Updated June 25, 2015.

My daughter is constantly dieting. Should I be concerned?

Maintaining proper weight is important to overall health, but so is good nutrition. If your daughter is avoiding all milk and dairy products and severely restricting her food intake, she is probably not getting enough calcium. She needs a more balanced diet that includes low-fat milk products and other calcium-rich foods. Calcium supplements may also be helpful to ensure that she gets enough of this essential nutrient.You should discuss your concerns with your daughter's doctor.

If your daughter is one of the almost 5 percent of American girls and young women with eating disorders, the problem is even more serious. Eating disorders, especially anorexia nervosa, can lead to missed or irregular menstrual periods or the complete absence of periods, known as amenorrhea. These are signs of low estrogen, a hormone that is essential for developing bone density and optimal peak bone mass. Girls with anorexia nervosa will often have fractures as a first sign of the disease. Furthermore, reduction in estrogen production in adolescence will increase your daughter's risk of osteoporosis and fracture later in life. In severe cases, girls with eating disorders may even develop osteoporosis as early as their 20s. In severe cases, the damage to their bones cannot be reversed later in life.
Look for the following signs and see your daughter's physician if you think your daughter has, or is at risk of developing, an eating disorder.

• missed menstrual periods after having had them regularly for at least several months

• extreme and/or unhealthy-looking thinness
• extreme or rapid weight loss
• frequent dieting practices such as
• eating very little
• not eating in front of others
• trips to the bathroom following meals
• preoccupation with thinness
• focus on low-calorie and diet foods
• overtraining or excessive exercise

How does physical activity help my kids' bones?

Muscles get stronger when we use them. The same idea applies to bones: the more work they do, the stronger they get. Any kind of physical exercise is great for your kids, but the best ones for their bones are weight-bearing activities like walking, running, hiking, dancing, tennis, basketball, gymnastics, and soccer. (Children who tend to play outside will also have higher vitamin D levels.) Swimming and bicycling promote your kids' general health, but are not weight-bearing exercises and will not help build bone density. Organized sports can be fun and build confidence, but they are not the only way to build healthy bones.The most important thing is for your kids to spend less time sitting and more time on their feet and moving. Alone or with friends, at home or at the park--one of the best gifts you can give your kids is a lifelong love of physical activity. Bone-building activities

• walking
• tennis
• running
• volleyball
• hiking
• ice hockey
• field hockey
• dancing
• skiing
• soccer
• skateboarding
• gymnastics
• in-line skating
• basketball
• weight lifting
• jumping rope
• aerobics

Is it possible to get too much exercise?

For most people, including children and teens, the challenge is to get enough physical activity. However, excessive exercise and overtraining, often coupled with restrictive eating, can be a problem, especially for some female athletes and dancers, as well as girls who become obsessive about weight loss. Overtraining, like eating disorders, can result in decreased estrogen and eventually lead to thin bones that break easily.
Years ago, it was not unusual for coaches and trainers to encourage athletes to be as thin as possible for many sports, including dancing, gymnastics, figure skating, running, and diving. Fortunately, many coaches now realize that being too thin is unhealthy and can negatively affect performance as well as lifelong health.

So, my kids need to eat foods that are rich in calcium and get plenty of weight-bearing exercise. Is there anything else they can do to keep their bones healthy?

Yes. They should avoid smoking. You probably know that smoking is bad for the heart and lungs, but you may not know that it's harmful to bone tissue. Tobacco, nicotine, and other chemicals found in cigarettes may be directly toxic to bone, or they may inhibit absorption of calcium and other nutrients needed for bone health. The many dangers associated with smoking make it a habit to be avoided.
You may think it's too early to worry about smoking, but the habit typically starts during childhood. In fact, most people who use tobacco products start before they finish high school. The good news? If your kids finish high school as nonsmokers, they will probably stay that way for life.

Children who learn good eating and exercise habits by their preteen years are more likely to carry these habits with them for the rest of their lives.

Go On To Part 4 --- Osteoporosis Prevention For Kids --->