Bone-healthy nutrition is a family affair! From grandma to the youngest grandchild – nutrition that builds and maintains strong bones should be a priority for the entire family.

Childhood and adolescence is the most important time in which to build up bone strength – and parents can be creative in finding ways to include nutrient-rich foods in their kids' diet. This is the time of life when both the size and strength of our bones increases significantly. Although the process of bone building continues to our mid-twenties (when ‘peak bone mass’ is achieved), approximately half is accumulated during adolescence - and a quarter is actually built up during the two-year period of fastest growth.

Peak bone mass is largely hereditary, but there are two important factors which will help determine whether a child actually does reach his or her optimum bone mass - nutrition and exercise.

In terms of nutrition, young people need to have a ‘bone-healthy’ diet which includes the right nutrients to maximize their bone strength potential. The diet should include foods that are high in calcium, vitamin D, and other nutrients such as protein, vitamin K, magnesium, zinc, and carotenoids (found in many leafy green vegetables, carrots, peppers, and fruits). 

Recommendations by health authorities reflect the need for extra calcium and protein in this age group. For example, international recommendations (Institute of Medicine) are 1300 mg/day of calcium for children aged 9-18, and 46 and 52 grams of protein respectively for girls and boys aged 14-18. However, estimates from various studies suggest that as many as 85% of adolescent girls do not meet the recommended daily allowance of calcium, with an average range of approximately 700 to 950 mg per day, and that more than half consume less than 500 mg per day¹.

Unfortunately, as most parents are all too aware, it can be a battle to get young people to choose nutritious foods over fast foods and sugary drinks. Most will prefer to drink sodas rather than milk, and many avoid nutritious vegetables or prefer munching on candy bars as opposed to snacking on yoghurts, nuts or dried fruits.

Here are five tips on how you can help your kids enjoy a more nutritious diet that will help optimize their bone health:

1. Start on healthy foods at a young age
Unlike teenagers, young children are largely dependent on the foods parents provide. That's why it’s best to start instilling healthy eating behaviours at a young age – when you still have maximum control of what your children eat throughout the day.

2. Make it available
One study found that one of the reasons why children do not regularly consume calcium-rich foods is the lack of availability of products such as yogurt, cheese or tofu in the home. The same study revealed that parents had no expectations for their children to consume calcium-rich foods.¹ As a parent, ensure your fridge is stocked with heathy food options that are easily available when hunger calls. Prepare meals that integrate wholesome calcium-rich foods like dairy products, fatty fish, a wide variety of vegetables, wholegrains, soy products, beans and lentils, nuts, seeds and fruits.

3. Don’t make it available
Cut back on the junk food in your pantry. Having fewer non-healthy options around will force your children to eat more nutritious snacks instead.

4. Milk the potential of breakfast
Breakfast is one of the easiest meals in which to add dairy and other nutritious foods to your children’s diet. Wholegrain toast or pancakes, fruit slices, muesli with yoghurt, eggs, wholegrain cereals with low-fat milk – there is so much potential to make breakfast count as a key ‘bone-healthy’ meal in the day.

4. Sneak it in
Is there any parent who hasn’t tried to ‘sneak in’ healthy ingredients? Whether you hide soy in a recipe, disguise a hated vegetable by adding a layer of melted low-fat cheese, or prepare desserts that combine hidden ingredients. Anything goes. Don’t hold back!

5. Look for healthy alternatives
Sometimes it’s just a matter of providing alternatives that will help your children or teens get that extra boost of calcium or vitamins. They won’t drink milk? Try unsweetened chocolate milk or offer fruit smoothies with milk. They won’t eat fresh fruit? Try dried fruits such as prunes as snacks. No to chick peas? Try serving humus dip with crackers. Won’t eat yoghurt? Serve desserts or sauces made with yoghurt. Be creative!

You can also encourage your kids to get involved in meal preparation – from choosing the recipe to buying the ingredients at the store with you, children who have helped prepare a meal are more likely to enjoy eating it – even if it contains ‘unpopular’ ingredients.

And, don’t forget to be a role model. Parents who eat irregular meals or are on fad diets aren’t setting a good example. A healthy body-weight contributes to optimal bone health and even children can be influenced by an unhealthy focus on weight-loss. One study of eating behaviour in preadolescent girls found that many did not want to eat calcium-rich foods (such as cheese or milk) in order to avoid dietary fat ². 

Research has proven that the foundation for osteoporosis prevention begins in childhood – so as a parent, rest assured: strategies to help your child get that extra boost of healthy nutrients are well worth the effort.

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References
1. Levers-Landis, C. E., Burant, C., Drotar, D., Morgan, L., Trapl, E. S., & Kwoh, C. K. (2003). Social support, knowledge, and self-efficacy as correlates of osteoporosis preventive behaviors among preadolescent females. Journal of Pediatric Psychology, 28(5), 335-345.
2. Vue, H., & Reicks, M. (2007). Individual and environmental influences on intake of calcium-rich food and beverages by young Hmong adolescent girls. Journal of nutrition education and behavior, 39(5), 264-272.

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World Osteoporosis Day
World Osteoporosis Day is marked on 20th of October every year, the highlight of longer-term campaign dedicated to raising global awareness of the prevention, diagnosis and treatment of osteoporosis and prevention of fractures. Organized by the International Osteoporosis Foundation (IOF), World Osteoporosis Day launches campaigns and activities by national osteoporosis patient societies all across the world. www.worldosteoporosisday.org 

World Osteoporosis Day 2020 Partners
Global Partner: Sunsweet
Local Partners (Switzerland): Sandoz, Amgen, UCB
Supporters: Amgen, Kyowa Kirin, GSK, Sandoz, UCB