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 and tanner stage on bone density, content and area in teenage women
One hundred and twelve Caucasian girls , 11.9±0.5 years of age at entry , were r and omized into a 24-month , double-masked , placebo-controlled trial to determine the effect of calcium supplementation on bone mineral content , bone area and bone density . Supplementation was 500 mg calcium as calcium citrate malate ( CCM ) per day . Controls received placebo pills , and compliance of both groups averaged 72 % . Bone mineral content , bone mineral area and bone mineral density of the lumbar spine and total body were measured by dual energy X-ray absorptiometry ( DXA ) . Calcium intake from dietary sources averaged 983 mg/day for the entire study group . The supplemented group received , on average , an additional 360 mg calcium/day from CCM . At baseline and after 24 months , the two groups did not differ with respect to anthropometric measurements , urinary reproductive hormone levels or any measurement of pubertal progression . The supplemented group had greater increases of total body bone measures : content 39.9 % versus 35.7 % ( p=0.01 ) , area 24.2 % versus 22.5 % ( p=0.15 ) and density 12.2 % versus 10.1 % ( p=0.005 ) . Region-of-interest analyses showed that the supplemented group had greater gains compared with the control group for bone mineral density , content and area . In particular , in the lumbar spine and pelvis , the gains made by the supplemented group were 12%–24 % greater than the increases made by the control group . Bone acquisition rates in the two study groups were further compared by subdividing the groups into those with below- or above-median values for Tanner score and dietary calcium intake . In subjects with below-median Tanner scores , bone acquisition was not affected by calcium supplementation or dietary calicum level . However , the calcium supplemented subjects with above-median Tanner had higher bone acqusition rates than the placebo group with above-median Tanner scores . Relative to the placebo group , the supplemented group had increased yearly gains of bone content , area and density which represented about 1.5 % of adult female values . Such increases , if held to adult skeletal maturity , could provide protection against future risk of osteoporotic fractures
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 .