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 .
The effects of a high calcium dairy food on bone health in pre-pubertal children in New Zealand.
Childhood and adolescence is the period of most rapid skeletal growth in an individual 's lifetime . A greater peak bone mass achieved in the first 2 - 3 decades of life , may protect against the risk of osteoporotic fracture in later life . The aim of this r and omized , controlled study was to assess in pre-pubertal boys and girls ( aged 8 - 10 years ) the effect of 18 months of a calcium enriched , cocoa flavoured product on bone density , bone growth and bone size in New Zeal and children . One hundred and fifty four pre-pubertal boys and girls ( aged 8 - 10 years ) were r and omized to receive a high calcium dairy drink or a control drink reconstituted with water for 18 months . They were assessed at baseline and then every 6 months for the first 18 months , while they were having the supplement ; they were then followed up 12 months after supplementation had finished . Bone mineral density and bone mineral content were assessed at the total body , hip and spine . Indicators of bone size ( vertebral width and height ) were also measured at the spine . Anthropometric data was collected , medical history question naires were administered ( including the Tanner or pubertal stage question naire ) , dietary calcium intake was assessed with a calcium food frequency question naire and calcium supplement compliance was determined . There was no significant difference between the 2 groups for bone mineral density or bone mineral content at any time point . There was no difference in vertebral height or width at any stage of the study , indicating no additional influence on bone size at the lumbar vertebrae . There were no significant differences between height , weight , lean mass or fat mass at any time point . Both groups had higher habitual calcium intakes than recommended for this age group going into the study and throughout the study . In this 2(1/2 ) year study ( 18 months supplementation , 1 year follow-up ) we did not observe a difference in bone mineral density in pre-pubertal children . This was probably due to their high habitual dietary calcium intake whereby minimal addition of calcium to the diet reached the threshold level where no further benefit was seen . There were no significant differences between the two groups in body composition . Growth and the mean height and weight remained between the 50th and 75th percentile for their age . We have shown calcium supplementation in children with high habitual dietary calcium intake appears not to have additional effects on bone mass . Calcium supplementation needs to be targeted in those children with low habitual dietary calcium intake
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 .