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Osteoporosis May Be a Pediatric Disease


Osteoporosis is typically diagnosed in middle-aged and older women, and less often in older men, but what if the loss of bone density that characterizes osteoporosis gets its start during infancy or even in the womb? Could osteoporosis be a pediatric disease?

The National Institute of Arthritis and Musculoskeletal and Skin Diseases notes on their “Juvenile Bone Health” web site that osteoporosis has been called “a pediatric disease with geriatric consequences” because the bone density and strength that children and adolescents achieve are important determinants of the bone health for the rest of their lives. But the critical age for bone mass may be even earlier.

Bone health depends on many factors, including having an adequate amount of calcium, vitamin D, and other nutritional elements that make up bone. Researchers from the US Army Research Institute of Environmental Medicine and North Carolina State University conducted studies on neonatal pigs as surrogates for human infants to determine how much calcium infants need to optimize bone density and strength as they get older, and what is the best source of that calcium. The study’s authors presented their findings at the Federation of American Societies for Experimental Biology 2010 meeting in Anaheim.

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The researchers fed 12 piglets a calcium-rich diet and another 12 piglets a calcium-deficient diet during the first 18 days of their lives. When the researchers examined samples of bone marrow, organs, and hind leg bone at the end of the study, they found that the piglets fed a calcium-deficient diet had compromised bone density and strength. The bone marrow tissue of these same piglets also seemed to be predisposed to become fat cells rather than osteoblasts (bone-forming cells). The presence of fewer osteoblasts during infancy may result in a reduced ability of bones to grow and repair themselves during later years.

Osteoporosis affects an estimated 10 million men and women in the United States, with about 80 percent of cases diagnosed in women. According to the National Osteoporosis Foundation, approximately 34 million additional people are believed to have low bone mass, which places them at increased risk for osteoporosis. Most people who have osteoporosis or low bone mass do not even know they have it, and the first clue is often a fracture associated with a fall or, in severe cases, simply bending over or turning around.

The lead researcher, Dr. Chad Stahl, an associate professor in the Department of Animal Science at North Carolina State University, noted that maintaining good calcium nutrition for children and adolescents is known to be important, but that this recent study “suggests that calcium nutrition of the neonate may be of greater importance to life-long bone health due to its programming effects on mesenchymal stem cells” (bone marrow tissue from which osteoblasts are formed). This idea might cause healthcare professionals “to begin thinking about osteoporosis not so much as a disease of the elderly, but instead as a pediatric disease with later onset.”

Federation of American Societies for Experimental Biology
National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Osteoporosis Foundation