Building Strong Bones
Abstract: Our bones play very important roles in general movement, posture and protecting vital organs. As we get older and suffer from joint and movement pain, bone fractures and osteoporosis we often wonder “why, oh why did I not look after my bones?” A crucial period to influence bone strength and avoid all these problems is in the early stages of growing up when bones are still developing. Let’s take a look at the stages of bone development; you may discover it’s not as simple as drinking lots of milk or simply worrying about calcium intake.
Growth and development in the early years of childhood is an important stage which can have a significant impact on our health and well-being as adults. From birth to 5 years of age, we more than double in height. Although not as dramatic, growth continues until we reach the end of puberty (15-19 years for females; 16-21 for males). Coinciding with our height increase is the growth of our bones, which stop growing at the end of puberty. Whilst bones are growing, it is the only stage we are able to strengthen our bones. From birth to the start of puberty, bone mass can increase up to 7 times. Once bones stop growing, they reach their peak bone mass, which means they are as strong as they will ever be. This remains steady for the next 20 years, before the natural aging process causes a decline in bone strength. In many individuals, the bone strength becomes so low, they develop osteoporosis. Thus the early years of childhood are our only chance to influence how strong our bones will be. The peak bone mass (strength of bones) will differ for each individual depending on how well they optimized their bone growth during childhood. Strong bones are vital for general growth and basic movements, enhancing coordination, agility and good posture. Building strong bones can also reduce the risk of fractures, teeth cavities and osteoporosis. So how can one optimize their bone strength by reaching a high peak bone mass?
Our biggest growth spurt occurs in the first 5 years of life. Our growth rate then remains fairly steady until we stop growing.
Peak bone mass varies between individuals because it is dependent on nutrient intake and the building of bone mass during the first 20 years of life
How to assist strong growing bones
The formation and structure of bone requires many essential nutrients. While calcium is the most well known, there are many other vitamins and minerals that are required for healthy bone growth. Calcium along with phosphorus are minerals which is essentially what forms and makes bone tissue. Around 99% of calcium and 85% of phosphorus found in your body is located in your bones. However, to absorb these minerals from your diet and then transfer them to the bones, the body needs vitamin D. Vitamin K and magnesium also assist in this process. To form and strengthen bones, the body also needs zinc, vitamin C, manganese, folic acid and vitamin B6. If a child receives sufficient levels of these nutrients, their bones will be strong. However, if they are even marginally deficient in just one of these nutrients (not just calcium), it can result in a low peak bone mass, leaving bones weak, brittle and more prone to breakage. In addition, basic movements and posture can be affected as well as an increase risk of tooth cavities and osteoporosis. Really poor bone growth can also lead to bone deformities. The financial burden (hospital, dentist and chiropractor visits) from having weak bones can also be a strain.
How to obtain these nutrients
The nutrients required for bone growth can be obtained largely in green vegetables and dairy. However, it is very difficult to get children (particularly under the age of 5) to eat large enough portions of these food groups to obtain enough nutrients to optimize bone growth. There is a global increase in childhood obesity, suggesting today’s children are consuming diets rich in calories and fats and poor in nutrient quality. In addition, nutrient levels are significantly reduced (up to 80%) during food processing, preparation and cooking or when flavours are added so children will actually enjoy the food! To make matters worse, consuming protein-rich sources of calcium such as milk and whey-protein based formulas significantly reduce the amount of calcium that is actually absorbed due to its interaction with protein. In some countries there are also fears of contamination with dairy and meat products, placing more pressure on parents providing their child with a balanced diet. So what is a solution? There is no cause to panic. Simply provide a balance of nutrient sources through; green vegetables, fruit, nuts and meat and a variety of dairy products, not just relying on a few glasses of milk every day. When possible, introduce lightly steamed vegetables and avoid frying every meal they have. If you are still concerned about their nutrient intake, supplements containing calcium combined with the other important nutrients for bone health can assist you.
- Kerstetter, J.E., K.O. O’Brien, and K.L. Insogna, ‘Low protein intake: the impact on calcium and bone homeostasis in humans’. J Nutr, 2003. 133(3): p. 855S-861S.
- National Health & Medical Research Council (NHMRC), ‘Nutrient reference values for Australia and New Zealand: Including recommended dietary intakes’ (Report) 2006.
