairy products in your own daily food choices and make time for exercise. If you model healthy behaviors like these, your child is likely to do the same.
  • Find out if nutrition education is part of your child’s curriculum. Ideally, nutrition education programs promote healthy foods from all of the food groups, as well as daily physical activity.
  • Go to mealsmatter.org for recipes that include dairy and other nutrient-rich foods.

    1Hagino H, et al. “Increasing incidence of distal radius fractures in Japanese children and adolescents.” J Orthop Sci. 2000;5(4):356-60.
    2Bengnér U, Johnell O. “Increasing incidence of forearm fractures. A comparison of epidemiologic patterns 25 years apart.” Acta Orthop Scand. 1985 Apr;56(2):158-60.
    3Landin LA. Fracture patterns in children. Analysis of 8,682 fractures with special reference to incidence etiology and secular changes in a Swedish urban population 1950-1979. Acta Orthop Scand Suppl 1983;202:1-109.
    4Khosla S, Melton LJ 3rd, Dekutoski MB, Achenbach SJ, Oberg AL, Riggs BL. “Incidence of childhood distal forearm fractures over 30 years: a population-based study.” JAMA. 2003 Sep 17;290(11):1479-85.
    5USDA Economic Research Service
    6National Osteoporosis Foundation
    7American Academy of Pediatrics, “Optimizing bone health and calcium intakes of infants, children and adolescents.” Pediatrics 2006;117(2):578-585.
    8Taylor, et al. “Orthopedic Complications of Overweight in Children and Adolescents.” Pediatrics Vol. 117, No. 6 June 2006, pp. 2167-2174 (doi:10.1542/peds.2005-1932)
    9Goulding A, Grant AM, Williams SM. Bone and body composition of children and adolescents with repeated forearm fractures. J Bone Miner Res. 2005; 20:2090-2096.

About Dairy Council
Dairy Council of California develops nutrition education programs designed to be personally relevant to each user. Making healthy food choices from all food groups and including daily physical activity are the foundation for lifelong health and wellness. Healthy Eating Made Easier®.

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