Bone Health in Children
CRC Press – 2012 – 241 pages
Bone health is one of the most widely discussed topics in pediatric nutrition. Ensuring adequate calcium and vitamin D intake is essential, and other factors also play a significant role. Bone Health in Children explores the recent decades of research and public commentary on the subject, debunks popular myths, and clarifies the often confusing and contradictory scientific literature. Presenting practical and theoretical education and advice, the book provides rational and accessible information geared to a wide audience of individuals interested in this critical element of pediatric health.
Providing a solid understanding as to how dietary guidelines are developed and evaluating the strengths and weaknesses of their underlying data, this volume answers practical questions crucial for choosing diets for children while also delving into the more theoretical aspects of conducting and interpreting medical research.
"Nutrition and bone health have become important issues in pediatrics. This book, addressed not only to pediatricians, but also to parents and public health workers, is divided into 15 chapters, the title of the first is "Why does bone health in children matter?" and the last "Frequently asked questions". The in-between reviews nutritional issues by age groups, pregnancy, children without diseases, etc. A practical text."
—Professor Zvi Laron, Pediatric Endocrinology Reviews, Vol. 10, No. 4, July 2013
Why does bone health in children matter, and what are the key players in bone health?
Why does bone health in children matter?
Key players in bone health
How do we identify and quantify dietary requirements?
The language of dietary requirements
Guideline development: The Institute of Medicine (IOM)
The IOM process
Other approaches to dietary guidelines
How can we compare these dietary guideline terms to recommendations such as those of the American Academy of Pediatrics (AAP)?
If an adolescent consumes 1290 mg per day of calcium and the guidelines say they should get 1300 mg per day, is this a real problem?
Nutritional status markers
Vitamin D levels
Interpreting serum 25(OH)D levels
Rickets: A historical perspective
Rickets: Clinical features and X-ray findings
Feeding premature babies after they go home
What are the recommendations for calcium and vitamin D in healthy full-term infants in the first 6 months of life?
The second 6 months of life and early signs of rickets
What should be done?
Toddlers (children younger than 4 years of age)
Calcium and the recommended dietary allowance (RDA)
What do children eat?
Rickets in toddlers
How to achieve vitamin D intakes in toddlers
Early school-age children (ages 4 to 8)
Should a healthy child have a routine or annual measurement of his serum vitamin D (25(OH)D) level?
Bone density measurements and children
How do you make sure a school-age child is getting enough vitamin D and calcium?
What happens to bone and when does it happen?
What drives bone mineralization during puberty and what is meant by peak bone mass?
Amount and source of calcium and vitamin D in adolescent diets
The role of exercise in bone health
Pregnancy and lactation
Fetal bone mineralization
Calcium and vitamin D in pregnancy and perinatal outcomes
Teenage pregnancy and lactation
Children with chronic illnesses
Summary related to bone health and chronic illnesses
Myths and realities of calcium intake in children: Can’t we just fortify all our foods?
Are there any harmful effects from consuming soda related to bone health?
What is the most calcium that should be in the diet or taken from supplements by children and adolescents?
How do food companies decide what foods to fortify with calcium and bone-related nutrients? How do they decide how much to add?
The technical side of fortifying foods
The cost of the fortificant
The target population for the product, especially if there are age-group related regulatory rules involved in the fortification
Marketing of the products
National food policies
The X factor
Myths and realities of vitamin D intake in children
Sunshine and vitamin D
Skin color and calcium and vitamin D
Why don’t we just megadose with all the bone-related vitamins and minerals such as vitamin D? What makes doctors and dietitians reluctant to do so?
Vitamin D toxicity
Beyond bone health: Vitamin D
Vitamin D and influenza
Vitamin D in children: Autism
Putting it all together: Bone health as part of good nutrition for infants and children
Summary: Early school-age children (ages 4–8)
Summary: Maternal nutrition
Unanswered questions: How do we conduct and publicize good nutritional research?
How do we publicize the study results once we are done?
Measuring calcium absorption: How is it really done?
Mass balance studies
The development of radioactive calcium studies
Stable isotope studies of calcium absorption
Global research of calcium metabolism using stable isotopes
A historical note regarding calcium stable isotope studies
How can a registered dietitian evaluate calcium intake for research studies?
Summary ideas related to research studies in this area
Programming and genetics
Does milk make a child grow tall?
Frequently asked questions
Steven A. Abrams, M.D., is a Professor of Pediatrics at Baylor College of Medicine. He is a board certified pediatrician and a neonatologist. He practices clinical neonatology in Houston, Texas.
Keli M. Hawthorne, M.S., R.D., L.D., is a registered dietitian working in nutrition research at Baylor College of Medicine in Houston, and she is a practicing clinical dietitian at Texas Children’s Hospital.