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 effect of calcium supplementation on bone density in premenarcheal females: a co-twin approach.
The age and developmental stage at which calcium supplementation produces the greatest bone effects remain controversial . We tested the hypothesis that calcium supplementation may improve bone accrual in premenarcheal females . Fifty-one pairs of premenarcheal female twins ( 27 monozygotic and 24 dizygotic ; mean + /- sd age , 10.3 + /- 1.5 yr ) participated in a r and omized , single-blind , placebo-controlled trial with one twin of each pair receiving a 1200-mg calcium carbonate ( Caltrate ) supplement .  Areal bone mineral density ( aBMD ) was measured at baseline and 6 , 12 , 18 and 24 months . There were no within-pair differences in height , weight , or calcium intake at baseline .  Calcium supplementation was associated ( P < 0.05 ) with increased aBMD compared with placebo , adjusted for age , height , and weight at the following time points from baseline : total hip , 6 months ( 1.9 % ) , 12 months ( 1.6 % ) , and 18 months ( 2.4 % ) ; lumbar spine , 12 months ( 1.0 % ) ; femoral neck , 6 months ( 1.9 % ) . Adjusted total body bone mineral content was higher in the calcium group at 6 months ( 2.0 % ) , 12 months ( 2.5 % ) , 18 months ( 4.6 % ) , and 24 months ( 3.7 % ) , respectively ( all P < 0.001 ) . Calcium supplementation was effective in increasing aBMD at regional sites over the first 12 - 18 months , but these gains were not maintained to 24 months
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 .