To the emerging adult: “Why should you care about your bones?”

Having spent the past two decades on college campuses, first as a student and now as a professor, I realize maintaining a healthy lifestyle is not always easy for a college student! Although food options have since improved, late-night snacking, the vast availability of fast food and lack of exercise make college a time of weight gain. The “freshman 15” is real; although we now know that this is more like a ~7.5 lbs weight gain in the first year of university. This is concerning because this period of emerging adulthood (18 to 29 years) is important for establishing long-term behavioral patterns. This is also a critically important time for bone development, and these unhealthy habits can affect future bone health.

Figure: Bone mass across the lifespan taken from 2016 NOF review and recommendations.

Although we gain most bone mass during childhood, peak bone mass, which is the maximum amount of bone a person will have during their life, is likely only achieved by early adulthood. Some bone sites like the lumbar spine may only achieve peak bone mass in the late 30s. Achieving maximal peak bone mass is even more important for females, due to the increase in bone loss after menopause. Since peak bone mass will determine the future risk of fractures and osteoporosis (see Figure), lifestyle factors during the young adult period are going to be important for optimizing bone health.

So, what can you do?

  1. Get enough calcium and vitamin D.  Minerals like calcium and phosphate make up ~2/3 of bones. Hence, getting enough dietary calcium as well as vitamin D, which is needed for the absorption of calcium, is key for optimizing bone mass. Whereas calcium is found abundantly in the food supply, with dairy foods containing the most bioavailable source, vitamin D is found naturally in only a few foods. Hence, fortified foods and supplementation may be needed to meet daily vitamin D needs.
  2. Make sure you exercise. Exercise strengthens the muscles which surround bone, but also helps maintain balance and reduce the risk of falls. Weight-bearing activities like jumping are going to be best for your bones as well as resistance exercises such as weight lifting.
  3. Don’t smoke and consume alcohol in moderation. Although the evidence is not yet clear, it does appear that excessive alcohol and cigarette smoking, especially during periods of growth, can be detrimental to bone health.

These few small steps during early adulthood can change the trajectory of your bone health for life.

Sina Gallo, PhD, is a Registered Dietitian and Associate Professor in Foods and Nutrition at the University of Georgia. Dr. Gallo’s research focuses on improving maternal and child nutrition to prevent development of chronic diseases like osteoporosis later in life.