Abstract
Background: Bone mineralization can be influenced by physical activity and dietary factors; however, the relative contributions of these factors are not well defined. Physical activity in adolescents can be implemented with physical education (PE) classes and there is no reported data on their impact on bone mineralization. This study investigates the relationship between PE class attendance, dietary factors, and bone mineralization in adolescents. Methods: 57 adolescents (median age 17.00 [16.00-17.00] years) were enrolled in this study. Bone mineralization was assessed with bioelectrical impedance analysis (BIA) and dietary knowledge and selected foods intakes were assessed with a validated questionnaire. Results: PE attendance and dietary knowledge were positively associated with bone mineralization in the multivariate models (R(2) = 0.85, p < 0.001 for the best model, and R(2) = 0.81, p < 0.001 for the simplified model), and PE attendance was the dominant positive factor among the modifiable ones (B = 0.20, p = 0.02, and B = 0.25, p = 0.004, respectively). The impact of calcium sources intake was diminished when controlled for PE class attendance. Conclusions: PE attendance is one of the key factors of bone mineralization in adolescents. Our study showed that the role of calcium sources intake was diminished when acknowledging physical activity data, however dietary knowledge remained a significant predictor. Enhancing dietary knowledge and promoting physical activity are key targets for improving bone health.