Milk Intake, Sun Exposure, and Caffeinated Energy Drink Consumption in Children and Adolescents: Evidence, Uncertainty, and Implications for Peak Bone Mass Accrual
Abstract
Background/objectives: Childhood and adolescence are critical periods for bone mineral accrual and future skeletal reserve. Milk intake, sun exposure and caffeinated energy drink consumption are familiar lifestyle concepts, but they differ substantially in biological proximity and evidential strength. This structured narrative review critically evaluates these exposures in relation to peak bone mass accrual in youth.
Methods: PubMed/MEDLINE, Scopus, Web of Science, the Cochrane Library and Google Scholar were searched from database inception to 23 June 2026. Search terms combined pediatric population terms with bone outcomes and exposure terms related to milk/dairy, calcium, vitamin D, sun exposure, physical activity, sleep, caffeine and energy drinks. A literature collection flowchart and a GRADE-informed evidence appraisal table are provided to improve transparency and clinical interpretability.
Results: Evidence is strongest for adequate calcium intake, calcium-rich foods and weight-bearing physical activity as modifiable contributors to skeletal accrual. Vitamin D is essential for mineral homeostasis, but supplementation effects on bone density in otherwise healthy children are context-dependent and appear most relevant for deficiency prevention or treatment. Milk intake is best interpreted as a practical marker of calcium-rich dietary patterns rather than as the only route to calcium adequacy. Sun exposure is an indirect determinant of vitamin D status and is modified…
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