The National Osteoporosis Foundation has issued this scientific statement to provide evidence-based guidance and a national implementation strategy for the purpose of helping individuals achieve maximal peak bone mass early in life.
Considering the evidence-based literature review, we recommend lifestyle choices that promote maximal bone health from childhood through young to late adolescence and outline a research agenda to address current gaps in knowledge. The best evidence (grade A) is available for positive effects of calcium intake and physical activity, especially during the late childhood and peripubertal years—a critical period for bone accretion.
Bone modelling is sensitive to mechanical loading, emphasizing the importance of physical activity throughout growth. Bone is most responsive to physical activities that are dynamic, moderate to high in load magnitude, short in load duration, odd or nonrepetitive in load direction, and applied quickly.
Quality of Evidence
Grade A – Clear evidence in a position paper
Strength of Recommendation
Grade 1- Strong recommendation
The research available for physical activity does not examine the effects of specific types of exercise and few studies examine the dose loading effects of any one type of exercise.
Therefore, National Osteoporosis Foundation concludes that physical activity is important for growing bone, but we do not fully understand the characteristics of physical activity that impact bone such as mode, frequency, intensity, and duration.
- The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations.
Weaver C. Gordon C, Janz K et al
J Osteoporosis International 2016;27(4):1281-1386