As a general measure, in order to create the most favorable environment for bone growth and development, the correct intake of nutrients, especially calcium, according to the patient's age, sex, and physical characteristics should be actively promoted. Physical activity has also a major role in the full attainment of an individual's genetically determined potential peak of bone mass. This is extremely important, since it has been estimated that a 10% increase of peak bone mass reduces by 50% the risk of one osteoporotic fracture during adult life. Diet should be varied and correctly balanced. For example, fruit and vegetable consumption is positively linked with BMD in girls (42).
Adolescents should be encouraged not only to acquire healthy habits (balanced diet, regular exercise), but also to avoid bone-damaging behaviors such as smoking or excessive alcohol consumption (43,44).
Special attention must of course be paid to disease-specific needs. For example, protein-energy malnutrition has been reported in 10% to 50% of adolescents with JIA (45).
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