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Calcium requirements in adolescents

Steven A Abrams, MD
Section Editors
Kathleen J Motil, MD, PhD
Diane Blake, MD
Deputy Editor
Alison G Hoppin, MD


Nutritional needs during adolescence are influenced by the onset of puberty, with its associated increased growth rate and changes in body composition. From the preadolescent years to the end of the second decade of life, bone size and bone mass increase rapidly. The accumulation of total bone mineral between the ages of 8 and 18 years is approximately 146 grams per year, with the greatest deposition occurring during puberty [1]. Adequate calcium intake is necessary to maximize peak bone mass and to minimize both the risk of fractures in adolescence and the development of osteoporosis in adulthood [2-5]. Adequate vitamin D is also important to bone health. (See "Vitamin D insufficiency and deficiency in children and adolescents".)


Several important associations exist between pubertal events, peak height velocity, and bone mineralization. (See "Normal puberty".)

Approximately one-half of total body calcium is laid down during puberty in females and one-half to two-thirds in males [6-8]; by the end of puberty, males have nearly 30 percent more total body calcium than do females [9].

In a longitudinal study, bone width increased before mineral content, which increased before bone density [6]. The changes occurred earlier in girls than in boys, with most of the changes in girls occurring in the 12 months before and after menarche. The increase in bone density during puberty is greater in African-American girls than Caucasian girls [10].

During the pubertal growth spurt, bone growth outpaces bone mineralization, leading to a relative reduction in bone mineral content [8]. In a longitudinal study, the nadir of bone mineral density coincided with peak height velocity in both boys and girls [11]. The same study reported that the incidence of distal radius fractures coincided with the same time point, suggesting that the relative paucity of bone mineral density is clinically significant.

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Literature review current through: Nov 2017. | This topic last updated: May 04, 2017.
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