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Bone Mineral Density in Children
A REVIEW
Grace Cole
Biology 110, section DF1
Professor Mateja
November 13, 2014
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Abstract
Bone Mineral Density (BMD) is becoming a large health concern, especially in juveniles
since their bone health when young will affect their bone health when grown. In this article,
Szadek and Scharer examine bone density and how to prevent childhood osteoporosis. The
paper explains the definition of osteoporosis and osteopenia according to the World Health
Organization (WHO) and International Society of Clinical Densitometry (ISCD). The authors
also discuss a few lab studies and treatments for low BMD. They found that the best course of
action is to treat conservatively (Szadek & Scharer, 2014). They suggest clinicians to implement
lifestyle changes towards the prevention of low BMD, as opposed to aggressively attacking the
osteoporosis.
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Bone Mineral Density in Children
A review
This article is a practical guide for pediatric clinicians and explains much about bone
density, so I would characterize it as practical and educational. The central concept that the
authors attempt to convey is the importance of children’s lifestyles that will prevent low bone
mineral density. This article seems to be written as a pediatrician’s guide to dealing with a
patient’s low bone density. The authors recommend researching the child’s genetics, activity
level, and nutrition for risk factors and they favor consulting a bone metabolic specialist before
reacting aggressively (Szadek & Scharer, 2014).
The key ideas defined in the article are as follows: bone health in the pediatric
population, bone formation, risk factors, bone health assessments, prevention, and treatment
(Szadek & Scharer, 2014). In order to get the major points across, the authors continually
mention preventative lifestyles to increase bone health. They provided a few supporting images
and tables, and two appendices that supply a list of calcium food sources.
A strength presented by the authors is the four tables that placed within the body of the
article. The tables outline etiologies of decreased BMD in children, medications associated with
decreased BMD, recommended dietary allowance of calcium and vitamin D (Szadek & Scharer,
2014). These supply readers with definitive data that supported the topics in the paper.
Overall, the article seems balanced, although the authors definitely support conservative
action. The treatment of osteoporosis is hardly discussed, though. For instance, when talking
about the DXA scan results, they restate WHO’s definition of osteoporosis, “a bone mineral
density measurement (T-score) that falls 2.5 standard deviations or more below the average value
of a young healthy adult” (Szadek & Scharer, 2014). However the authors do not mention much
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about treatment after that. They simply advise clinicians to consult bone mineral specialists
before going further than lifestyle changes and suggest a laboratory assessment and leave it at
that.
My perspective has changed to understand how important exercising good fitness as a
child is to one’s health then and later as an adult. I had not previously realized exactly how
influential one’s lifestyle now is to one’s health later. My question based on the paper is what
other ways there are to assess bone health. They mention dual-energy X-ray absorptiometry
(DXA), Quantitative Ultrasound (QUS), and many more, but talk only about DXA and QUS. If
there are “several modalities available to assess bone density” (Szadek & Scharer, 2014), which
ones are best? The authors could have clarified the differences between the methods of
measuring bone density.
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References
Szadek, L. L., & Scharer, K. (2014, September 26). Identification, Prevention, and Treatment of Children
with Decreased Bone Mineral Density. Journal of Pediatric Nursing, 29(5), e3-e14.
doi:http://dx.doi.org/10.1016/j.pedn.2013.11.002