Researchers measured bone area and bone mineral content by DXA in 164 Canadians repeatedly from childhood into their twenties and thirties. Bone area stopped growing one to two years before bone mineral content did, and peak bone mass was reached by the end of the second decade or early in the third, depending on the skeletal site. Close to 40% of adult total body bone mineral was gained in the four years around the growth spurt.
Study breakdown
Why this study was done
Peak bone mass is the most bone mineral a person ever has. It is reached in youth, and everything lost later comes off that starting point, which matters for fracture risk in old age. When it is reached was disputed: some studies put it around 20, others said bone was still being added into the thirties. Most earlier work was cross-sectional, and puberty starts up to five years apart in healthy children, so comparing people by birthday blurs the picture. The authors measured the same children repeatedly from age 8 into their twenties.
How it was run
This is the Saskatchewan Pediatric Bone Mineral Accrual Study, an observational cohort with a mixed longitudinal design. From 1991, 220 students aged 8 to 15 at two Saskatoon schools had annual DXA scans, a low-dose X-ray that measures bone. Testing ran to 1997, paused five years, then resumed for up to four visits between 2002 and 2007. This analysis used only participants measured in both childhood and adulthood: 75 males and 89 females, 98% white and middle class. Bone area and mineral content were measured at the whole body, lumbar spine, total hip and femoral neck. Each person's data were aligned not on age but on their own age at peak height velocity, the point of fastest growth in height, averaging 11.8 years in girls and 13.5 in boys.
What they found
Bone area stopped growing first, and bone mineral content followed one to two years later.
- Whole body bone area rose until 4 years past peak height velocity, mineral content until 6 years past it, roughly age 18 in girls and 20 in boys.
- Lumbar spine bone area stopped at 3 years past, mineral content at 4.
- Femoral neck bone area stopped at 1 year past, mineral content at 2, roughly age 14.8 in girls and 16.5 in boys.
- No site gained bone area after 5 years past peak height velocity, or mineral content after 7 years past it.
- In the four years around peak height velocity, 39% of adult whole body mineral content was laid down in both sexes, 43% at the lumbar spine in males, 46% at the total hip in females and 33% at the femoral neck in both.
- About 22% of adult whole body mineral content went on in the two years around peak height velocity alone.
In females, the mineral laid down across adolescence was double what is later lost between ages 50 and 80.
Limitations
The cohort is 164 people, 98% white and middle class, from one Canadian city. The authors note that bone acquisition differs by ethnicity and that their results could be specific to this cohort and its environment. The upper age reached was about 30, so they cannot prove peak bone mass was final, only that it had plateaued. DXA carries measurement error and is affected by changing soft tissue, so average values do not land exactly at 100%. The authors also record a dispute in the field: some argue bone strength, not mass, determines fracture risk, and that no clear evidence yet links bone mass gained in youth to bone mass decades later. Funding came from Canadian public bodies, and all authors state they have no conflicts of interest.
What it means in practice
The value here is timing. It shows the window for building bone closes earlier than often assumed, by the end of the second decade or very early in the third, and that much adult bone is laid down in the few years around the growth spurt. It tests no intervention. Nobody was given calcium, vitamin D or anything else, so it cannot say what raises peak bone mass. It is observational, in one narrow population. The authors compare their figures with a Chinese cohort whose girls accrued bone at similar rates on less than half the recommended calcium intake, a caution against reading nutrient intake into these numbers.
Frequently Asked Questions
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Because the patented ingredients behind our four formulas went through dedicated research, and research costs real money. A generic curcumin or bacopa supplement hasn't been tested in the form you get from us. You're paying for an ingredient with research behind it, not just a label.
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