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Young people continue to gain bone mineral after height growth

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New research shows that the late teen years are an important period for gaining bone mineral, even after a teenager attains their adult height.

The study, published in JAMA Pediatrics, highlights a little-recognised window of opportunity to optimise bone mass.

“We often think of a child’s growth largely with respect to height, but overall bone development is also important,” explained lead author Dr Shana E. McCormack, a paediatric researcher at Children’s Hospital of Philadelphia (CHOP). “This study shows that roughly 10% of bone mass continues to accumulate after a teenager reaches his or her adult height.”

The research team analysed data from the Bone Mineral Density in Childhood Study, which took detailed bone and growth measurements during annual visits for up to seven years in more than 2,000 healthy children, adolescents and young adults.

They found that height gains substantially outpaced gains in bone mineral content prior to adolescence, which may explain the high fracture rates among children and adolescents.

Bone growth is site-specific, with bone mineral density developing at different rates in different parts of the skeleton. Overall, a significant proportion of bone is accrued after adult height is achieved.

The authors concluded that late adolescence offers a window of opportunity for health interventions with young people.

“Late adolescence is when some teenagers adopt risky behaviours, such as smoking and alcohol use, worse dietary choices and decreased physical activity, all of which can impair bone development,” McCormack said. “This period is a time for parents and caregivers to encourage healthier behaviours, such as better diets and more physical activity.”

Previous research at CHOP showed that high-impact, weight-bearing exercise improves bone strength in children, even among those who may have genetic predispositions for bone fragility.

“We’ve known for a long time that maximising bone health in childhood and adolescence protects people from osteoporosis later in life,” said study co-author Babette S. Zemel, PhD. “This study reinforces that understanding, and suggests that late adolescence may be an underrecognised period to intervene in this important area of public health.”