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 .
A Comparison of Oral and Intravenous Bisphosphonate Therapy for Children with Osteogenesis Imperfecta
Bone mineral density and fracture rates in children with osteogenesis imperfecta improve with intravenous bisphosphonates . The efficacy of oral bisphosphonates has not been established . This report is an analysis of an open-label , prospect i ve , r and omized clinical trial of oral compared to intravenous bisphosphonate medications in children with osteogenesis imperfecta . Children were stratified according to bone age , pubertal stage , and type of osteogenesis imperfecta and then r and omized to receive intravenous pamidronate , 3 mg/kg over 3 days every 4 months , or oral alendronate 1 mg/kg , from a minimum of 10 mg to a maximum of 20 mg daily . The primary efficacy outcome was change in bone mineral density . Secondary outcomes included change in biomarkers of bone turnover , fracture incidence , and growth rate .  Ten children were r and omized ( 6 oral and 4 intravenous ) . Two other children were assigned to intravenous treatment due to chronic abdominal pain . In each group , three patients had type III/IV osteogenesis imperfecta , while three had type I. All 12 children completed 8 months of therapy ; nine completed 12 months . Bone mineral density increased in both oral and intravenous groups equally and beyond that expected with normal growth . All children had a decrease in biochemical markers of bone turnover . Linear growth showed a moderate increase above that for age . There was a non-significant decrease in fracture incidence in both groups
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 .