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 .
Calcium supplementation and bone mineral density in adolescent girls.
OBJECTIVE To evaluate the effect of calcium supplementation on bone acquisition in adolescent white girls . DESIGN A r and omized , double-blind , placebo-controlled trial of the effect of 18 months of calcium supplementation on bone density and bone mass . SUBJECTS Ninety-four girls with a mean age of 11.9 + 0.5 years at study entry . SETTING University hospital in a small town . INTERVENTIONS Calcium supplementation , 500 mg/d calcium as calcium citrate malate ; controls received placebo pills . MAIN OUTCOME MEASURES Bone mineral density and bone mineral content of the lumbar spine and total body were measured by dual-energy x-ray absorptiometry and calcium excretion from 24-hour urine specimens . RESULTS Calcium intake from dietary sources averaged 960 mg/d for the entire study group . The supplemented group received , on average , an additional 354 mg/d of calcium . The supplemented group compared with the placebo group had greater increases of lumbar spine bone density ( 18.7 % vs 15.8 % ; P = .03 ) , lumbar spine bone mineral content ( 39.4 % vs 34.7 % ; P = .06 ) , total body bone mineral density ( 9.6 % vs 8.3 % ; P = .05 ) , and 24-hour urinary calcium excretion ( 90.4 vs 72.9 mg/d ; P = .02 ) , respectively . CONCLUSIONS Increasing daily calcium intake from 80 % of the recommended daily allowance to 110 % via supplementation with calcium citrate malate result ed in significant increases in total body and spinal bone density in adolescent girls . The increase of 24 g of bone gain per year among the supplemented group translates to an additional 1.3 % skeletal mass per year during adolescent growth , which may provide protection against future osteoporotic fracture
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 .