Children today tend to play more indoors than outside, but although they may still gain as much enjoyment from indoor play, it could be having a major impact on their bone health.
Mostly gone are the days when traditional children’s activities such as climbing trees or riding bikes on their own outside were the norm. Instead, thanks in part to improved technology and growing safety concerns from parents, young children are more often found playing indoors.
We asked Dr Alasdair Wright, GP and musculoskeletal specialist, for his expert advice on the matter.
“Many children are becoming much less active than in previous generations due to indoor computer-based entertainment technology,” explains Dr Alasdair Wright. “As a result, there’s a concern that some children don’t get enough exercise or vitamin D to provide the optimum conditions for bone development.”
Vitamin D and bone health
According to a consensus statement on vitamin D produced by major health organisations in the UK, the vitamin is an essential nutrient required for healthy bones, and to help control the amount of calcium in the blood.
Exposure to sun is the main source of vitamin D, although a small amount comes from dietary sources, and prolonged deficiency can lead to the conditions such as rickets in children and osteoporosis and other bone-related conditions in adults.
Worryingly, recent reports have shown that rickets – a health condition previously eradicated – is beginning to come back and is affecting some young children. It’s caused by a lack of vitamin D and produces symptoms such as muscle weakness, bone pains and a delay in walking.
It’s not only vitamin D that’s important for bone health – being active in childhood is important for muscle strengthening too. “It’s well known that children need regular exercise to promote bone growth and strength,” comments Dr Wright.
A 20-year study by the Menzies Research Institute, involving nearly 300 children in Australia, recently revealed the importance of being active in childhood. The study found that physical activity during childhood can actually help increase the amount of cartilage in the knee, helping to prevent conditions such as osteoarthritis later in life.
The results showed that children who took part in physical activities such as jumping, running, doing sit-ups and skipping benefited from better bone health in their 30s, 40s and beyond.
Being fit and active is beneficial for health in a multitude of ways, so it’s an important trait to encourage and something that all the family can get involved in.
“Exercise is crucial for keeping children’s bones strong. An active childhood can help build bones and prevent the brittle bone condition, osteoporosis, in later life,” explained Juliette Morgan, from the National Osteoporosis Society (NOS).
They say there are plenty of exercises that can help build strong bones, including:
•Skipping – five minutes or more of skipping per day helps add impact to bones.
•Running – encourage your child to play outside or make the most of their time in the school playground.
•Badminton and tennis – these high impact racket sports help build bone density.
•Football and netball – these team sports are good for all-round fitness.
It’s not just the exercise that will be good for bone health, but being in the sun too. “Although we have to be careful to avoid children getting too much sun which could potentially lead to future skin problems, short periods of regular exposure to sunlight is important for bone health,” says Dr Wright.
“Sun creams should be used to provide protection for longer periods of exposure to the sun’s potentially damaging rays but still allow the skin to make enough Vitamin D.”
Foods for bone health
Around 10 per cent of vitamin D intake comes from food and, in order to gain the best benefits, there are bone-friendly foods to include on your family menu.
“Dietary intake of vitamin D is important and can be found in foods such as oily fish, liver, milk, cheese and egg yolks. Vitamin D enhances the uptake of calcium into the bones, so it’s essential that children get enough dietary calcium through the consumption of dairy based foods such as milk, cheese and yogurt,” says Dr Wright.
“Adequate dietary calcium can also be obtained from foods such as green leafy vegetables, nuts – especially almonds – salmon, figs, sesame seeds or calcium-enriched soya products.”
Indoor exercise ideas
If it’s not always possible or safe for children to play outside, indoor exercising can be beneficial too, helping encourage muscle growth and strengthening bones.
“Outdoor exercise has the advantage of sunlight stimulating the skin production of vitamin D, but indoor exercise is just as effective in providing the right stimulus to strengthen bones,” explains Dr Wright. “Exercises which involve weight-bearing activities are best for bone development.”
Making exercise fun helps encourage children to enjoy it and continue with it into their teens. Indoor exercises such as stretching or sit-ups can be useful to do and Juliette from the NOS suggests that young children in particular may enjoy simple exercises to music or dancing indoors.
Read our lifestyle article ‘boosting bone health’ for more information on how to build strong bones or visit the rest of the Musculoskeletal Centre for more information on bone health.
Also see our recipes pages for recipes, such as Stargazy pie and tomato omelette, that have been specifically designed to help support bone health.
Other useful resources
Vitamin D consensus statement
University of Tasmania research
Journal of Family Health Care
National Osteoporosis Society
Find out more about the child health care options available to your family. You can also discover more information in our Pregnancy and Childcare Centre or if you have a specific question, you can ask our experts.