Optimizing bone health in children and adolescents

Committee on Nutrition

Research output: Contribution to journalReview article

131 Citations (Scopus)

Abstract

The pediatrician plays a major role in helping optimize bone health in children and adolescents. This clinical report reviews normal bone acquisition in infants, children, and adolescents and discusses factors affecting bone health in this age group. Previous recommended daily allowances for calcium and vitamin D are updated, and clinical guidance is provided regarding weight-bearing activities and recommendations for calcium and vitamin D intake and supplementation. Routine calcium supplementation is not recommended for healthy children and adolescents, but increased dietary intake to meet daily requirements is encouraged. The American Academy of Pediatrics endorses the higher recommended dietary allowances for vitamin D advised by the Institute of Medicine and supports testing for vitamin D deficiency in children and adolescents with conditions associated with increased bone fragility. Universal screening for vitamin D deficiency is not routinely recommended in healthy children or in children with dark skin or obesity because there is insufficient evidence of the cost-benefit of such a practice in reducing fracture risk. The preferred test to assess bone health is dual-energy x-ray absorptiometry, but caution is advised when interpreting results in children and adolescents who may not yet have achieved peak bone mass. For analyses, z scores should be used instead of T scores, and corrections should be made for size. Office-based strategies for the pediatrician to optimize bone health are provided. This clinical report has been endorsed by American Bone Health.

Original languageEnglish (US)
Pages (from-to)e1229-e1243
JournalPediatrics
Volume134
Issue number4
DOIs
StatePublished - Jan 1 2014

Fingerprint

Bone and Bones
Vitamin D
Recommended Dietary Allowances
Vitamin D Deficiency
Health
Calcium
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Child Health
Adolescent Health
Weight-Bearing
Cost-Benefit Analysis
Age Groups
Obesity
X-Rays
Pediatrics
Skin
Pediatricians

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Optimizing bone health in children and adolescents. / Committee on Nutrition.

In: Pediatrics, Vol. 134, No. 4, 01.01.2014, p. e1229-e1243.

Research output: Contribution to journalReview article

Committee on Nutrition 2014, 'Optimizing bone health in children and adolescents', Pediatrics, vol. 134, no. 4, pp. e1229-e1243. https://doi.org/10.1542/peds.2014-2173
Committee on Nutrition. / Optimizing bone health in children and adolescents. In: Pediatrics. 2014 ; Vol. 134, No. 4. pp. e1229-e1243.
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