- Peacock, M., Calcium absorption efficiency and calcium requirements in children and adolescents. Am J Clin Nutr, 1991. 54(1 Suppl): p. 261S-265S
- World Health Organization (WHO), “Population-based prevention strategies for childhood obesity: report of a WHO forum and technical meeting, Geneva, 15–17 December 2009.” 2010
- World Health Organisation (WHO). The WHO Multicentre Growth Reference Study (MGRS) 1997-2003.
What is Lactoferrin?
The structure of lactoferrin
Abstract: Lactoferrin is a protein that is produced most abundantly in breast milk (in particular colostrum, the first milk produced after birth). However, it is also present in our saliva, tears, mucus and white blood cells. So what exactly is it doing in all these obscure places? Lactoferrin is part of your immune system to fight off many different types of infections. Let’s take a look to see exactly what it can do and why it is so unique!
Fighting off infections
Lactoferrin has very broad anti-microbial properties. This means it can reduce the infections of a large range of nasty bugs and germs. These include bacteria (eg. E.coli, salmonella and staphylococcus), viruses, fungi and parasites. Lactoferrin has the ability to not only inhibit and stop these bugs and germs from growing inside the body, it can also effectively kill them, preventing and reducing symptoms, disease and inflammation.
Boosting the Immune System
Aside from its own immune properties, lactoferrin has shown to increase the number of immune cells, proteins and pathways that help fight off infections. Lactoferrin also enhances the growth of good bacteria in the digestive system. This is important as they can fight off bad bacteria and promote a healthy digestive system, reducing symptoms like diarrhea and tummy aches and pains.
How to increase the lactoferrin supply
In the early stages of development, your child is most vulnerable to infections and illness because the immune system is still developing. Thus it is no surprise that we are sick more times in our first year, than any other year of life. Making sure your child has enough lactoferrin will assist in not only reducing the number of times they become ill, but it also reduces the severity and duration of symptoms they will have. This is one the important reasons why mother’s should breastfeed, it provides an excellent dose of lactoferrin to help your baby through a tough battle against germs and bugs. In addition, breast milk also contains antibodies and other proteins that boost the child’s immune system. Once they stop breastfeeding, the only food source that contains lactoferrin is cow’s milk; however the actual amount of lactoferrin is negligible (only 1-5% of the amount found in human breast milk). If you wish to boost your lactoferrin levels in your child or as an adult, lactoferrin supplements are available. The use of lactoferrin supplements have just recently emerged but have already shown to be effective in reducing the risk and severity of bacterial blood infections (sepsis) and lower respiratory infections in newborns, virus-induced diarrhea and vomiting in children and viral infections in adults.
|Infants and children given lactoferrin supplements (red) have a significantly reduced risk of infections and reduced severity and duration of illness symptoms than those who do not take lactoferrin supplements (Control – blue).|
Breastfeeding and lactoferrin supplements have proven to significantly boost the immune system and reduce the incidence and severity of illness. These two measures may go along way to relieve the stress and anxiety of parents, constantly looking after their children getting sick, time and time again.
Improve Iron status during pregnancy
Not only is lactoferrin a safe, natural way to boost your immune health during pregnancy, it can also improve iron status during this important period. The demand for iron during pregnancy increases by 50% as it is needed for the expansion of the circulatory system (fetal and placenta) and fetal brain development. Iron deficiency is the most common nutrient deficiency and iron deficiency anaemia is the most frequent anaemia in the world. Iron supplements (eg. Ferrous sulfate) are often recommended to cure iron deficiency during pregnancy; however they often fail to increase levels significantly and are well known for their gastrointestinal side effects. Lactoferrin supplements have been shown to improve iron status in pregnant women significantly greater than iron supplements of large doses. In addition, no side effects were reported with the use of lactoferrin supplements. Lactoferrin has the ability to bind to iron, improving its absorption in the intestines and its transportation to cells.
- Lonnerdal, B., Bioactive proteins in human milk: mechanisms of action. J Pediatr, 2010. 156(2 Suppl): p. S26-30.
- Lonnerdal, B., Nutritional roles of lactoferrin. Curr Opin Clin Nutr Metab Care, 2009. 12(3): p. 293-7.
- Tian, H., et al., Influence of bovine lactoferrin on selected probiotic bacteria and intestinal pathogens. Biometals, 2010. 23(3): p. 593-6.
- Egashira, M., et al., Does daily intake of bovine lactoferrin-containing products ameliorate rotaviral gastroenteritis? Acta Paediatr, 2007. 96(8): p. 1242-4.
