Optimizing bone health in adolescents

The purpose is to provide a brief overview of factors that impact adolescent bone health and review special populations that deserve extra consideration of their bone health status.

Optimization of modifiable factors is critical for adolescents to reach peak bone mass. Binge drinking, tobacco use, and certain medications all have accumulating evidence showing detrimental impacts on adolescent bone health and certain populations are more at risk for poorer bone health outcomes because of the nature of their conditions. Furthermore, very recent evidence suggests that in certain patients who have a history of insufficient nutritional and hormone status, 'catch-up' bone acquisition may not occur, underscoring the importance of early attention to these modifiable factors.

Providers caring for adolescents should be aware of the many different populations at risk for poor bone health. Treatment that might further compromise bone health should be considered judiciously and providers should encourage optimization of any modifiable factor when possible.