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 .
Calcium-enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind, placebo-controlled trial.
High calcium intake during childhood has been suggested to increase bone mass accrual , potentially result ing in a greater peak bone mass . Whether the effects of calcium supplementation on bone mass accrual vary from one skeletal region to another , and to what extent the level of spontaneous calcium intake may affect the magnitude of the response has , however , not yet been clearly established . In a double-blind , placebo-controlled study , 149 healthy prepubertal girls aged 7.9+/-0.1 yr ( mean+/-SEM ) were either allocated two food products containing 850 mg of calcium ( Ca-suppl . ) or not ( placebo ) on a daily basis for 1 yr . Areal bone mineral density ( BMD ) , bone mineral content ( BMC ) , and bone size were determined at six sites by dual-energy x-ray absorptiometry . The difference in BMD gain between calcium-supplemented ( Ca-suppl . ) and placebo was greater at radial ( metaphysis and diaphysis ) and femoral ( neck , trochanter , and diaphyses ) sites ( 7 - 12 mg/cm2 per yr ) than in the lumbar spine ( 2 mg/cm2 per yr ) . The difference in BMD gains between Ca-suppl . and placebo was greatest in girls with a spontaneous calcium intake below the median of 880 mg/d . The increase in mean BMD of the 6 sites in the low-calcium consumers was accompanied by increased gains in mean BMC , bone size , and statural height . These results suggest a possible positive effect of calcium supplementation on skeletal growth at that age . In conclusion , calcium-enriched foods significantly increased bone mass accrual in prepubertal girls , with a preferential effect in the appendicular skeleton , and greater benefit at lower spontaneous 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 .