- Manzoni, P., et al., Bovine lactoferrin supplementation for prevention of late-onset sepsis in very low-birth-weight neonates: a randomized trial. JAMA, 2009. 302(13): p. 1421-8.
- Mulder, A.M., et al., Bovine lactoferrin supplementation supports immune and antioxidant status in healthy human males. Nutr Res, 2008. 28(9): p. 583-9.
- King, J.C., Jr., et al., A double-blind, placebo-controlled, pilot study of bovine lactoferrin supplementation in bottle-fed infants. J Pediatr Gastroenterol Nutr, 2007. 44(2): p. 245-51.
- Okada, S., et al., Dose-response trial of lactoferrin in patients with chronic hepatitis C. Jpn J Cancer Res, 2002. 93(9): p. 1063-9.
- Paesano, R., et al., Lactoferrin efficacy versus ferrous sulfate in curing iron disorders in pregnant and non-pregnant women. Int J Immunopathol Pharmacol, 2010. 23(2): p. 577-87.
- Paesano, R., et al., Oral administration of lactoferrin increases hemoglobin and total serum iron in pregnant women. Biochem Cell Biol, 2006. 84(3): p. 377-80.
Keeping “baby fat” for too long can put a child’s health at risk. How can you help your child get fit and maintain a healthy weight into adulthood? The following steps may be helpful:
- Be Active! Get your family focused on fitness. Go bike riding in the park or running around the block. There are so many great activities to do.
- Maintain a healthy balanced diet and stick to it. Encourage all the family to make better dietary choices for themselves.
- Visit your doctor for medical advice
These recommendations are not comprehensive and are not intended to replace the advice of your health provider.
About childhood obesity
Ten percent of children (at least 155 million youngsters) worldwide are overweight or obese.  Around 30-45 million within that figure are classified as obese – accounting for 2-3% of the world’s children aged 5-17. The majority of overweight or obese children appear to be in Western countries. Here are some statistics:
- 20-25% of children are overweight or obese
- Overweight children doubled between 1985-1995
- Obese children tripled between 1985 and 1995
North and South America: 
- Nearly half of the children predicted to be overweight by 2010
- An increase of one-third in recent years
- US: 20-30% of children are obese
United Kingdom: 
- Number of obese children has tripled in 20 years
- 10% of six year olds are obese
- 17% of 15 year olds are obese
European Union: 
- Childhood obesity highest in southern Europe, 20-35% children overweight
- Northern Europe 10–20% of children are overweight
The proportion of overweight children are also expected to increase significantly in the Middle East and Southeast Asia while Mexico, Chile, Brazil and Egypt have rates comparable to fully industrialized nations .
A survey conducted in Saudi Arabia from 1994 to 1998 included 12,701 children aged 1-18 years old, showed that 11-12% of children were overweight , and over 6% were obese .
Asia lags behind the U.S. and Europe in obesity, but Thailand, Malaysia, Japan and the Philippines have all reported troubling increases in childhood obesity in recent years. In China, the rise in childhood obesity is particularly alarming. Up to 10% of China’s 290 million children are believed to be overweight or obese, and that percentage is expected to double a decade from now .
The rapid modernisation of China and other Asian countries has produced an alarming spike in the rate of obesity and diabetes. The rate of obesity among Asian children is increasing by 1% each year, roughly the same rate as in Britain, the US and Australia .
Major contributors to childhood obesity include genetics, unhealthy diets, and sedentary lifestyles. Overweight children often become adults with weight problems that contribute to a wide variety of health problems, but even during childhood and adolescence, being overweight can contribute to such disorders as type 2 diabetes, high cholesterol, high blood pressure, insulin resistance, and liver disease. Being overweight also has social and psychological consequences for children in terms of social discrimination, poor self-esteem, and depression.
Parents, family members, and others who are important people in a child’s life can either help or harm an obese child’s situation. As with all children, those with weight problems need acceptance, support, and encouragement from their family. Eating, exercising, and other health habits of family members play important roles in influencing the same behaviors in children.
What are the symptoms?
The ideal weight for a growing child or adolescent should be determined with the help of a health professional, who can also determine whether any unusual medical problems might be contributing to weight gain, whether any current health problems exist that are related to being overweight, and appropriate weight control methods.
