The bone mass attained early in life is perhaps the most important determinant of lifelong skeletal health. Persons with the highest peak bone mass after adolescence have the greatest protective advantage when bone density declines as a result of aging, illness, and diminished hormone production. Bone mass may be related not only to osteoporosis and fragility fractures later in life, but also to fractures in childhood and adolescence. Bone health would be improved if schools appropriately emphasized physical education and activity.^2,3

Genetic factors exert a strong and perhaps predominant influence on peak bone mass, but physiological, environmental, and modifiable lifestyle factors can also play a significant role. Among these are adequate nutrition and normal body weight, and regular physical activity. Thus, maximizing bone mass early in life presents a critical opportunity to reduce the impact of bone loss related to aging.³