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How can I help keep my kids' bones healthy?

The same healthy habits that keep your kids going--and growing--will also benefit their bones. One of the best ways to encourage healthy habits in your children is to be a good role model yourself. Believe it or not, your kids are watching, and your habits--both good and bad--have a strong influence on theirs.

What are the two most important lifelong bone health habits to encourage now? Proper nutrition and plenty of physical activity.

Eating for healthy bones means getting plenty of foods rich in calcium and vitamin D. Most kids get enough vitamin D from sunlight (or from foods like egg yolks or fortified milk), but most do not get enough calcium in their diets. Younger kids (ages 2-8) are more likely to get adequate calcium, but among older kids (ages 9-19), only 19 percent of girls and 52 percent of boys get enough calcium to ensure optimal peak bone mass.

Are your kids getting enough calcium?

The National Academy of Sciences 1997, recommended calcium intake:

Infants: birth-6 months 210 mg, 6 months-1 year 270 mg

Children and Young Adults: 1-3 years 500 mg, 4-8 years 800 mg, 9-18 years 1,300 mg

Adult Women and Men: 19-50 years 1,000 mg, 50+ years 1,200 mg

Pregnant or Lactating Women: 18 years or younger 1,300 mg, 19-50 years 1,000 mg

Calcium is found in many foods, but the most common source is milk and other dairy products such as yogurt and cheese. Drinking one 8-oz glass of milk provides 300 milligrams (mg) of calcium, which is about one-third of the recommended intake for younger children and about one-fourth of the recommended intake for teens.

How can I persuade my daughter to drink milk instead of diet soda? She thinks milk will make her fat.

Soft drinks tend to displace calcium-rich beverages in the diets of many children and adolescents. In fact, research has shown that girls who drink soft drinks consume much less calcium than those who do not.

It's important for your daughter to know that good sources of calcium don't have to be fattening. Skim milk, low-fat cheeses and yogurt, calcium-fortified juices and cereals, and green leafy vegetables can all fit easily into a healthy, low-fat diet. Replacing even one soda each day with milk or a milk-based fruit smoothie can significantly increase her calcium intake.

But my kids don't like milk.

Drinking milk isn't the only way to enjoy its benefits. For example, try making soup and oatmeal or other hot cereals with milk instead of water. Pour milk over cold cereal for breakfast or a snack. Incorporate milk into a fruit smoothie or milkshake. Chocolate milk and cocoa made with milk are also ways to increase the milk in your child's diet.

Sources of calcium also might include an ounce or two of cheese on pizza or a cheeseburger, a cup of calcium-enriched orange juice, or a small carton of yogurt. Your kids can also get calcium from dark green, leafy vegetables like kale or bok choy, or foods such as broccoli, almonds, tortillas, or tofu made with calcium. Many popular foods--cereals, breads, juices--now have calcium added, too. Check the Nutrition Facts label on the package to be sure.

My teenage son loves milk, but it seems to upset his stomach. Could he have lactose intolerance?

People with lactose intolerance have trouble digesting lactose, the sugar found in milk and dairy foods. Lactose intolerance is not common among infants and young children, but can occur in older children, adolescents, and adults. It is more common among people of African American, Hispanic, Asian, and American Indian descent.

Most kids with lactose intolerance are able to digest milk in smaller amounts and combined with other foods, like cereal. They may tolerate other dairy products such as cheese or yogurt even if milk is a problem. Lactose-free milk products are now available in most stores, and there are pills and drops you can add to milk and dairy products that make them easier to digest.

Be sure to include plenty of foods with calcium in the meals and snacks you plan for your kids. Almonds, calcium-fortified orange juice, tortillas, fortified cereals, soy beverages, and broccoli with dip are a few great choices. While it's best to get calcium from food, calcium supplements can also be helpful.

Should I give my kids calcium supplements?

Experts believe calcium should come from food sources whenever possible. However, if you think your children are not getting adequate calcium from their diet, you may want to consider a calcium supplement. For optimal absorption, no more than 500 mg of calcium should be taken at one time.

Go On To Part 3 --- Osteoporosis Prevention For Kids --->