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Women in perimenopause and beyond, because they are most at risk—and most likely to know they are at risk—for low bone density. But the 6-Week Bone Density Program works for everyone—any age, both sexes—who wants to create a healthy foundation for a healthy life. I’ve already mentioned that it is never too early or too late to get or keep your bones healthy. We need to raise our awareness that men are definitely at risk, too, which is why I wanted to take some time out to address the male of the species here. For women reading this chapter, the take-home message is: this book isn’t just for you. Your parents, children, partners, and friends need healthy bones, too, and the strategies here will work for all of them.Most important—for both sexes—is the fact that the very best way to avoid low bone density is to reach the point when your body naturally starts to lose bone mass with the healthiest, densest bones possible. You can do this only while you are young. Very young. This book is predicated on the fact that you can make or keep your bones healthy at any age, but the fact of the matter is you get only one opportunity to create maximum bone density naturally. That window is wide open from birth through adolescence and into young adulthood. Once it closes, though, there are no “do-overs.” You’ll still have many effective options for protecting your bones, but you’ll be fielding a team of second-string players, truth be told. The first-round draft picks are reserved for kids.For the first quarter-century or so of your life, bone formation outpaces breakdown. Infants’ bones rapidly grow longer and wider, adding calcium at a terrific rate. Lengthening and widening continues through childhood, while density and thickness also increase. The process speeds up still more during adolescence. Teenage growth spurts (between 11 and 15 for girls and 12 and 17 for boys) are a result of peak bone growth rates, and a fifth of full adult height is generally added during those times. Bone mass keeps building even after teens are no longer growing taller, and by the age of 20, 90 percent of total bone density is set.If you want to give your children a gift that truly keeps on giving, help them develop healthy habits early. The best way to prevent low bone density and all its attendant problems is through good nutrition, adequate calcium intake, and plenty of exercise in childhood and adolescence. If you teach them well, not only will you help them build up all the bone density their genetic potential calls for, but you will also start them out with the kind of healthy lifestyle that will serve them well for a hundred reasons throughout their entire lives.Genetics is holding most of the cards when it comes to determining peak bone mass. But the outcome of the game is by no means a foregone conclusion. One study of identical twins ages 6-14 showed that the twin given 1,800 mg of calcium a day up to puberty had bones 5 percent more dense than the other twin, given 900 mg a day. That 5 percent increase translates into a 40 percent drop in the risk of fracture later in life. Proper diet is your ace in the hole for reaching the genetic potential for bone density. Children need basically what adults need—which is laid out in the later part of this book. But I want to point out here some of their unique requirements in regard to calcium, and give you some hints for encouraging good habits in those who don’t, say, share your enthusiasm for green leafy vegetables.The average American child does not get enough calcium. Worse still, intake is generally falling. The typical child’s diet now contains only about half the calcium it did fifty years ago. Most kids get only about 75 percent of the RDA for calcium. Girls in particular shortchange themselves after reaching the double digits, when weight concerns become common, and they tend not to eat enough nutritious food. They tend to cut back on “fattening” milk and dairy products, and “diet” primarily by drinking a lot of diet sodas. That’s disastrous for any bones, but especially for growing bones.For the first 6 months of life, babies should be getting 400 mg of calcium daily. As long as babies are exclusively drinking breast milk or formula, they will get basically what they need, but as you begin introducing solid food, you should be sure to include a variety of dairy products (and other good sources of calcium) as soon as your pediatrician OKs them. (All breast-fed babies do need liquid vitamin D supplements to make sure they can use the calcium they get.) From 6 to 12 months, infants need 600 mg a day, so it is best if they have several calcium-rich foods in their repertoires. After the first birthday, the calcium requirement goes up to 800 mg and increases again at age 6 to between 800 and 1,200 mg. Eleven-year-olds need 1,200-1,500 mg, and everyone should keep that up through age 24. (That’s 5 cups of milk a day, to give you some perspective.) For girls, the period just before puberty brings the highest demand for calcium of any age, and bone builds at its fastest pace through about four years after the first period.Studies have linked eating a wealth of dairy products—and so calcium—in childhood with greater bone density in adulthood. It is best to get calcium from food as much as possible, using fortified food and supplements if backup is needed. Dairy products will be the first choice for most children. Kids younger than 6 need 3 cups of milk (or the equivalent—there are 300 or so mg of calcium in 1 cup) every day, pushing the tally up to 4 cups for those 6 and older and 5 cups for teenagers. That’s got to mean serving milk with every meal and snack. (Hint: There’s nothing wrong with mixing in a bit of chocolate syrup to entice reluctant milk drinkers.) Using low- or nonfat products for everyone over 2 will protect their hearts and weight while providing a smidge more calcium than whole milk. For bonus points, if you see one of those milk mustache ads with a celebrity your child thinks is “the coolest,” point it out.Even the straightforward solution of simply getting enough glasses of milk or cups of yogurt can be a tough goal for kids, just as it is for adults. Especially for girls, or nonmilk drinkers, a calcium supplement may be the way to go. More and more children’s chewable vitamins are including calcium these days, though you’ll have to read the label carefully to determine just how much is in the pills labeled “Extra Calcium!,” since some are better sources than others. The levels are still pretty low in the multivitamins, so you might want to choose a separate supplement. Try a liquid or chewable form, or a flavored antacid (making sure you get the kind without any aluminum). Kids, too, need vitamin D to help their bodies use the calcium they get. Studies show that children who don’t consume enough products fortified with vitamin D have inadequate calcium absorption and slowed bone formation, particularly during winter.We already know our children watch too many hours of television, but here’s another result of that you may not have considered: by being glued to the tube, they are spending too much time indoors and don’t get enough sunlight to allow their bodies to make the vitamin D they need.After lack of calcium, the other biggest hurdle to good bone development in young people is how much soda they drink. Sound like any adults you know? Sodas contain lots of phosphorus, which interferes with bone formation. The caffeine in many sodas also contributes to the problem by increasing the excretion of calcium (taking it out of the body, rather than it going into the bones). Anyone who drinks an excessive number of sodas will have parathyroid hormone levels that are constantly at the highest end of the normal range, which is enough to slow the rate at which new bone cells are deposited where they are needed. Encourage your child to choose drinks wisely, and set a good example yourself. Unless you have a most unusual kid, you’ll never get away with “Do as I say and not as I do.” Actions speak louder than words.You have complete control over your children’s diet for only a short time. This is a good time to teach them to love wholesome, nutritious foods before they even discover the plethora of junk food out there in the wider world. You can’t make them eat or not eat any particular food, so your best bet is to prepare them to make their own smart choices. The habits formed in the earliest years—whether good or bad—are hard to shake. Even children as young as 9 will make informed decisions about taking care of their health—if they have the information. They may be getting some lessons at school, but you can’t count on that (or on what exactly they are taught), so you’ll have to take an active role. At any rate, studies show that the teenagers with the healthiest diets have parents who are educated about and concerned with health issues. Despite the latest vogue for the notion that peers have more influence on kids than their parents do, that’s proof that children absorb a huge amount both from what their parents themselves do and from what parents say to them.So don’t sit back and wait for them to be ready to educate themselves. Encourage them as much as you can. You’ll have to use every trick in the book. No one knows your kids better than you, and different strategies work better at different ages, so you’ll have to map out your own course.*17\228\2*

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