CHAPTER 32: Bone Health: The Independent and Combined Effects of Calcium, Vitamin D and Exercise in Children and Adolescents

Early childhood and adolescence is considered the most important period for bone-mass optimization. Calcium, vitamin D and exercise play an important role on bone development during growth. In this chapter, we address the independent and combined effects of calcium and vitamin D and exercise on bone health in children and adolescents. Current research in this population indicates that both calcium and vitamin D intakes have a synergistic effect on bone mass and that adequate levels are necessary for normal bone mineralization. In addition, weight-bearing exercise has been shown to be a strong and positive predictor of bone health with evidence suggesting that its effect is enhanced when combined with adequate calcium and vitamin D intakes. While calcium, vitamin D and exercise are considered important modifiable factors of bone development, there is a need for further investigation on the interactions of these factors in order to improve bone development during the period of growth.