A photo of Heidi J. Kalkwarf.

Heidi J. Kalkwarf, PhD, RD

  • Scientific Director, Bionutrition & Body Composition Core Laboratory, CCTST
  • Associate Director, Digestive Health Center
    Associate Director, Pediatric Advanced Nutrition Fellowship
  • Professor, UC Department of Pediatrics



My research focuses on ways to characterize bone density and body composition during growth and maturation processes. My colleagues and I are also looking at how lifestyle factors, such as diet and exercise, and chronic pediatric health conditions impact bone density and body composition.

In our research, my team is attempting to solve how to carefully identify the tempo of bone accrual and fluctuations in lean mass and fat mass in healthy children during development and maturation. These findings help us develop tools to assist physicians in recognizing children with chronic medical conditions who are at risk of bone fragility, obesity and sarcopenia.

Throughout our research, we aim to find the right lifestyle factors, physical activity patterns and dietary changes linked to ideal bone health in children. In my lab, important developments include designing bone density 'growth charts' that are being utilized across the globe to better diagnose skeletal fragility in children.

During my dietetics training, I realized there were many gaps in our knowledge about what people should eat to keep themselves healthy. These gaps prevent nutritionists from providing their patients the optimal guidance on what to eat. When I started my career as a nutrition researcher several decades ago, there was little knowledge available about how bone density changed in children as they matured. I was determined to uncover standard, healthy changes in bone density as children grow before assessing other factors that may influence bone density, such as diet, fitness and disease.

I have over 30 years’ experience in the nutritional epidemiology field and first began working at Cincinnati Children’s Hospital Medical Center in 1990. I was a standing member of the NIH study section Neurological, Aging and Musculoskeletal Epidemiology (NAME). The National Institutes of Health have funded my research for the last three decades. I’ve been published in prestigious journals such as the New England Journal of Medicine, Journal of Clinical Endocrinology and Metabolism, the Journal of Bone and Mineral Research, the Journal of Pediatrics and Neuromuscular Disorders.

Over the years, I have been fortunate to collaborate with multidisciplinary teams to progress clinical research. We are constantly learning from each other as we pursue scientific discoveries.

BS: Washington State University, Pullman, WA, 1980.

MNS: Cornell University, Ithaca, NY, 1983.

PhD: Cornell University; Ithaca, NY, 1991.

Postdoctoral Fellowship: Children's Hospital Medical Center, Cincinnati, OH, 1990-1993.

Certification: Registered Dietitian, 1983.


Bone mineral density in infants and children; body composition; dietary intake assessment; dual energy x-ray absorptiometry (DXA); peripheral QCT

Research Areas

Gastroenterology Hepatology and Nutrition



Pediatric Bone Mineral Accrual Z-Score Calculation Equations and Their Application in Childhood Disease. Kelly, A; Shults, J; Mostoufi-Moab, S; McCormack, SE; Stallings, VA; Schall, JI; Kalkwarf, HJ; Lappe, JM; Gilsanz, V; Oberfield, SE; Shepherd, JA; Winer, KK; Leonard, MB; Zemel, BS. Journal of Bone and Mineral Research. 2019; 34:195-203.


Patterns of early life body mass index and childhood overweight and obesity status at eight years of age. Braun, JM; Kalkwarf, HJ; Papandonatos, GD; Chen, A; Lanphea, BP. BMC Pediatrics. 2018; 18:161.


Bone fragility in Turner syndrome: Fracture prevalence and risk factors determined by a national patient survey. Wasserman, H; Backeljauw, PF; Khoury, JC; Kalkwarf, HJ; Gordon, CM. Clinical Endocrinology. 2018; 89:46-55.


Association Between Linear Growth and Bone Accrual in a Diverse Cohort of Children and Adolescents. McCormack, SE; Cousminer, DL; Chesi, A; Mitchell, JA; Roy, SM; Kalkwarf, HJ; Lappe, JM; Gilsanz, V; Oberfield, SE; Shepherd, JA; Winer, KK; Kelly, A; Grant, SF A; Zemel, BS. JAMA Pediatrics. 2017; 171:e171769.


Low bone mineral density and fractures are highly prevalent in pediatric patients with spinal muscular atrophy regardless of disease severity. Wasserman, HM; Hornung, LN; Stenger, PJ; Rutter, MM; Wong, BL; Rybalsky, I; Khoury, JC; Kalkwarf, HJ. Neuromuscular Disorders. 2017; 27:331-337.


Physical Activity Benefits the Skeleton of Children Genetically Predisposed to Lower Bone Density in Adulthood. Mitchell, JA; Chesi, A; Elci, O; McCormack, SE; Roy, SM; Kalkwarf, HJ; Lappe, JM; Gilsanz, V; Oberfield, SE; Shepherd, JA; Kelly, A; Grant, SF A; Zemel, BS. Journal of Bone and Mineral Research. 2016; 31:1504-1512.


Child Physical Activity Associations With Cardiovascular Risk Factors Differ by Race. Edwards, NM; Kalkwarf, HJ; Woo, JG; Khoury, PR; Daniels, SR; Urbina, EM. Pediatric Exercise Science. 2016; 28:397-406.


The National Osteoporosis Foundation's position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Weaver, CM; Gordon, CM; Janz, KF; Kalkwarf, HJ; Lappe, JM; Lewis, R; O'Karma, M; Wallace, TC; Zemel, BS. Osteoporosis International. 2016; 27:1281-1386.


Reproducibility and intermethod reliability of a calcium food frequency questionnaire for use in Hispanic, non-Hispanic Black, and non-Hispanic White youth. Ollberding, NJ; Gilsanz, V; Lappe, JM; Oberfield, SE; Shepherd, JA; Winer, KK; Zemel, BS; Kalkwarf, HJ. Journal of the Academy of Nutrition and Dietetics. 2015; 115:519-27.e2.