Nutrition is one of the modifiable factors that contributes to bone accrual during childhood and adolescence, a critical period to prevent adult osteoporosis. Calcium and vitamin D seem to be the most important nutrients for optimal bone growth. Requirements for calcium intake are different among countries and organizations, and exact recommendations are difficult to determine since other dietary factors directly affect calcium metabolism, such as salt intake and vitamin D levels. Some scientists have suggested that the actual calcium requirements are overestimated and that increased dairy intake does not necessarily translate to better bone health in adults. Moreover, calcium can be obtained from other natural foods, such as cruciferous vegetables (turnip greens, broccoli rabe, kale, broccoli, and cabbage), endive, sesame seeds, legumes, almonds, calcium-fortified vegetable beverages, and canned sardines. Vitamin D should be obtained from food combined with appropriate sun exposure, and if that is not enough, vitamin D supplements can be used. Diets comprised a complex combination of nutrients and foods, and dietary patterns in children and adolescents play a key role in bone formation. A dietary pattern that is high in vegetables and fruits and low in processed foods (containing large amounts of added sugar and salt) is necessary to achieve optimal bone formation. Finally, physical activity, particularly activities that apply large forces, is even more important than dietary factors to contribute to bone accrual.