{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:32:34Z","timestamp":1790620354851,"version":"4.1.0"},"reference-count":41,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T00:00:00Z","timestamp":1623024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The incidence of osteoporosis is increasing as the population ages, as is the need to manage and prevent it. Adolescence is the period when the fastest development of bone mass takes place. Increasing adolescents\u2019 maximum bone mass and avoiding the risk factors for its loss are effective for preventing osteoporosis. This study investigated the factors influencing adolescents\u2019 bone mineral density (BMD). The participants were 126 middle- and high-school students from Gangwon-do; 47.6% (n = 60) were male, with an average age of 15 (range 12\u201318) years of age. It was found that age, carbonated beverages, snacks, and calcium supplements were variables that showed significant differences in adolescents\u2019 BMD. Additionally, through correlation analysis, it was found that height, weight, body mass index (BMI), body water, protein, minerals, body fat mass, and skeletal muscle mass were correlated with BMD. Multiple regression analysis identified age, calcium supplements, BMI, body fat mass, and skeletal muscle mass as BMD-associated factors. These results show that adolescents\u2019 BMD is higher with lower body fat mass, higher BMI and skeletal muscle mass, and a higher intake of calcium supplements.<\/jats:p>","DOI":"10.3390\/ijerph18116170","type":"journal-article","created":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T13:25:43Z","timestamp":1623072343000},"page":"6170","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Effects of Adolescents\u2019 Lifestyle Habits and Body Composition on Bone Mineral Density"],"prefix":"10.3390","volume":"18","author":[{"given":"Chang-Sook","family":"Han","sequence":"first","affiliation":[{"name":"Division of Nursing, Graduate School, Hallym University, 1 Hallymdaehak-gil, Chuncheon-si 135-841, Gangwon-do, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3323-8774","authenticated-orcid":false,"given":"Hyo-Kyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Nursing, Graduate School, Hallym University, 1 Hallymdaehak-gil, Chuncheon-si 135-841, Gangwon-do, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4850-8105","authenticated-orcid":false,"given":"Suhee","family":"Kim","sequence":"additional","affiliation":[{"name":"School of Nursing and Research Institute of Nursing Science, Hallym University, 1 Hallymdaehak-gil, Chuncheon-si 135-841, Gangwon-do, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.afos.2016.11.004","article-title":"Osteoporosis prevention and osteoporosis exercise in community-based public health programs","volume":"3","author":"Nguyen","year":"2017","journal-title":"Osteoporos. Sarcopenia"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Dinis, J., Pereira, A.I., and Fonseca, E.M. (2012). Mathematical model for the assessment of fracture risk associated with osteoporosis. AIP Conf. Proc., 814\u2013817.","DOI":"10.1063\/1.4756262"},{"key":"ref_3","first-page":"939","article-title":"Osteoporosis or low bone mass in adults aged 50 years old and above in Republic of Korea, 2008\u20132011","volume":"7","author":"Kim","year":"2014","journal-title":"Public Health Wkly. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Guideline Development Committee (2008). Korean Society of Bone Metabolism. Osteoporosis diagnosis and treatment 2007. Endocrinol. Metab., 23, 76\u2013108.","DOI":"10.3803\/jkes.2008.23.2.76"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1694S","DOI":"10.3945\/ajcn.113.058255","article-title":"Tea and bone health: Steps forward in translational nutrition","volume":"98","author":"Shen","year":"2013","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1016\/j.injury.2016.04.018","article-title":"Quality of life after hip fracture in the elderly: A systematic literature review","volume":"47","author":"Peeters","year":"2016","journal-title":"Injury"},{"key":"ref_7","first-page":"42","article-title":"A study on reference values and prevalence of osteoporosis in Korea: The Korea National Health and Nutrition Examination Survey 2008\u20132011","volume":"18","author":"Lee","year":"2013","journal-title":"J. Korean Off. Stat."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1177\/1757913912463293","article-title":"Osteoporosis prevention and motivation for weight-bearing physical activity and calcium consumption","volume":"132","author":"Nguyen","year":"2012","journal-title":"Perspect. Public Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1359\/jbmr.1998.13.10.1602","article-title":"A longitudinal study of bone gain in pubertal girls: Anthropometric and biochemical correlates","volume":"13","author":"Cadogan","year":"1998","journal-title":"J. Bone Miner. