Counseling Patients About Calcium Requirements For Their Teenage Daughters – Preventing osteoporosis down the road depends on it

James Meschino DC, MS, ROHP
The Osteoporosis Society tells us that one in four women over 50 develops osteoporosis in modern society, which leads us to believe that it’s a condition that requires attention once we are in our 40’s or 50’s. We couldn’t be more wrong! The truth is that the nutrition, supplementation and lifestyle habits of young women, between ages 13 and 20 years, are the most important factors that determine risk of developing osteoporosis in later years. As 25% of women who experience an osteoporotic hip fracture die within the first year from pneumonia and other complications, it becomes the obligation of responsible parents to initiate a proper osteoporosis prevention program in the lives of their teenage daughters. And the good news is that researchers have now given us an exact blueprint to follow.

Bone Calcium Accumulation During The Teen Years
It’s not as if you feel this happening to you, but between ages 13-20 (full range is 11-24 yrs), our bodies have the ability to absorb calcium from the intestinal tract with a very high degree of efficiency – but this absorption capacity declines with age. As such, teenage girls provided with ideal amounts of calcium are known to drive calcium into their bones at rate of 400-500 mg per day (prior to puberty the rate is a mere 140-165 mg per day). If they do this day after day, year after year, throughout their teenage years, they end up with optimal bone density by age 20-24. This is important because later in life, when estrogen and other hormones decline, calcium leaks out of bone into the bloodstream, is filtered by the kidneys and is excreted in the urine. In other words, the calcium that was once part of their bone structure, gets excreted in their urine as they get older.

Sure, they can take extra calcium later in life to slow down the rate of calcium loss from bone.  And with resistance exercise and 1400 – 2000 IU of vitamin D, they may even help stabilize their bone density. But for many women, they just simply didn’t get enough calcium when they were younger and they end up paying a very dear price for it as early as age 45 (when osteopenia or osteoporosis is often discovered upon bone density testing).

What’s A Girl To Do?
There is no need to tell me how hard it is to convince teenagers to subscribe to a healthy diet and exercise program for the sake of preventing diseases that may occur in their 50’s or 60’s.  In your teens, conditions like osteoporosis, heart disease, cancer, dementia, just don’t seem that imminent – these are things that happen to people who are ancient. It’s impossible for them to understand how quickly life ticks away and the years pass.

Fortunately, research has shown that the teenage version of an osteoporosis prevention program is very, very simple, yet highly effective. So, they really don’t have to make any major adjustments to get the benefit you want for them.

In 2003, G. Rozen showed that teenage girls achieved optimal calcium accretion (accumulation) in bone at a daily calcium intake of 1200 mg per day. As the average teenage girl consumes only 500 mg of calcium from her diet, Rozen found that providing an additional 700 mg per day of calcium from a calcium supplement worked like a charm to enable teenage girls to maximize their bone density during those important teenage girls.

In 2008, H. Lambert and fellow researchers confirmed what G Rozen had shown back in 2003. In a placebo-controlled study they showed that teenage girls given an additional 555 mg of calcium, from a supplement, achieved significantly greater gains in their total body density compared to the teenage girls given the placebo pill.

The Take Home Message
In the ideal world, teenage girls would consume 1200-1500 mg of calcium a day from food, go to the gym and lift weights three times per week, perform aerobic exercise regularly, avoid foods, beverages and behaviors that rob the body of calcium, such as soda pop, salty foods and drinks, alcohol, caffeine and cigarettes, and would get the full gambit of other bone support nutrients, including Vitamin D, magnesium, zinc, copper, B- vitamins, silicon and protein.

At the very least I suggest that you speak to the patients you have who have teenage girls about putting them on a High Potency Multiple Vitamin and Mineral that contains 500 mg of elemental calcium and 400 IU of vitamin D, along with some zinc, copper and magnesium. In many cases its also good idea to add one caplet of a Bone Support Supplement that can provide an additional 250 mg of calcium and 400 IU of Vitamin D, along with silicon, the icariin flavonoid (from the Epimedium herb) and other bone support nutrients.

Why is this so important for girls? Simply because later in life the decline in estrogen (around menopause) is the major trigger that promotes calcium loss from bone. This is the reason more women than men get osteoporosis. However, one in eight men over 50 now develops osteoporosis, and thus, the same prevention program is suitable for teenage boys.

Men are living longer and osteoporosis is becoming a major health condition, which really starts to be a factor for men over the age of 65. Once again, optimal calcium and vitamin D intake during the teenage years is a critical determinant of one’s risk for osteoporosis later in life – whether you are a female or a male.

And, of course, physical activity, resistance training and weight bearing exercises are primary strategy in keeping bones strong throughout one’s lifetime.

1. Rozen G, Renneri G, Dodiuk-Gad R, et al. Calcium supplementation provides an extended window of opportunity for bone mass accretion after menarche. Am J Clin Nutr. 2003; 78:993-8
2.  Lambert HL, Eastell R, Karnik K, Russell JM, Barker ME. Calcium supplementation and bone mineral accretion in adolescent girls: an 18-mo randomized controlled trial with 2-y follow-up. Am J Clin Nutr. 2008:87, 2:455-462