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Once bone density is lost, it is difficult if not impossible to restore.

SPEAKING AT a symposium at Stanford University in Stanford, Calif., held in conjunction with the national conference on advances in perinatal and pediatric nutrition, which ended on Wednesday, Dr. Laura Bachrach said that prevention of the bone-thinning disease osteoporosis “must begin from the first day of life.” “We know that peak bone mass is gained between the ages of 20 and 30 and that this serves as a bone bank for the remainder of your life. The larger the bone bank account, the longer you can withstand withdrawals before you get into trouble,” said Bachrach, who is a professor of pediatric endocrinology at Stanford University.

According to the Washington, D.C.-based National Osteoporosis Foundation, one in two women and one in eight men older than 50 will have an osteoporosis-related fracture in their lifetime. Common sites for osteoporosis fractures are the hip, spine, wrist and ribs. One in four hip-fracture patients older than 50 die within one year of diagnosis. Teens at high risk of osteopenia, a precursor of osteoporosis, include girls who exercise too rigorously, a factor that can cause a decline in the production of estrogen, a hormone implicated in healthy bones. Other high-risk youngsters include anorexics, whose low-calorie intake weakens bones, and asthmatics treated with steroids, a class of drugs that can interfere with the production of a key bone matrix protein.

While osteoporosis is marked by thin, fragile bones that can easily fracture, people diagnosed with osteopenia typically have no history of fracture despite reduced-bone density.

Although 60 to 80 percent of an individual’s susceptibility to osteoporosis is genetic, Bachrach believes it’s important that physicians focus on the 20 to 40 percent factor that is lifestyle-related.

For teens, “deposits” in the bone bank should be made by consuming a calcium quota of 1,200 to 1,500 milligrams per day, the equivalent of four to five glasses of milk, said Bachrach. Consuming food and beverages with a high salt content increases the amount of calcium lost in urine and stools. A teen who eats a ham sandwich and pickle, for example, would need to drink an additional glass of milk to compensate for calcium loss.

Weight-bearing exercise also strengthens bones, but it’s important to differentiate between activities like swimming that benefit cardiovascular health and those that maximize bone acquisition. Running, jumping and gymnastics are optimal exercises for bone health, said Bachrach. Once bone density is lost, it is difficult if not impossible to restore. In a study published last year in the European Journal of Endocrinology, Japanese researchers led by Dr. Mari Hotta of the Tokyo Women’s Medical College found that anorexics who gained weight did not experience a parallel increase in bone density. Other studies have found that prescribing estrogen to athletes and anorexics with estrogen-deficiency had little or no effect on reversing osteopenia.