Establishing good bone health in children

Osteoporosis is a major public health concern, and is likely to increase in prevalence as the current population ages. One proposed benefit of establishing good bone health in children is the optimization of peak bone mass, which may have an effect on fracture risk in adulthood. Preventing childhood fractures is also desirable. Optimal skeletal health is not only influenced by bone mass but also bone size, shape and microarchitecture. Methods of assessing these properties of bone have improved over recent years, and therefore our understanding of the determinants of bone health has improved. Potential factors which influence bone health include genetics, hormones, nutrition, exercise and other lifestyle factors. These may interact with each other and they can vary in their impact at different times across the life cycle. This review will examine the effects of these factors in the foetus, infant, child and adolescent.