Fragile children

Philip J. Goscienski, M.D.

June 2010

With the mounting concern about childhood obesity it seems contradictory to think of our youngest generation as fragile. In 1985 the President's Council on Physical Fitness and Sports reported that 40 percent of boys between the ages of 6 and 12 years could not do more than one pull-up, nor could 70 percent of girls. Those numbers are more dismal now. And even though today's young people are less active than previous generations they are increasingly likely to break a bone.

The increasing incidence of fractures in children is a warning that we are raising a generation of fragile children who will become fragile adults. Between 1970 and 2000 the incidence of fractures in young persons in one Midwestern locale increased by nearly one-third in boys and more than 50 percent in girls. It's tempting to think that it's because kids are more active these days and that new gadgets like in-line skates and skateboards are responsible for the increase. A deeper look is more sobering: children with fractures have significantly lower bone density than their intact peers.

It's common knowledge that osteoporosis is more likely to occur in women and that they bear the brunt of hip fractures in old age. When today's adolescent girls, few of whom get any exercise at all, reach middle age and beyond they face an enormous risk of fractures. That is an inescapable conclusion for we already know that girls with low levels of physical activity have measurable decreases in bone density of the hip even before they reach the age of 25. This is especially ironic for that is the age when their skeleton should have reached almost full maturity. Beyond the age of 30 the opportunity for building a more dense bony skeleton has passed.

The obesity rate in children has quadrupled since 1970 and fat kids have more fractures. Compared to the rest of his or her body mass a child's skeleton becomes relatively smaller as obesity increases, a simple case of structural overload.

Nutrition also matters but it's not just because nearly 90 percent of teenagers don't get enough calcium. They don't get enough other bone-building nutrients either, including magnesium, zinc, omega-3 fats and several vitamins, notably vitamin D. A clear case in point: adolescent girls who suffer from anorexia nervosa are especially likely to have a decrease in bone density and they are at increased risk of fracture even years after recovery.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at