Feature Archive

Powerful Bones, Powerful Girls

Bad to the Bone

By Jeanie Lerche Davis
WebMD Feature

Reviewed By Michael Smith

Chances are, 9-year-old Ali Brown doesn't know the word "osteoporosis." But she eats lots of cheese, munches a Flintstone vitamin every day (the plus-calcium variety), and gets tons of exercise -- inline skating, jumping on a trampoline.

Her mother doesn't like to admit it, but osteoporosis is low on her worry list. "Heart disease and breast cancer run in my family," says Jana Brown. "I tend to focus there."

Even adults have a hard time taking osteoporosis seriously.

There's no pain, no obvious sign that your bones are getting brittle. The first sign is often a fracture -- your wrist, spine, or hip breaks. Many of our grandmothers spent long years lying in bed with hip fractures.

Today: "A hip fracture is the No. 1 reason elderly people end up in nursing homes. Within the first year, 20% die," says Saralyn Mark, MD, endocrinologist and geriatrician, and medical advisor to the Department of Health and Human Services' Office on Women's Health.

Mark is a spokeswoman for the nationwide "Powerful Bones, Powerful Girls" campaign.

Her own mother has been battling osteoporosis for decades, Mark says.

"It's hard for her to walk ... she's fallen several times," she tells WebMD. Her mother's bones are so weak, she can't even carry her own purse. "She needs my dad to carry her purse at the mall. It's hard for her to sleep in bed because she's had a back fracture."

It all could have been prevented: "She was a smoker, didn't get much calcium, wasn't terribly physically active."

That's the grim reality of osteoporosis. "Quality of life can be severely affected," says Mark.

Here's another issue: What kids do now affects their risks later on. "I've said it before, it's a disease with pediatric origins and geriatric consequences," she tells WebMD.

Are Kids Getting the Message?

Only 14% of girls and 36% of boys age 12 to 19 are getting enough calcium, experts say. Yet as much as 98% of adult bone is established by the end of the teen years.

Those formative years are "the critical years," says Stephen I. Esses, MD, chairman of spinal disorders at Baylor College of Medicine in Houston.

"Kids need to be eating a good diet, getting enough calcium," he tells WebMD.

Exercise is also important -- "soccer, baseball, anything," Esses says. "It doesn't make any difference what the sport is, as long as they get into that mindset, where it becomes part of their lifestyle, that's what's important." Exercise builds up your muscles, which protect bones when you fall or sprain a joint.

Smoking is out of the question. "It's a major cause of osteoporosis," he adds. "Smoking is the worst thing you can do."

The best source of calcium for kids and adults is food, says Sheah Rarback, MS, RD, assistant professor of pediatric nutrition at the University of Miami Medical School. Rarback is also a spokeswoman for the American Dietetic Association.

"Dairy products are the richest source -- not the only source, but the richest -- plus they have vitamin D, which helps your body absorb calcium," she tells WebMD. Low-fat and fat-free dairy products (including yogurt and cheese), dark green vegetables, sardines, and salmon are all good sources. "Also, calcium-fortified juices, cereals, and soy products work very well." And a tablespoon of blackstrap molasses equals 3/4 cup of greens.

Calcium supplements come in two forms: calcium carbonate, which needs to be taken with food, and calcium citrate, which does not have be taken with food.

Unless a calcium supplement is in a chewable vitamin, they're too big for children, says Rarback. "That's why we always encourage kids to get their calcium from food."