Due to the routine supplementation of vitamin D in infancy and childhood, and the fortification of cow's milk with this vitamin, vitamin D deficiency is rarely observed in children in North America. The Impact of Other Nutrients While phosphorous is an important nutrient for bone health, it may have a negative effect on calcium status. High phosphate intakes, particularly in the presence of low calcium levels, have been linked to bone loss in laboratory animals. Preliminary research suggests that excessive consumption of phosphate-containing soft drinks may contribute to low peak bone mass, though the mechanism for this effect is not fully understood. It is possible that these beverages are detrimental to bone health because they are ingested in place of milk.
Dietary sodium exerts an important influence on calcium balance and bone acquisition.
As is the case in adults, sodium is the primary determinant of urinary calcium excretion in adolescent girls. Excessive protein intake triggers urinary calcium losses in adults, but may not be as detrimental to the skeletal health of girls. The skeletal benefits of physical activity in youth are well-established. On the other hand, excessive exercise in youth can cause injury to growth plates and can actually trigger bone loss in girls if the menstrual cycle is interrupted. The precise exercise prescription for optimizing peak bone mass has not been established.