Nutritional Basis of Skeletal Growth

Many factors influence skeletal growth and ultimate peak mass acquired by adulthood. Genetics is thought to contribute 60-80% of peak bone mass and lifestyle factors 20-40%. Genes that control body size are undoubtedly influential in controlling skeletal growth. Crude markers for genetic differences include race and gender. This chapter focuses on lifestyle factors including all of the cultural exposures and individual choices that influence skeletal growth, notably physical activity and diet. The interplay of these nature-nurture factors is emphasized, but methodological limitations impede any progress. In this chapter, the influence of nutrition and the interaction of diet and exercise in the development of male peak bone mass is reviewed, recognizing that the evidence for boys is much less than for girls. Skeletal fragility, which occurs naturally during the pubertal growth spurt or due to pediatric disorders, is also discussed.