There is an all too familiar scenario playing out these days across the country. Children, and especially adolescents, are not getting enough calcium and vitamin D at a time in their lives when they need it to fuel the incredible increase in bone density occurring as they grow. They are, therefore, increasing their risk of osteoporosis in the future. Many teens take in approximately one serving of dairy products per day, preferring, instead, soft drinks, energy drinks, or iced sweet tea. Many don’t exercise and spend virtually no time outdoors, preferring television, the internet, or video games. Now, aside from the very obvious issues of obesity and potential heart disease in many of these kids, there is another disaster awaiting them if this lifestyle is maintained, osteoporosis (bone fragility) with the risk of fractures as they age. The low calcium and vitamin D intake and lack of weight-bearing exercise all increase the risk.
The problem is that, even in the best of circumstance, both men and women reach a peak in bone density by the early twenties, and greater than half of a person’s peak bone mass is accumulated during the teen years. Sadly, starting in the early to mid thirties that peak bone mass starts to decrease, and it goes down throughout the rest of our lives. Therefore, children and adolescents need to get enough Calcium and Vitamin D to make certain their bone density peaks at as high a level as possible.
How much Calcium and Vitamin D do we need? Practically speaking infants who are breast feeding (as you know by FAR the best option for their overall health) get plenty of calcium but do need to be supplemented with Vitamin D, as human milk is low in Vitamin D. The 400 IU of Vitamin D they need daily can be easily obtained with a liquid tri-vitamin your baby’s physician can prescribe. Bottle fed babies do not need these supplements because they have been added to the milk, if they are on a commercially available infant formula supplemented with iron.
Older children need increasing amounts of Calcium (700 mg/d from 1-3years, 1000 mg/d from 4-8 years, and 1300 mg/d from 9-18) before the needs decrease just slightly in adults (1000 mg/day for 18-50 year olds and up to age 70 for men, 1200 mg/day for women aged 51-70 years). Vitamin D recommendations remain constant at 600 IU/day until after 70 years of age when they increase to 800 IU/day unless a vitamin D deficiency is diagnosed which would likely require vitamin D supplements.
Cow’s milk has approximately 300 mg of Calcium and approximate 100 IU of Vitamin D in eight ounces. Some citrus juices are now fortified to the same level with Calcium and Vitamin D, as are many brands of soy milk, rice milk, and almond milk (read the labels to make certain). Cheeses have about half as much Vitamin D as milk per serving, as a rule. Many fish are excellent sources of Vitamin D, as is Cod Liver Oil (your grandmother was smarter than you think about nutrition!). Leafy green vegetables (except spinach) are excellent sources of Calcium.
In essence, one needs approximately four to six servings of Vitamin D and Calcium rich foods DAILY. Children should also supplement their Vitamin D levels by spending short amounts of time in the sun, not more than 10 minutes without sunblock or sun-protective clothing to avoid later skin cancer (UV B causes the skin to manufacture Vitamin D).
In short our children need to take in more Calcium and Vitamin D, exercise regularly, and stay away from too much fast food. They need to avoid fad diets that do not include a healthy balance of all food groups. In addition as they grow into teens and young adulthood, excessive daily caffeine, smoking and excessive intake of alcohol have been associated with poor bone health. While osteoporosis may seem like an old person’s disease, in reality the loss of bone mass begins in early adulthood. So for children and adolescents the time to begin steps to prevent future fragility fractures due to osteoporosis is today.
Whole, 8 oz 300
Low-fat, 8 oz 300
Skim, 8 oz 300
Yogurt and Ice Cream
Plain yogurt, fat-free or low-fat, 6 oz 300
Ice cream, low-fat or high-fat, 8 oz 140-210
Mozzarella, part-skim, 1 oz 205
American, 1 oz 175
Cheddar, 1 oz 205
Swiss, 1 oz. 220-270
Cottage, (1% milkfat), 4 oz. 70
Fish and Shellfish
Sardines, canned in oil, 3 oz. (drained) 325
Salmon, pink, canned, 3 oz. (drained) 180
Shrimp, canned, 3 oz. (drained) 125
Bok choy ( cabbage) raw, 8 oz. 75
Broccoli, 8 oz. 60
Kale, cooked, 8 oz. 95
Soybeans, mature, 8 oz. (cooked/drained) 175
Turnip greens, fresh, 8 oz. 200
Oranges, 1 whole 50
Dried figs, 2 figs 55
Tofu, prepared with calcium, 4 oz. 200-345
Fruit juice, 6 oz. 200-345
Soy milk, 8 oz. (with added calcium) 80-500
Cereal, 8 oz. (with added calcium) 100-1,000
*The calcium content listed is estimated and can vary due to multiple factors such as fortification and fat content. Conversion: 8 oz.= 1 cup