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 .
Treatment of osteopenia and osteoporosis in renal transplant children and adolescents.
Successful renal transplantation corrects many of the metabolic abnormalities associated with the development of renal osteodystrophy , but despite a well-functioning graft osteopenia , growth failure , spontaneous fractures , and avascular necrosis remain prevalent in adult and pediatric kidney recipients . A paucity of information exists regarding the effects of different therapies to prevent and treat bone loss in the renal transplant recipients . We constructed a design to study the effect of different modalities of treatment on bone mass in our renal transplant children . Among 93 patients who underwent renal transplantation at the age of 17 yr or less and were subjected to dual-energy X-ray absorptiometry ( DEXA ) , we blindly r and omized 60 patients who had osteopenia or osteoporosis ( T-score = -1 by DEXA ) in a prospect i ve study . Their mean age at time of transplantation was 13.4 + /- 4.3 yr . The mean duration after transplantation was 48 + /- 34 months . The patients were classified r and omly into four groups . Each group consisted of 15 patients : group 1 was the control group , group 2 received oral alfacalcidol 0.25 microg daily , group 3 received oral alendronate 5 mg daily , and group 4 received 200 IU/day nasal spray calcitonin .  Parameters of bone turnover , calcium metabolism , and DEXA were measured before and after 12 months of treatment duration . The characteristics of all groups were comparable at the beginning of the study . At the lumber spine , bone mass density decreased from -2.4 to -2.8 in group 1 , increased from -2.3 to -0.5 in group 2 , from -2.3 to -1.9 in group 3 , and from -2.3 to -1.0 in group 4 . The four groups had similar patient profiles , serum creatinine , intact parathyroid hormone , osteocalcin , and deoxypyridinoline . This study confirmed the value of alfacalcidol and antiresorptive agents in the treatment of osteopenia and osteoporosis in young renal transplant recipients . These therapies were safe , tolerable , simple to administer and potentially applicable to other renal transplant patients
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 .