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Osteoporosis: a pediatric concern?
Robert A Faulkner1, Donald A Bailey
1College of Kinesiology, University of Saskatchewan, Saskatoon, Sask., Canada.
Insights
Osteoporosis prevention must start in childhood. Early lifestyle interventions, including nutrition and physical activity, are crucial for building strong bones and reducing future fracture risk.
Area of Science:
- Public Health
- Pediatrics
- Bone Biology
Background:
- Osteoporosis and fractures pose a growing global health challenge.
- Historically viewed as a disease of the elderly, osteoporosis has recognized pediatric origins.
- Peak bone mass is influenced by genetics, but lifestyle factors significantly impact childhood bone development.
Purpose of the Study:
- To highlight the pediatric antecedents of osteoporosis.
- To emphasize the need for research into modifiable lifestyle factors and childhood illnesses affecting adult bone health.
- To underscore the importance of early intervention strategies for osteoporosis prevention.
Main Methods:
- Review of current knowledge on bone development and osteoporosis.
- Discussion of limitations in current bone assessment techniques (e.g., dual-energy X-ray absorptiometry).
- Anticipation of advancements in assessing bone strength properties.
Main Results:
- Childhood and adolescence are critical periods for bone development.
- Modifiable lifestyle factors (physical activity, nutrition) are key determinants of bone health.
- Further research is needed to precisely define the impact of childhood factors on adult bone health.
Conclusions:
- Intervention strategies targeting osteoporosis must commence in childhood or adolescence for maximum efficacy.
- Establishing optimal bone mass during growth years is essential for reducing long-term fracture risk.
- A comprehensive approach integrating genetic and lifestyle factors is necessary for lifelong bone health.
Abstract:
Osteoporosis and related fractures are a major public health concern globally, and the incidence and subsequent morbidity, mortality and health care costs are expected to increase dramatically over the coming decades. Although osteoporosis was once considered (primarily) a disease of the elderly, there is now universal agreement that the condition has pediatric antecedents. Although genetic factors play an important role in the attainment of an optimal adult (peak) bone mass and strength, lifestyle factors such as physical activity and nutrition are also important determinants of children's bone development. However, there is still much research needed to identify the exact role of modifiable lifestyle factors and childhood illness on long-term adult bone health and fracture risk. Much of our current knowledge is based on bone mineral content and areal bone mineral density assessed by dual-energy X-ray absorptiometry; but with rapidly advancing technology, researchers will be able to more accurately assess other indices of bone strength, such as the material and structural properties of bone, during the growing years. Based on our current knowledge, however, it is clear that intervention strategies aimed at reducing the incidence of osteoporosis must begin in childhood or adolescence if they are to have maximal effect.
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