While it’s never too late to start looking after your bones, this window for reaching peak bone mass and density ends when people reach their late twenties to early thirties - so it makes sense to start investing in bone health as early as possible. Once a child is no longer breast or bottle feeding it can be a bit trickier to measure their vitamin and mineral intake, but with a bit of prudence at the grocery list stage this can be made a lot easier.
Always consult your GP if you are concerned about your child’s health or unsure of their nutritional needs.
Nobody would disagree with the notion that getting your kids into the habit of eating healthily is vital to their wellbeing now and in the future, but sometimes getting children to eat leafy greens instead of gummy greens is an uphill struggle.
This article outlines the dietary needs for building healthy bones and offers some nutritious food suggestions that might make mealtimes a little easier.
Most of us are aware of the importance of the mineral calcium when it comes to building strong bones. Happily, it is abundant in several foods that many kids love to eat: cheese, yoghurt and milk, as well as fortified bread. It’s also found in tahini, so if your young ones enjoy houmous then that’s a good snack food to have with fortified bread or veggie sticks.
If your child doesn’t eat dairy, there are other good options, such as almond butter on apple slices or a fortified-soymilk banana milkshake. They may even be among those very rare and mysterious children that are actually happy to eat kale and okra – if so, good for you!
However, if you are concerned your child isn’t getting enough calcium through being a picky eater, you might want to look at supplementing. You can get gummy sweets with calcium that most kids will eat enthusiastically (and be disappointed they only get one or two a day).
Daily calcium guideline amounts:
Be sure not to exceed stated doses on supplements unless otherwise advised by your child’s GP. Too much calcium from supplements could put a strain on kidneys and can cause hypercalcemia (a build-up of calcium in the blood). Hypercalcemia can cause weakened bones (amongst other health problems).
Calcium-rich meal and snack suggestions:
Fizzy Drinks Leach Calcium
Whilst there isn't conclusive evidence as to why this is the case, studies have shown there is a link between high fizzy drink consumption and increased risk of bone fractures. So encourage kids to choose healthier drinks rather than carbonated versions and nip that fizzy pop habit in the bud.
Vitamin D is a fat-soluble vitamin essential for calcium absorption and bone mineralisation. The two forms important in humans are ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). When taken in supplement form, D3 is generally considered to be better absorbed by the human body than D2.
Our bodies synthesise our own vitamin D3 when exposed to sunlight outdoors, but depending on where you live, it may not produce satisfactory amounts to fulfil daily requirements and therefore vitamin D will need to be obtained from supplementation. It is interesting to note that you cannot overdose from vitamin D3 from the sun (although you can, of course, get skin damage from too much sun, so be vigilant with your children when they are exposed to the sun).
Vitamin D insufficiency affects almost 50% of the population worldwide. A severe vitamin D deficiency can lead to rickets (weak bones) in children.
Good sources of vitamin D include fatty fish such as trout, salmon, tuna and mackerel, as well as egg yolk, butter and liver. These are often not favourites of children and so, thankfully, vitamin D is added to certain food products like breakfast cereals (think Cheerios) and fortified margarines. Something interesting to note: mushrooms that have been exposed to sunlight generate vitamin D.
Because vitamin D is one of the hardest nutrients to ensure your child is getting an adequate amount of during the autumn and winter months, a supplement is a good idea during the darker months. For very young children, birth to five years old, your child’s GP might recommend a daily supplement all year round.
Recommended dietary daily allowance for vitamin D is 10 micrograms (40 International Units (UI).
Be sure not to exceed stated doses on supplements unless otherwise advised by your child’s GP. While you can’t overdose from sunlight exposure, too much vitamin D from supplementation can have the same effects of calcium toxicity and cause hypercalcemia (a build-up of calcium in the blood).
Note: Dairy milk is not considered a good source of vitamin D in the UK as, unlike in some other countries, it is not fortified.
Vitamin D is not abundant in food, but here are some meals and snack suggestions that contain vitamin D:
Vitamin K is another important vitamin when it comes to bone health, ensuring calcium is directed where it is needed. Research suggests that low levels of this vitamin in the blood is associated with poor bone density in adults. As well as being found in plant foods such as dark-green leafy vegetables, our bodies – like with vitamin D – can produce vitamin K by itself (using bacteria in our digestive system), so supplementing with vitamin K shouldn’t be necessary, unless there is a prolonged or frequent use of antibiotics.
However, there are two types of vitamin K: K1 and K2. K1 has had the most attention paid to it and is usually the form found in supplements, but there has been some research on K2 that suggests this might be more helpful in transporting calcium to the places we need it. Unlike K1, vitamin K2 is synthesised by bacteria not in our bodies and is found in high-fat meat, cheese, egg yolk and fermented foods such as unpasteurised sauerkraut and natto (the latter two being suitable for vegans, although perhaps not something many children will be willing to eat).