Dietary changes that may be helpful
Unhealthy eating patterns resulting in overconsumption of foods high in fat, calories, or added sugars are a major contributor to childhood obesity. Since these patterns often include habits learned from the family, attention should be paid to providing fresh healthy food to the entire family and encouraging healthy eating by example.
Making the right food choices when eating outside the home is also a priority. To teach good lifetime eating habits, try the following:
- Make healthy food easy to see at home and keep unhealthy foods out of sight
- Plan meals and snacks ahead of time so that healthy choices can be available
- Avoid using food as a reward or withholding food as punishment
- Eat slowly and pay attention to when you are hungry and when you are satisfied
- Eat with the family and avoid eating in front of the TV
- Try to eat mostly fruit and vegetables throughout the day
- Drink water when thirsty instead of other beverages
- Start the day with a healthy breakfast to prevent cravings later on
There is only limited research on the prevention of childhood obesity with diet. Breast-feeding during infancy is usually associated with a reduced risk of developing obesity during early childhood, though the reasons for this effect are unclear. Children 7-12 years of age in a school program designed to reduce carbonated-drink consumption resulted in a reduction in the number of overweight children after 12 months. Most authorities believe that the best diet for treating childhood obesity is a heart-healthy diet low in saturated fat and cholesterol, but high in vitamins, minerals, and other important nutrients.
It has been discovered that overweight adolescents lost more weight with a low-carbohydrate diet than with a low-fat diet. Very-low-carbohydrate (ketogenic) diets have been shown to cause rapid weight loss in very obese children in short-term preliminary and controlled trials, but the long-term safety or this diet are unknown. More research is needed to evaluate low-carbohydrate diets for treating childhood obesity.
The Glycemic index and glycemic load describe the tendency of foods to raise blood sugar. Eating meals containing foods that have a low glycemic index or glycemic load may influence appetite and other body mechanisms that affect excessive weight gain in children. Obese children using a low glycemic index diet lost more weight compared with a similar group on a low fat diet. Further, obese adolescents eating freely on a low glycemic diet lost more weight and body fat after six months than did a similar group of adolescents following a typical low-calorie, low-fat diet.
Very low calorie “modified fasting” diets, typically using high-protein meal replacement beverages, have been tried in preliminary and controlled studies of obese children with good short-term results. These programs are not beneficial long term, with the weight lost in these diets often regained. There are also health risks associated with their use. Little is known about their effect on growth and other health issues in children.
Lifestyle changes that may be helpful
The lack of physical activity is a major contributing cause of childhood obesity. Programs to improve the weight of children are usually enhanced through increased physical activity. Watching television and playing computer games are unhealthy habits that contribute to the sedentary lifestyle of many children, and controlled research has shown that weight control is more successful when these activities are minimised and healthier alternative activities are provided. Children are recommended to get at least an hour of moderate physical activity most days of the week, and more may be necessary to offset genetic and other influences. Fun activities that involve other family members or other children will help make getting more exercise a positive experience.
Weight-loss efforts that are very restricted in calories or protein can prevent a child from gaining lean body mass (such as muscle) during the normal growth process. A healthy moderate diet in combination with an appropriate exercise program is the best program overweight children. A controlled trial found that strength training, when added to a low-calorie diet, resulted in a greater gain of lean body mass (while still promoting weight loss), compared with diet alone in obese children.
Treatment for childhood obesity involves screening for heart disease risk and other health risk factors, and providing information on improving diet and exercise habits. No medications are approved for treating childhood obesity.
Vitamins that may be helpful
Increasing fibre in your child’s diet may be beneficial in a weight-loss program. Dietary fibre ‘dilutes’ calories, slows down the eating process, and may make your child feel full while eating fewer calories. This means lots of fruit and vegetables, grains and cereals.
Holistic approaches that may be helpful
Techniques in changing behavior are considered useful for helping children break old habits and form healthier habits. These techniques may be learned from counseling professionals, support groups, educational programs, or books.
Getting further help
If you want to discuss your child’s eating and activity habits or weight, the following professionals can provide advice and information:
- Maternal and child health nurse
- Local GP
- Community health centre
- Reuters Health, May 2004
- Dept Health and Human services, Center for Disease Control and Preventionhttp://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps
- BBC Science and Nature website http://www.bbc.co.uk/science/hottopics/obesity
- IASO International Obesity TaskForce
- MSNBC http://www.msnbc.msn.com/id/11694799/
- Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey BMJ 2000;320;1240