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Factors for strong bones

Star2 logo Star2 5/10/2017 Dr Tee E Siong

A baby is born with about 300 bones at birth. Some of your child’s bones are made up of cartilage (smooth elastic tissue with a rubber-like texture), while others are partly made up of the same material. As they grow, the bones fuse together and the cartilage hardens, ultimately leaving 206 bones that we, as adults, have.

Caring for your child’s bones early on is important because by the time they reach their 20s, bone growth stops (peak bone mass).

Moreover, our bones perform many important functions such as:

• Protecting important and delicate organs (e.g. the brain is protected by the skull and the heart is protected by the ribcage).

• Providing movement and mostly acting as levers along with the skeletal muscles, tendons, ligaments and joints.

• Helping to produce both red and white blood cell via red bone marrow.

• Storing minerals such as calcium and phosphorus.

• Helping to store fat via the yellow bone marrow of long bones.

• Helping to produce and store growth factors through certain bones.

• Allowing us to hear via minuscule bones in the ear.

• Releasing and absorbing alkaline salts to keep body pH balanced.

Many factors can influence the health of your child’s bones, including inadequate intake of calcium, vitamin D and lack of weight-bearing exercise to strengthen bones. It is therefore important to optimise your child’s bone mass from young to prevent osteoporosis and brittle bones.

Brittle bones are prone to fractures later in life, and you prevent this by providing your child with proper nutrition.

Eat a healthy diet

A healthy balanced diet will provide all the necessary nutrients, including vitamins and minerals, for building strong bones. But two nutrients of particular significance are calcium and vitamin D.

Calcium is a mineral required to build bones and keep them healthy.

Approximately 99% of the body’s calcium is found in the bones and it is required for normal bone growth and development.

In addition to keeping bones healthy, calcium also helps out with blood-clotting, transmission of neurons and muscle contraction.

We need to include a variety of foods that are rich in calcium in our daily diet. Food that are good sources of calcium include:

• Milk and milk products, e.g. cheese and yoghurt.

• Fish with edible bones, e.g. canned sardines and anchovies.

• Beans and bean products, e.g. yellow dhal, tofu and tempeh.

• Vegetables, e.g. spinach, watercress, mustard leaves, cekur manis, tapioca leaves, kailan and broccoli.

• Other alternatives are processed foods that are fortified or enriched with calcium, e.g. cereals, biscuits, soybean milk, bread and juice.

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This may come as a surprise – vegetables such as broccoli, spinach, watercress, mustard leaves, cekur manis, tapioca leaves and kailan are also good sources of calcium. Photo: TNS

Vitamin D also plays an important role in building strong bones. It is essential for calcium absorption and utilisation, mineral metabolism for bone development and health, and other functions.

There are two forms of vitamin D.

Vitamin D2 is mostly man-made and added to foods.

Vitamin D3 is synthesised by humans in the skin when it is exposed to sunlight. It can also be obtained from some animal-based foods.

Foods that provide vitamin D include fatty fish (e.g. salmon, tuna, sardine, mackerel), cod liver oil and egg yolk.

It can also be found in foods fortified with vitamin D such as milk and cereals.

However, vitamin D is present in a small number of foods and usually in small amounts. Hence, direct sunlight exposure to the skin is a good way to achieve an optimum level of vitamin D.

Encourage your child to spend some time outdoor exercising or playing games to get sun exposure, so that their body can make some vitamin D.

Milk – a nutritious food

Milk and milk products are good sources of calcium and vitamin D for bones.

They also contain other essential nutrients like protein, which is important for growth.

The Malaysian Food Pyramid recommends two to three servings of milk and milk products everyday.

That’s equivalent to three glasses of milk. Or consume one glass of milk, one cup of yoghurt and one slice of cheese a day.

While calcium and vitamin D are known to be vital for bone health, several additional nutrients such as vitamins A, B, C and E, as well as folate and minerals such as copper, zinc, selenium, iron and magnesium, also play a part in building and maintaining strong bones.

To ensure your child receives all the nutrients he needs for optimal bone growth and health, he should practice a varied, well-balanced diet as recommended in the Malaysian Food Pyramid.

Be active!

Besides eating well, children should also be encouraged to be more physically active.

Examples of bone-strengthening exercises include jogging, running, walking, hiking, climbing stairs, dancing, gymnastics, and sports that involve running or jumping (e.g. football, basketball, volleyball and racquet sports).

Reduce screen time (e.g. using smartphone, tablet, TV or computer) and being sedentary.

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Children should be encouraged to be more physically active in order to strengthen their bones. Photo: Filepic

The most important thing to do is to start your child early with these healthy lifestyle habits.

Living healthy not only benefits your child’s bones, but also helps to strengthen and maintain overall health, ensuring your child is able to face the challenges of the day and reach his full potential.

Dr Tee E Siong is a nutritionist and president of Nutrition Society of Malaysia. This article is courtesy of Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. This article is supported by an educational grant from Marigold UHT Milk. For further information, visit The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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