title: An update on childhood bone health: mineral accrual, assessment and treatment.
abstract: OBJECTIVE
  To update the reader's knowledge about the factors that influence bone mineral accrual and to review the advances in the assessment of bone health and treatment of bone disorders.
  
  
  RESULTS
  Maternal vitamin D status influences neonatal calcium levels, bone mineral density (BMD) and bone size. In turn, BMD z-score tends to track in childhood. These factors highlight the importance of bone health as early as fetal life. Dual-energy x-ray absorptiometry is the mainstay of clinical bone health assessment in this population because of the availability of appropriate reference data. Recently, more information has become available about the assessment and treatment of bone disease in chronically ill pediatric patients.
  
  
  CONCLUSIONS
  Bone health must become a health focus starting prenatally in order to maximize peak bone mass and to prevent osteoporosis-related bone disease in adulthood. Vitamin D, calcium and weight-bearing activity are the factors of key importance throughout childhood in achieving optimal bone health as BMD z-score tracks through childhood and into adulthood. Recent updates of the International Society for Clinical Densitometry focus on the appropriate use of dual-energy x-ray absorptiometry in children of all ages, including children with chronic disease, and on the treatment of pediatric bone disease.
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Columbia University Medical Center, New York, New York, USA.
authors.forename: Aviva B
authors.initials: AB
authors.lastname: Sopher
authors.forename: Ilene
authors.initials: I
authors.lastname: Fennoy
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Oberfield
mesh_terms: D015502:Absorptiometry, Photon; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001847:Bone Diseases / Q000453:epidemiology*; D001842:Bone and Bones / Q000378:metabolism* / Q000473:pathology; D002136:Calcium, Dietary / Q000627:therapeutic use*; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D039382:Maternal Nutritional Physiological Phenomena; D014807:Vitamin D / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary; D014807:Vitamin D