“…There is more knowledge about healthcare in urban areas, including better nutrition (milk, dairy products, and vitamin D and Ca supplements intake) and higher income, which contribute to better access to these nutritional products, whereas physical activity, smoking, and alcohol consumption are more common in rural areas (Gu et al 2007). On the other hand, environmental factors such as exposure to compounds related to industrial emissions, automotive exhaust, metals, waste, and many other toxicants generated in urban areas are also related to bone tumors in children (Garcfa-Pérez et al 2017); also, a delay of 2-2.5 years in their bone development compared with their peers, a deficiency in BMD and vitamin D, and some serum bone turnover markers such as osteocalcin, B-cross laps, and procollagen type I N propeptide (PINP) in adolescents have been reported in urban zones (Zhumalina et al 2020).…”