Study Finds Association between Lower Bone Density and Vitamin D Deficiency in African American Children with Forearm Fractures

Washington, DC—Researchers at Children’s National Medical Center have found that African American children who experience forearm fractures are more likely to have lower bone density and vitamin D deficiency compared to children without fractures. Obesity may also increase the risk of fractures, according to the study, which will appear in the September issue of Pediatrics.

“Childhood is an important time to build strong bones and optimize bone health because 90 percent of peak bone mass is achieved by age 18. These results reinforce just how important it is for kids to get their exercise, calcium, and vitamin D for healthy bones so that they don’t continue to have difficulties in adulthood,” said Leticia Ryan, MD, MPH, lead author of the study and an emergency medicine pediatrician at Children’s National. “We hope to look at the public health aspects of promoting bone health as a means of injury prevention.”

Researchers found that African American children with forearm fractures have lower bone mineral density and are more likely to be vitamin D deficient compared to African American children without fractures. Obesity also may increase the risk of fractures in this population. The authors noted a dose-dependent relationship between vitamin D level and fracture risk. Every increased unit of vitamin D level led to a 10 percent decrease in fracture risk. Given that 90 percent of peak bone mass is achieved by age 18, deficient bone health in childhood can lead to more fractures and weaker bones in adulthood.

Normally a concern among older populations who experience bone health deficits and osteoporosis-related fractures, forearm fractures have been increasing among children and result in substantial health care costs. Because bone health status during childhood may directly impact adult bone health, opportunities to intervene during childhood should be pursued.  Current research has focused on this incidence level among Caucasian children and has found that forearm fracture risk in childhood is influenced by low calcium and low milk intake as well as high body mass index. The study from Children’s National looked specifically at bone mineral density and vitamin D levels of 150 African American children, ages 5 to 9, some who presented with forearm fractures, and some who did not have fractures.

“A forearm fracture could be an indication for parents that they need to have a larger conversation with their child’s pediatrician about bone health and what steps to take to ensure proper bone development,” stated James Chamberlain, MD, senior author of the study and Division Chief of Emergency Medicine and Trauma Services. “The best thing parents can do for their children is to make sure they’re getting enough calcium, vitamin D, and exercise.”

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