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 .
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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 clinical and radiological assessment of cyclic intravenous pamidronate administration in children with osteogenesis imperfecta.
Over the past 20 years , orally administered biphosphonates have been used extensively in the management of a number of common skeletal disorders of different etiology . Recently , in clinical practice , in a number of cases in whom oral therapy is insufficient or contraindicated , intravenous administration of pamidronate presents an alternative therapeutic option . In order to investigate the clinical and radiological effects of cyclic intravenous pamidronate administration in children with osteogenesis imperfecta , a prospect i ve open study of pamidronate treatment was undertaken in a cohort of eight bed-bounded ( 3.6 - 13.8 years ) patients with severe osteoporosis and vertebral deformities .  Pamidronate was administered at a dose of 0.5 mg/kg/ day for three days . Tri-monthly cyclic intravenous infusions were performed over-one year . Bone density , verebral corpus heights , estimated volumetric bone density and biochemical measurements were analyzed . Side effects of the therapy were determined via question naire . Significant reductions in the number of bone fractures and pain were observed in all patients . Ambulation scores were significantly altered and seven of eight patients became independent . Serum alkaline phosphatase levels decreased significantly . Lumbar X-ray and densitometry showed a striking improvement by the end of the treatment period . Even spaced dense lines corresponding to infusion periods were observed on roentgenograms of the radio-ulnar region . Pubertal progression and growth velocity were not affected inversely during therapy . Although we did not observe any severe side effect , one patient 's blood urea nitrogen level was altered slightly . In conclusion , one year cyclical pamidronate treatment seems to be effective and safe in improving bone mineralization and in reducing fracture incidence in severe osteoporosis
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 .