Bone Health in Children: 1st Edition (Hardback) book cover

Bone Health in Children

1st Edition

By Steven A. Abrams, Keli M. Hawthorne

CRC Press

241 pages | 22 B/W Illus.

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pub: 2012-03-20
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Bone health is one of the most widely discussed topics in pediatric nutrition. Ensuring adequate calcium and vitamin D intake is essential, and other factors also play a significant role. Bone Health in Children explores the recent decades of research and public commentary on the subject, debunks popular myths, and clarifies the often confusing and contradictory scientific literature. Presenting practical and theoretical education and advice, the book provides rational and accessible information geared to a wide audience of individuals interested in this critical element of pediatric health.

Highlights include:

  • The Institute of Medicine process by which Dietary Reference Intakes (DRIs) are developed
  • Iron, calcium, and vitamin D requirements for infants, children, and pregnant and lactating women
  • Controversy over high-dose vitamin D supplementation and pregnancy
  • Detailed explanation of the scientific research process related to human nutrition
  • The nonbone health aspects of vitamin D and why literature claims about this topic can be misleading
  • Frequently Asked Questions regarding nutrition with answers in short format

Providing a solid understanding as to how dietary guidelines are developed and evaluating the strengths and weaknesses of their underlying data, this volume answers practical questions crucial for choosing diets for children while also delving into the more theoretical aspects of conducting and interpreting medical research.


"Nutrition and bone health have become important issues in pediatrics. This book, addressed not only to pediatricians, but also to parents and public health workers, is divided into 15 chapters, the title of the first is "Why does bone health in children matter?" and the last "Frequently asked questions". The in-between reviews nutritional issues by age groups, pregnancy, children without diseases, etc. A practical text."

—Professor Zvi Laron, Pediatric Endocrinology Reviews, Vol. 10, No. 4, July 2013

Table of Contents

Why does bone health in children matter, and what are the key players in bone health?

Why does bone health in children matter?

Key players in bone health


Vitamin D



How do we identify and quantify dietary requirements?

The language of dietary requirements

Guideline development: The Institute of Medicine (IOM)

The IOM process

Other approaches to dietary guidelines

How can we compare these dietary guideline terms to recommendations such as those of the American Academy of Pediatrics (AAP)?

If an adolescent consumes 1290 mg per day of calcium and the guidelines say they should get 1300 mg per day, is this a real problem?

Nutritional status markers

Vitamin D levels

Interpreting serum 25(OH)D levels


Rickets: A historical perspective

Rickets: Clinical features and X-ray findings

Premature infants

Feeding premature babies after they go home

Full-term infants

What are the recommendations for calcium and vitamin D in healthy full-term infants in the first 6 months of life?

The second 6 months of life and early signs of rickets

What should be done?

Toddlers (children younger than 4 years of age)

Calcium and the recommended dietary allowance (RDA)

What do children eat?

Vitamin D

Rickets in toddlers

How to achieve vitamin D intakes in toddlers

Other nutrients

Early school-age children (ages 4 to 8)

Should a healthy child have a routine or annual measurement of his serum vitamin D (25(OH)D) level?

Bone density measurements and children

How do you make sure a school-age child is getting enough vitamin D and calcium?


What happens to bone and when does it happen?

What drives bone mineralization during puberty and what is meant by peak bone mass?

Amount and source of calcium and vitamin D in adolescent diets

The role of exercise in bone health

Pregnancy and lactation

Fetal bone mineralization

Lactation physiology

Calcium and vitamin D in pregnancy and perinatal outcomes

Teenage pregnancy and lactation

Children with chronic illnesses

Juvenile arthritis


Cystic fibrosis

Summary related to bone health and chronic illnesses

Myths and realities of calcium intake in children: Can’t we just fortify all our foods?

Are there any harmful effects from consuming soda related to bone health?

What is the most calcium that should be in the diet or taken from supplements by children and adolescents?

How do food companies decide what foods to fortify with calcium and bone-related nutrients? How do they decide how much to add?

The technical side of fortifying foods

The cost of the fortificant

The target population for the product, especially if there are age-group related regulatory rules involved in the fortification

Marketing of the products

Safety concerns

Label claims

National food policies

The X factor

Myths and realities of vitamin D intake in children

Sunshine and vitamin D

Skin color and calcium and vitamin D

Why don’t we just megadose with all the bone-related vitamins and minerals such as vitamin D? What makes doctors and dietitians reluctant to do so?

Vitamin D toxicity

Beyond bone health: Vitamin D

Vitamin D and influenza

Vitamin D in children: Autism

Putting it all together: Bone health as part of good nutrition for infants and children

Summary: Infants

Summary: Toddlers

Summary: Early school-age children (ages 4–8)

Summary: Adolescents

Summary: Maternal nutrition

Unanswered questions: How do we conduct and publicize good nutritional research?

How do we publicize the study results once we are done?

Measuring calcium absorption: How is it really done?

Mass balance studies

The development of radioactive calcium studies

Stable isotope studies of calcium absorption

Global research of calcium metabolism using stable isotopes

A historical note regarding calcium stable isotope studies

How can a registered dietitian evaluate calcium intake for research studies?

Summary ideas related to research studies in this area

Programming and genetics

Does milk make a child grow tall?

Frequently asked questions



About the Authors

Steven A. Abrams, M.D., is a Professor of Pediatrics at Baylor College of Medicine. He is a board certified pediatrician and a neonatologist. He practices clinical neonatology in Houston, Texas.

Keli M. Hawthorne, M.S., R.D., L.D., is a registered dietitian working in nutrition research at Baylor College of Medicine in Houston, and she is a practicing clinical dietitian at Texas Children’s Hospital.

Subject Categories

BISAC Subject Codes/Headings:
MEDICAL / Nutrition
MEDICAL / Orthopedics
MEDICAL / Pediatrics
MEDICAL / Surgery / General