study, available bone density reference data were not optimal for evaluating the status of children because sample sizes were too small and standardized protocols were not used for including and measuring patients, Dr. Kalkwarf noted. As well, the collection and analysis of previous data were inconsistent and did not factor in variables for age, sex and race -- all important reference points in evaluating the bone health of children.

"Before this data it was like comparing apples to oranges," Dr. Kalkwarf said. "Now, pediatricians can monitor children according to the chart we developed and determine if they are normal or if there's something that needs to be investigated further."

Cincinnati Children's was invited by the NICHD to participate in the national multi-institutional study, which used dual-energy x-ray absorptiometry (DXA) to measure bone mineral content (BMC) and density (BMD) in 1,500 healthy children between the ages of 6 and 17. The study is the first to include all criteria needed to serve as a pediatric reference database for normal bone density in children:

1. The most current measurement technology with standardized data acquisition
2.A well-characterized, healthy and ethnically diverse sample large enough to capture normal bone mass variability
3.Statistical analysis methods that adequately characterize age-related trends and value distribution at different ages

The study found that bone mass is still increasing at age 16 in girls and 17 in boys, underscoring the importance of maintaining healthy nutrition and lifestyle habits as teens approach adulthood and identifying children prone to bone deficiencies. Dr. Kalkwarf said most people continue to accumulate bone mass into their 20s, although this study did not evaluate patients beyond the age of 17.

Another key finding shows differences in bone density between African American and non-African American children. A
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