Note: Cover -- Contents -- Preface -- Contributors -- Osteoporosis: A Pediatric Concern? -- Abstract -- Osteoporosis: The Size of the Problem -- A Growth and Development Issue? -- Factors Affecting Bone Mineral Acquisition -- Issues -- Conclusion -- References -- The Biomechanical Basis of Bone Strength Development during Growth -- Abstract -- Long Bone Strength: Material Composition and Structure -- Bone Material Composition -- Long Bone Structure -- Measuring Long Bone Strength -- Measuring Material Composition -- Measuring Bone Structural Strength -- Measures Combining Material and Structural Strength -- Long Bone Growth: Length, Size, Mass and Tissue Density -- Bone Length -- Bone Size and Geometry -- Bone Mass -- Bone Tissue Density -- Cortical Density -- Trabecular Density -- Bone Strength -- Regulation of Bone Strength Development -- Muscle Development and Bone Strength -- Hormonal Factors Regulating Bone Growth -- Longitudinal Bone Growth -- Bone Size -- Tissue Density -- Summary and Conclusions -- References -- The Effect of Exercise on Bone Mass and Structural Geometry during Growth -- Abstract -- The Effect of Exercise on Bone Mass, Geometry and Strength during Growth -- Effect of High-Impact Athletic Training on Bone Geometry and Strength during Growth -- Effect of Recreational and Leisure Activity on Bone Geometry and Strength during Growth -- Effect of School-Based Exercise Interventions on Bone Geometry and Strength -- Summary and Conclusion -- References -- Evidence for an Interaction between Exercise and Nutrition for Improved Bone Health during Growth -- Abstract -- Understanding the Terms 'Interaction ' or 'Effect Modification ' -- Combined Effect of Calcium, Vitamin D, or Protein and Exercise during Growth: Is There Evidence for an Interaction on Bone? -- Calcium -- Vitamin D -- Protein and Energy Intake -- Summary and Conclusion. , References -- Gene-Environment Interactions in the Skeletal Response to Nutrition and Exercise during Growth -- Abstract -- The Importance of Peak Bone Mass -- Genetics and Bone Mass and Strength -- Gene-Environment Interaction - Bone Response to Nutritional and Mechanical Factors during Growth -- Summary and Conclusion -- References -- The Effect of Energy Balance on Endocrine Function and Bone Health in Youth -- Abstract -- Description of Exercise-Associated Menstrual Cycle Disturbances -- Skeletal Parameters in Female Athletes with Menstrual Cycle Disturbances -- Bone Turnover in Women with Nutritionally Related Amenorrhoea -- Bone Turnover in Adolescents with Nutritionally Related Amenorrhoea -- Proposed Mechanisms of Disturbed Bone Turnover under Conditions of Energy Deprivation -- Reduced Synthesis and Action of Insulin-Like Growth Factor I in Energy Deprivation -- Insulin-Like Growth Factor I and Bone Turnover in Nutritionally Related Amenorrhoea -- Serum Leptin Concentration and Bone Metabolism -- Effect of Intense Training on Endocrine Function and Bone Health in Young Male Athletes -- Recommendations for the Prevention and Treatment of Low Bone Density in Female Athletes -- References -- Risk Factors for Fractures in Normally Active Children and Adolescents -- Abstract -- Epidemiology of Fractures during Growth -- Fracture Patterns Differ from Those of Adults -- Fracture Rates Vary with Age and Sex -- A Few Children Sustain Most of the Fractures -- Trauma Precipitates Fracture -- Childhood Fractures Are Becoming More Common -- Risk Factors for Fracture during Growth -- Children with Repeated Fractures Usually Fracture First at a Young Age -- Children Who Fracture Have Lower Bone Mass -- Musculoskeletal Weakness -- High Adiposity -- Medications with Toxic Actions on Bone -- Genetic Factors -- Intrauterine Factors -- Nutritional Factors. , Inadequate Dietary Calcium -- Calorie Deprivation -- Beverage Choices -- Milk Avoidance -- Cigarette Smoking -- Strategies for Preventing Fractures during Growth -- Creating a Safe Play and Sport Environment -- Limiting Risk-Taking Behavior -- Management of Low aBMD -- General Strategies to Reduce Fractures during Growth -- References -- Does Exercise during Growth Preve t Fractures in Later Life? -- Abstract -- The Fragility Fracture Problem -- Does Exercise during Growth Increase the Accrual of Bone Mass and Improve Bone Structure? -- Are Exercise-Induced Benefits to Areal Bone Mineral Density Retained following the Cessation of Training? -- Are Exercise-Induced Benefits in Bone Mass Preserved with Retirement? -- Are Exercise-Induced Structural Changes of the Skeleton Preserved with Retirement? -- Influence of Current Physical Activity and Detraining on Fracture Risk -- Summary and Conclusion -- References -- Lessons Learned from School-Based Skeletal Loading Intervention Trials: Putting Research into Pra tice -- Abstract -- Lesson 1: Exercise in Youth Confers Substantial Skeletal Benefit -- Lesson 2: Prepuberty and Early Puberty May Provide the Ideal 'Window of Opportunity' in Which to Intervene -- Lesson 3: Bone Responds to Specific Loading Characteristics -- Modality -- Intensity -- Frequency -- Duration -- Progression -- Lesson 4: Calcium Enhances the Effects of Exercise on the Young Skeleton -- Lesson 5: School-Based Exercise Interventions for Bone Health Are Feasible and Safe -- Tips to Delivering a Successful School-Based Intervention -- Conclusion -- Appendix: Example of Osteogenic Loading Activities, Progressions and a Circuit Program -- :Healthy Bones: Circuit Training -- Circuit Format -- References -- Subject Index.