K2 is further divided into MK4 (synthetic) and MK7 (natural) and you can supplement with K2-MK7 as these are now easily available and are often paired with vitamin D3.
There is not yet any official RDA for K2, but the guidelines for daily vitamin K intake are:
Vitamin K meals and snack suggestions:
Magnesium is another important mineral for bone health, however more research is needed on the optimal dose on the risk of osteoporosis and bone fractures if supplementing. Overdosing on magnesium has been found to have the opposite effect, weakening bones instead of fortifying.
Therefore, it makes sense to get your child’s magnesium requirements from magnesium-rich foods such as nuts (e.g., Brazil, almond, pecan and cashew), beans and legumes (e.g., soybeans, peanuts, baked beans), pumpkin seeds, wholegrains and dark-green leafy vegetables, and generally supplement only if these foods are not consumed.
Daily magnesium guideline amounts:
Magnesium meal and snack suggestions:
As well as being an important nutrient for all-round immune system health, zinc has an essential role in bone health, with zinc deficiencies having been associated with decreased bone density.
Luckily zinc is very easy to get in your child’s diet, being in many fortified breakfast cereals and in staples such as baked beans, oats, nuts, seeds, chickpeas, lentils, red meat and poultry. Oysters are high in zinc, but good luck getting your little ones to try those.
Daily zinc guideline amounts:
Zinc meal and snack suggestions:
This is the phase in life when the greatest gains in bone size and strength are made, with bones developing rapidly. This is also the time when perhaps it is hardest to get your children to eat healthily as you will have less control over their meals, but you can make sure they have nutritious snacks and meals wherever possible.
It is especially important for young women to optimise their bone health at this age, as this will ensure that hormone-related changes in later life can be weathered effectively, preventing fractures and bone-related diseases.
Meal suggestions for a day that promotes bone health:
Breakfasts – fortified cereal with milk or soymilk, almond or peanut butter on wholewheat toast, scrambled eggs on toast, Greek yoghurt and fruit, porridge.
Lunches – houmous and red pepper pitta, cheese on toast, tuna niçoise salad, chicken satay strips, tomato soup with grated cheddar cheese, cheese and tomato sandwich.
Dinner – Spanish omelette, tofu stir fry, beans on toast with cheese, tuna pasta bake, roast chicken, peas and creamy mashed potatoes, almond cake and custard
Snacks – nuts and seeds, peanuts, parfait, milkshakes, edamame, grissini or veg sticks and houmous, almond butter on apple slices, mango lassi
Eating a varied diet ensuring you include healthy food choices from across all the food groups – a 'rainbow' of fruits and vegetables, starches/grains, dairy or non-dairy alternative, protein and fat - goes a long way to helping maintain good health, including bone health.
It’s important to lead by example and eat healthy food yourself so your kids learn to make it a normal part of their lives. It can help to get them involved in preparing meals and to give them options to choose from, even if it’s just a choice between two different meals. Making meals fun and interesting by using cookie cutters or arranging food in fun ways can encourage younger children to eat, whilst older children might enjoy different theme nights (finger food, vegetarian, seafood) or foods from around the world (Italian night is bound to be popular).
If you do have to resort to sneaking healthy food in, there are many ways to do it without your kids noticing, such as a putting a handful of kale into a banana smoothie, adding broccoli rice or frozen spinach into pasta dishes, hiding finely chopped courgette on pizza, grinding seeds and nuts and sprinkling them into cereal or soups, and mixing sweet potato fries in with standard white potato fries, etc. Get creative.
Exercise is essential for building strong bones. When we move, especially whilst bearing our own weight such as walking, running, jumping, etc., we signal to our bones that they are needed and they respond by becoming stronger and denser. Taking part in physical activity may be the single most important thing your child can do for their bone health.
It’s important to ensure babies are active from the start: finger gripping, crawling, tummy time, supervised play, etc., to encourage muscle and bone strengthening.
Luckily, physical activity is one thing that usually comes very naturally to young children – climbing, jumping, dancing, running and generally just being active are excellent for building strong bones. Indoors or outdoors, it’s important to encourage physical activity every day. A trip to the park in summer has the added bonus of a dose of vitamin D. If you have the space, a trampoline is excellent for encouraging strong bones and if you get a big one you can join in the fun.
Encourage your kids to enjoy school sports and PE lessons and any extra-curricular activities that get them moving.
As children move into their teenage years, they can be prone to reducing their physical activity, and sedentary lifestyles sat in front of the TV or games console can become the norm.
So, if your child is a member of a sports team or has a physical activity they enjoy doing, be it tap dancing, skateboarding, gymnastics or playing rounders in the park, encourage them to keep it up. Or if they decide to give up something they feel they have outgrown, encourage them to take up something else, such as badminton, football or dance classes, or simply drag them off the settee for a walk in the park with the dog.
Investing in your children’s bone health now will pay dividends for them later in life. If you have any concerns about your child’s development, consult your GP for advice.
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