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 .
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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 .
Bone mineral contents and plasma osteocalcin concentrations of Gambian children 12 and 24 mo after the withdrawal of a calcium supplement.
BACKGROUND Our r and omized , placebo-controlled supplementation study of 160 rural Gambian children aged 8.3 - 11.9 y showed that an increase in calcium intake of 714 mg/d for 12 mo result ed in a 5 % increase in forearm bone mineral acquisition and a 22 % decrease in plasma osteocalcin concentration , a bone formation marker , but had no effect on height or bone dimensions . OBJECTIVE We investigated whether these results were sustained after supplement withdrawal . DESIGN All participants were followed up 12 ( FU1 ) and 24 ( FU2 ) mo after supplementation ended . Bone mineral content ( BMC ) , bone mineral density ( BMD ) , and BMC adjusted for bone width , body weight , and height ( size-adjusted BMC ) were measured at the midshaft and distal radius . Plasma osteocalcin concentration was measured at FU1 . RESULTS At follow-up , the calcium group had greater bone mineral status than did the placebo group at the midshaft radius ( mean difference + /- SE ) , FU1 : BMC ( 4.7 + /- 1.6 % ; P = 0.004 ) , BMD ( 5.1 + /- 1.1 % ; P < /= 0.0001 ) , size-adjusted BMC ( 5.0 + /- 1.1 % ; P < /= 0.0001 ) ; FU2 : BMC ( 3.8 + /- 1.6 % ; P = 0.02 ) , BMD ( 2.7 + /- 1.3 % ; P = 0.04 ) , size-adjusted BMC ( 2.5 + /- 1.3 % ; P = 0.06 ) . Similar differentials were observed at the distal radius but were not significant . No significant differences in plasma osteocalcin concentrations ( FU1 : -0.5 + /- 6.5 % ; P = 0.9 ) were observed between groups . CONCLUSION Although some of the effects of calcium supplementation were still evident at follow-up , further studies are required to determine whether short-term increases in calcium intake have lasting benefits for Gambian children
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 .