Calcium for Bone Health
Anne Kolker MS, Registered Dietitian
Kids need to get enough calcium and vitamin D in order to develop healthy bones. Healthy bones are strong bones that have developed with a high amount of calcium. This is important for their older years. The National Osteoporosis Foundation says that one in two women and one in eight men over 50 will have an osteoporosis related fracture in their lifetime. Thirty-three percent of women over 65 will experience a fracture of the spine and as many as 20% of hip fracture patients die within 6 months from conditions caused by lack of activity such as blood clots and pneumonia.
Do you know how much calcium your child needs? Here are some facts and helpful tips to make sure your child is on track for strong and healthy bones that will last a lifetime.
After reading the title of this article, some of you may be humming the childhood song: “The foot bone is connected to the leg bone.” This is a great song for little ones to learn the parts of the skeleton. Of course, when parents think of bones they think of calcium. The image of milk, or the famous milk commercials, has probably entered your thoughts at this point. But the ad campaigns should really be: “Got calcium and vitamin D? They do a skeleton good.”
Why Kids Need Calcium for Bone Health
Low calcium intake during childhood is associated with osteoporosis later in life. Osteoporosis is a disease of low bone mass and can result in broken, also called fractured, bones. We all know of someone’s relative falling down and breaking their hip. The reality is that their bones fractured first which then caused them to fall. The key is prevention; bones continue to grow strong until age 30. Thus it is important to ensure adequate calcium and vitamin D intake early on.
Vitamin D helps our bodies absorb calcium. Our bodies actually make vitamin D just by being exposed to sunlight (at least 3 times a week for 15 min). Most of us get enough sun but if you:
- always have sunscreen on
- are elderly (as we age our skin becomes less effective at converting vitamin D to its active form)
- are dark skinned
- live in northern climates
you may need to supplement your diet.
Children's Daily Calcium Needs
Only a few foods contain vitamin D naturally such as salmon, sardines, canned light tuna, and eggs. Fortified foods provide a dietary source of vitamin D and include milk, some cereals, breads, and fruit juices. Finally, multi-vitamins contain 400 IUs of vitamin D although amounts may vary depending on the brand.
The chart below indicates daily intake of calcium and vitamin D:
| Age | Calcium per day | Vitamin D per day |
|---|---|---|
| 0-6 months | 210 mg | 400 IUs* |
| 6-12 months | 270 mg | 400 IUs* |
| 1-3 years old | 500 mg | 200 IUs |
| 4-8 years old | 800 mg | 200 IUs |
| 9-18 years old | 1300 mg | 200 IUs |
| 19-50 years old | 1000 mg | 200 IUs |
| 50+ | 1200 mg | 200 IUs |
* Breastfed babies may need to get vitamin D supplements, check with your pediatrician first. Nursing mothers should also get extra vitamin D in their diet or from a supplement. Formulas also have the appropriate amounts of calcium and vitamin D.
Calcium Rich Food Ideas Chart
Dairy products are high in calcium and have vitamin D. But there are many other sources of calcium that you can add to your child's daily foods!
Here is another chart to illustrate which foods are good sources of calcium:
| Food | Servings | Calcium Content (may vary) |
|---|---|---|
| Milk, non-fat or lowfat | 1 cup | 300 mg |
| Soy or rice milk fortified with calcium | 1 cup | 300 mg |
| Cheddar cheese | 1.5 oz | 300 mg |
| Lowfat yogurt | 8 oz | 200 mg |
| Orange juice fortified with calcium | ½ cup | 175 mg |
| Frozen yogurt | ½ cup | 100 mg |
| Cheese pizza | 1 slice | 100 mg |
| Tofu firm with added calcium | 4 oz | 100 mg |
| Instant oatmeal | 1 cup | 100 mg |
| Almonds* | ¼ cup | 90 mg |
| Cottage cheese | ½ cup | 70 mg |
| Broccoli, cooked | 1 cup | 7 mg |
| Baked beans | ½ cup | 70 mg |
| Kale | ½ cup | 50 mg |
| Orange, medium | 1 | 45 mg |
| Sweet potatoes, mashed | ½ cup | 45 mg |
* Nuts can be a chocking hazard for children under 4 years of age – try almond butter instead. Some children can be allergic to nuts. Check with your pediatrician before adding new foods to a baby or toddler’s diet.
When purchasing food items be aware that the Daily Value for calcium is not listed by weight but rather by percentage of adult Daily Value weight. For calcium the adult Daily Value is 1000mg. This means that if the label states 20%, this product contains 200mg (1000mg x 0.20). Although your 9 year old child needs 1300mg, you can still use the % Daily Value to help guide you and compare products.
Kids and Calcium – Useful Links and Tools
Fun, Free Printable - Kids Building Strong Bones and Teeth – get the kids involved and make it a fun challenge to eat more calcium rich foods
Kids Printable - Building Strong Bones and Teeth Tracking Sheet – put up this fun tracking sheet and let your child color each box when they have had a high calcium food
Ways to help your child get enough calcium – tips for the whole family
Kids need more vitamin D - recommendations from the American Academy of Pediatrics
Questions about milk – does my child really need milk?
Are kids getting enough calcium? – recent study indicates no!
Get Kids Exercising For Bone Health
When our kids perform weight bearing exercises such as jumping rope, running, playing basketball, dancing, or even just walking, this tells their body to make more bone cells creating stronger bones. For tweens and teens, weight lifting is another activity they can do. Always consult with a personal trainer to ensure proper weight lifting techniques. It is important to monitor your teen’s diet because it is a time when breakfast is often skipped (think about the milk in the cereal) or dieting and skipping meals may occur. Also, although the mechanism is unclear, high soda intake may negatively affect calcium absorption.
Teach kids at a young age the importance of calcium and vitamin D. The best way to ensure that your child gets all the nutrients for a healthy body is by eating a healthy diet from all the food groups. Kids are learning from you. So keep it fun and positive and show them how fun it is to eat a balanced meal. If you need some help, check out our links and tools for this topic.