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Metrics details. Osteoporosis is an important public health issue in aging societies because of its associated morbidity, mortality, and decreased quality of life.

The study aims to identify the association of low bone mineral density, including osteoporosis and osteopenia, with environmental and personal factors. Multivariable logistic regressions were performed to identify the selected factors associated with low bone mineral density for multiple visit data. A total of , participants with , visits were included in this study. The prevalence of low bone mineral density BMD in the study population was Interventions in different directions, such as having better health behaviors, increasing sun exposure, and residing in a highly walkable environment, are beneficial for reducing the risk of low BMD.

Peer Review reports. Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone tissue. Osteoporosis is caused by a disorder in the equilibrium between bone resorption and formation [ 1 ]. A meta-analysis pooled different age groups and reported that the prevalence of osteoporosis in the world was Low bone mineral density BMD is a risk factor for osteoporotic fractures, resulting in decreased quality of life, morbidity, disability, and mortality [ 1 ].

Osteoporosis-related fractures cause a high socioeconomic burden due to increased healthcare costs and care requirements [ 1 ]. Osteoporosis is a common disease among the elderly. Therefore, prevention is a major public health issue worldwide. Previous studies have reported that the risk factors for osteoporosis include inadequate exercise, inadequate nutrition such as calcium and vitamin D, early menopause, smoking, and alcohol abuse [ 1 ]. Ultraviolet radiation UVR penetrates the skin and stimulates the conversion of 7-dehydrocholesterol to pre-vitamin D3 [ 7 ].