Enough evidence exists to recommend optimizing bone mass accrual during the pediatric years via increases in physical activity. It is logical to assume that this strategy may ultimately prove useful in preventing osteoporosis, although this remains unproven until prospective studies are carried out in which childhood physical activity is the exposure and the rate of osteoporotic fracture is the outcome. Retrospective studies of retired adult gymnasts and weightlifters suggest that the benefits of childhood physical activity continue into adulthood.

Since it is possible for children and adolescents to participate in bone-enhancing physical activities in a safe manner without undue disruption of normal school or leisure routines, they should be encouraged to participate in age-appropriate activities that provide high impact movements, particularly jumping, hopping, and running. With supervision, weight lifting is also appropriate since it actively loads bone. Sport, dance, and (for young children) movement education provide varied and enjoyable bone-healthy activities. When combined with a suitable diet, these activities are perhaps the best health promotion strategy for improving bone mass in children and adolescents. Finally, future research should include more ethnically-diverse populations, larger sample sizes to allow investigators to test interactions, and better methods for quantifying physical activity and bone mineralization.

See Physical Activity and Bone Health by K. Khan, H. McKay, P Kannus, D. Bailey, J. Wark, and K. Bennell for a thorough overview on how activity impacts bone development in children. (2001, Human Kinetics Publishers: Champaign, IL)

Specific ideas for promoting bone building physical activity in children and adolescents can be found at: http://www.cdc.gov/nccdphp/dnpa/bonehealth/index.htm