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 .
Interaction between calcium intake and menarcheal age on bone mass gain: an eight-year follow-up study from prepuberty to postmenarche.
Both late menarcheal age and low calcium intake ( Ca intake ) during growth are risk factors for osteoporosis , probably by impairing peak bone mass . We investigated whether lasting gain in areal bone mineral density ( aBMD ) in response to increased Ca intake varies according to menarcheal age and , conversely , whether Ca intake could influence menarcheal age . In an initial study , 144 prepubertal girls were r and omized in a double-blind controlled trial to receive either a Ca supplement ( Ca-suppl . ) of 850 mg/d or placebo  from age 7.9 - 8.9 yr .  Mean aBMD gain determined by dual energy x-ray absorptiometry at six sites ( radius metaphysis , radius diaphysis , femoral neck , trochanter , femoral diaphysis , and L2-L4 ) was significantly ( P = 0.004 ) greater in the Ca-suppl . than in the placebo group ( 27 vs. 21 mg/cm(2 ) ) . In 122 girls followed up , menarcheal age was recorded , and aBMD was determined at 16.4 yr of age . Menarcheal age was lower in the Ca-suppl . than in the placebo group ( P = 0.048 ) . Menarcheal age and Ca intake were negatively correlated ( r = -0.35 ; P < 0.001 ) , as were aBMD gains from age 7.9 - 16.4 yr and menarcheal age at all skeletal sites ( range : r = -0.41 to r = -0.22 ; P < 0.001 to P = 0.016 ) . The positive effect of  Ca-suppl .  on the mean aBMD gain from baseline remained significantly greater in girls below , but not in those above , the median of menarcheal age ( 13.0 yr ) . Early menarcheal age ( 12.1 + /- 0.5 yr ) : placebo , 286 + /- 36 mg/cm(2 ) ; Ca-suppl . , 317 + /- 46 ( P = 0.009 ) ; late menarcheal age ( 13.9 + /- 0.5 yr ) : placebo , 284 + /- 58 ; Ca-suppl . , 276 + /- 50 ( P > 0.05 ) . The level of Ca intake during prepuberty may influence the timing of menarche , which , in turn , could influence long-term bone mass gain in response to Ca supplementation . Thus , both determinants of early menarcheal age and high Ca intake may positively interact on bone mineral mass accrual
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 .