There was no effect of calcium supplementation  on femoral neck or lumbar spine BMD .
There was no evidence of effect modification by baseline calcium intake , sex , ethnicity , physical activity or pubertal stage .
While there is a small effect of calcium supplementation in the upper limb , the increase in BMD which results is unlikely to result in a clinical ly significant decrease in fracture risk .
The results do not support the use of calcium supplementation  in healthy children as a public health intervention .
These results can not be extrapolated to children with medical conditions affecting bone metabolism
BACKGROUND Clinical trials have shown that  calcium supplementation in children can increase  bone mineral density ( BMD ) although this effect may not be maintained .
There has been no quantitative systematic review of this intervention .
To determine the effectiveness of calcium supplementation for improving BMD  in children .
.
To determine if any effect varies by sex , pubertal stage , ethnicity or level of physical activity , and if any effect persists after supplementation is ceased .
Eating attitudes and habitual calcium intake in peripubertal girls are associated with initial bone mineral content and its change over 2 years.
This 2-year prospect i ve study examined associations among bone mineral acquisition and physical , maturational , and lifestyle variables during the pubertal transition in healthy girls . Forty-five girls , initially 10.5+/-0.6 years , participated .  Body composition and bone mineral content ( BMC ) at the spine and total body ( TB ) were assessed at baseline and annually thereafter using dual-energy X-ray absorptiometry ( DXA ) .  Nutrient intakes were assessed using 3-day diet records and a calcium food frequency question naire ( FFQ ) ,  physical activity by question naire , sexual maturation using Tanner 's stages of breast and pubic hair maturation , growth by height and weight , and eating attitudes using the children 's Eating Attitudes Test ( Children 's EAT ) . Mean children 's EAT subscale scores ( dieting , oral control [ OC ] , and bulimia ) were stable over time . Median split of OC subscale scores was used to form high and low OC groups . Groups had similar body composition , dietary intake , activity , and Tanner stage at baseline and 2 years . Using height , weight , and Tanner breast stage as covariates , girls with low OC scores had greater TB BMC at baseline ( 1452+/-221 g vs. 1387+/-197 g ; p = 0.030 ) and 2 years ( 2003+/-323 g vs. 1909+/-299 g ; p = 0.049 ) and greater lumbar spine ( LS ) BMC at 2 years ( 45.2+/-8.8 g vs. 41.2+/-9.6 g ; p = 0.042 ) . In multiple regression analysis , OC score predicted baseline , 2 years , and 2-year change in TB and spinal BMC , contributing 0.9 - 7.6 % to explained variance .  Calcium  intake predicted baseline , 2 years , and 2-year change in TB BMC , explaining 1.6 - 5.3 % of variance . We conclude that both OC and habitual calcium intake may influence bone mineral acquisition
There was no effect of calcium supplementation  on femoral neck or lumbar spine BMD .
There was no evidence of effect modification by baseline calcium intake , sex , ethnicity , physical activity or pubertal stage .
While there is a small effect of calcium supplementation in the upper limb , the increase in BMD which results is unlikely to result in a clinical ly significant decrease in fracture risk .
The results do not support the use of calcium supplementation  in healthy children as a public health intervention .
These results can not be extrapolated to children with medical conditions affecting bone metabolism
BACKGROUND Clinical trials have shown that  calcium supplementation in children can increase  bone mineral density ( BMD ) although this effect may not be maintained .
There has been no quantitative systematic review of this intervention .
To determine the effectiveness of calcium supplementation for improving BMD  in children .
.
To determine if any effect varies by sex , pubertal stage , ethnicity or level of physical activity , and if any effect persists after supplementation is ceased .