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1007\/s002230010067","article-title":"Lifestyle determinants of bone mineral: A comparison between prepubertal Asian-and Caucasian-Canadian boys and girls","volume":"66","author":"McKay","year":"2000","journal-title":"Calcif. Tissue Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"147","DOI":"10.4163\/jnh.2013.46.5.482","article-title":"Maternal and lifestyle effect on bone mineral density in Korean children and adolescents aged 8\u201319","volume":"46","author":"Lee","year":"2013","journal-title":"J. Nutr. Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"616","DOI":"10.5124\/jkma.2018.61.10.616","article-title":"Causes, diagnosis, and treatment of pediatric osteoporosis","volume":"61","author":"Lim","year":"2018","journal-title":"J. Korean Am. Med. Assoc."},{"key":"ref_13","first-page":"242","article-title":"A study of factors affecting bone mineral density in Korean adolescents: Anthropometric measurements, life style, and other environmental factors","volume":"38","author":"Ahn","year":"2005","journal-title":"J. Nutr. Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.1249\/01.MSS.0000142662.21767.58","article-title":"American College of Sports Medicine position stand: Physical activity and bone health","volume":"36","author":"Bloomfield","year":"2004","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"137","DOI":"10.21184\/jkeia.2016.02.10.1.137","article-title":"The life habits and exercise strategies for prevention and management of osteoporosis","volume":"10","author":"Yoo","year":"2016","journal-title":"J. Korea Entertain. Ind. Assoc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"129","DOI":"10.7570\/kjo.2013.22.3.129","article-title":"Bone health and calcium, vitamin D, potassium: Shortfall Nutrients in Korean","volume":"22","author":"Choi","year":"2013","journal-title":"J. Korean Med. Obes. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1007\/s11657-017-0333-4","article-title":"Calcium intake, bone mineral density, and fragility fractures: Evidence from an Italian outpatient population","volume":"12","author":"Vannucci","year":"2017","journal-title":"Arc. Osteoporos."},{"key":"ref_18","first-page":"1545","article-title":"A comparative analysis on change of body composition of middle school girls according to bone mineral density classification","volume":"25","author":"Kim","year":"2016","journal-title":"Kasetsart J. Soc. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"89","DOI":"10.3961\/jpmph.2013.46.2.89","article-title":"Physical activity in adolescence has a positive effect on bone mineral density in young men","volume":"46","author":"Kim","year":"2013","journal-title":"J. Prev. Med. Public Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1007\/s00198-002-1352-5","article-title":"The effect of age, weight, and lifestyle factors on calcaneal quantitative ultrasound: The ESOPO study","volume":"14","author":"Adami","year":"2003","journal-title":"Osteoporos. Int."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"432","DOI":"10.17495\/easdl.2018.12.28.6.432","article-title":"Relationship between nutrient intakes and anthropometric values, and bone mineral density of pre- and post-menopausal women in the Gyeongnam area","volume":"28","author":"Park","year":"2018","journal-title":"J. East Asian Soc. Diet. Life"},{"key":"ref_22","first-page":"14","article-title":"Relation among dietary habits, nutrient intakes and bone mineral density in Korean normal and obese elementary students","volume":"11","author":"Bae","year":"2006","journal-title":"Korean J. Commun. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.jocd.2017.06.018","article-title":"Quantitative ultrasound (QUS) in the management of osteoporosis and assessment of fracture risk","volume":"20","author":"Hans","year":"2017","journal-title":"J. Clin. Densitom."},{"key":"ref_24","unstructured":"Korean Ministry of Education, Korean Ministry of Health and Welfare, and Korean Centers for Disease Control and Prevention (2016). Guidelines for the Use of the Twelfth Korea Youth Risk Behavior Web-Based Survey, Korean Center for Disease Control and Prevention."},{"key":"ref_25","unstructured":"IPAQ Research Committee (2021, May 16). Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire (IPAQ)-Short and Long Forms. Available online: https:\/\/sites.google.com\/site\/theipaq\/scoring-protocol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.bone.2009.10.005","article-title":"Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly","volume":"46","author":"Rizzoli","year":"2010","journal-title":"Bone"},{"key":"ref_27","first-page":"57","article-title":"Bone mineral density in children and adolescents: Relation to puberty, calcium intake, and physical activity","volume":"82","author":"Boot","year":"1997","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_28","first-page":"38","article-title":"Bone mineral density and correlation factors in normal children and adolescence","volume":"14","author":"Oh","year":"2009","journal-title":"J. Korean Soc. Pediatr. Endocrinol."},{"key":"ref_29","first-page":"267","article-title":"Development of regression equation and correlation between BMD and body composition in middle school girls","volume":"16","author":"Kim","year":"2008","journal-title":"Korean J. Growth Dev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1111\/obr.12515","article-title":"Differences in bone mineral density between normal-weight children and children with overweight and obesity: A systematic review and meta-analysis","volume":"18","author":"Koes","year":"2017","journal-title":"Obes. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"G\u00e1llego Su\u00e1rez, C., Singer, B.H., Gebremariam, A., Lee, J.M., and Singer, K. (2017). The relationship between adiposity and bone density in US children and adolescents. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0181587"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12891-018-1933-x","article-title":"Bone mineral density at the hip and its relation to fat mass and lean mass in adolescents: The Troms\u00f8 study, fit futures","volume":"19","author":"Winther","year":"2018","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/j.nut.2013.12.003","article-title":"Excess body fat negatively affects bone mass in adolescents","volume":"30","author":"Mosca","year":"2014","journal-title":"Nutrition"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.bone.2014.04.027","article-title":"Fat mass is positively associated with bone mass in relatively thin adolescents: Data from the Kitakata kids health study","volume":"64","author":"Kouda","year":"2014","journal-title":"Bone"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/s00223-017-0314-z","article-title":"Low Skeletal muscle mass is associated with the risk of low bone mineral density in urban dwelling premenopausal women","volume":"101","author":"Kim","year":"2017","journal-title":"Calcif. Tissue Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.jocd.2012.07.008","article-title":"Associations of dietary calcium, vitamin D, milk intakes, and 25-hydroxyvitamin D with bone mass in Spanish adolescents: The HELENA study","volume":"16","author":"Mouratidou","year":"2013","journal-title":"J. Clin. Densitom."},{"key":"ref_37","first-page":"152","article-title":"Calcium supplementation for 2 years improves bone mineral accretion and lean body mass in Chinese adolescents","volume":"19","author":"Yin","year":"2010","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1001\/jama.1993.03510070063037","article-title":"Calcium supplementation and bone mineral density in adolescent girls","volume":"270","author":"Lloyd","year":"1993","journal-title":"JAMA"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1359\/jbmr.2003.18.9.1563","article-title":"Carbonated soft drink consumption and bone mineral density in adolescence: The Northern Ireland Young Hearts project","volume":"18","author":"McGartland","year":"2003","journal-title":"J. Bone Miner. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/S0271-5317(01)00324-4","article-title":"Relationship between carbonated and other low nutrient dense beverages and bone mineral content of adolescents","volume":"21","author":"Whiting","year":"2001","journal-title":"Nutr. Res."},{"key":"ref_41","unstructured":"CDC (Centers for Disease Control and Prevention) (2021, May 16). Physical Activity Facts, Available online: https:\/\/www.cdc.gov\/healthyschools\/physicalactivity\/facts.htm."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/11\/6170\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:11:43Z","timestamp":1760163103000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/11\/6170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,7]]},"references-count":41,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["ijerph18116170"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18116170","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,7]]}}}