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. 2024 Apr 5:7:100031.
doi: 10.1016/j.jposna.2024.100031. eCollection 2024 May.

Understanding the importance of peak bone mass

Timothy Hereford  1 , Alec Kellish  2 , Julie Balch Samora  3 , Louise Reid Nichols  1
Affiliations

Understanding the importance of peak bone mass

Timothy Hereford et al. J Pediatr Soc North Am. .

Erratum in

Abstract

Bone mass attained early in life is one of the most important determinants of lifelong skeletal health. Bone mineral content increases exponentially during childhood. In fact, 40%-60% of the total adult bone mass is accrued during puberty. By the end of the first 2 decades of life, peak bone mass has been reached. Between ages 20-50, bone mass has plateaued, but it continues to remodel. This is regulated by parathyroid hormone (PTH), vitamin D3, and insulin-like growth factor 1 (IGF-1). After the age of 50, bone mass begins to decrease. The purpose of this paper is to review the importance of maximizing peak bone mass and factors that can modify and maintain peak bone mass.

Key concepts: (1)Peak bone mass is attained by the end of the second decade of life.(2)There are more fractures during peak height velocity in adolescence as the body increases in size but bone mineralization lags behind.(3)The risk of adult osteoporosis starts in childhood.(4)There are modifiable and nonmodifiable risk factors that affect peak bone mass.

Level of evidence: IV.

Keywords: Bone health; Peak bone mass; Vitamin D.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: L. Reid Nichols reports a relationship with Smith and Nephew Inc. that includes speaking and lecture fees. Louise Reid Nichols reports a relationship with OrthoPediatrics that includes speaking and lecture fees. L. Reid Nichols reports a relationship with NuVasive that includes speaking and lecture fees. Editor, JPO, LRN. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
Peak bone mass is achieved with optimal lifestyle factors .
Figure 2
Figure 2
Bone mass accretion accelerates with onset of puberty, and peaks after peak height gain . BMC, bone mineral content.
Figure 3
Figure 3
Changes in bone structure with age progression .
Figure 4
Figure 4
This graph represents young children given either a placebo or supplemental calcium. The gray bars represent those that participated in higher physical activity. Calcium supplementation combined with physical activity resulted in higher bone mineral content (BMC) .
See this image and copyright information in PMC

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