Letter to the editor: Sex difference in the association between dietary iron intake and bone mineral density in adolescents aged 12–19: A cross-sectional study

We read with great interest the article by Li et al. (2025) [1] titled “Sex difference in the association between dietary iron intake and bone mineral density in adolescents aged 12–19: A cross-sectional study”, recently published in the Journal of Trace Elements in Medicine and Biology. The authors present compelling evidence for a sex-specific relationship between dietary iron intake and bone mineral density (BMD), identifying a significant positive association in male adolescents but not in females. This work is timely and of clinical relevance, considering the critical window of adolescence for optimizing peak bone mass and the widespread concern regarding inadequate micronutrient intake in youth. A notable strength of this study is its use of a large, nationally representative NHANES dataset and rigorous multivariable modeling to adjust for key covariates. The stratified analyses by sex and detection of significant interactions further underscore the potential role of sex hormones, growth patterns, and nutrient metabolism in modulating skeletal health trajectories during adolescence. To further enrich this line of inquiry, we wish to offer several perspectives for future research directions.