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 .
Effect of calcium supplementation on bone mineral accretion in gambian children accustomed to a low-calcium diet.
BACKGROUND Rural Gambian children have poor growth , delayed puberty , a low bone mineral content , and a low calcium intake . OBJECTIVE We investigated the effect of a calcium supplement on bone mineral accretion in rural Gambian children . DESIGN A r and omized , double-blind , placebo-controlled study was conducted in 160 children ( 80 boys , 80 girls ) aged 8.3 - 11.9 y.  Bone mineral content ( BMC ) , bone mineral density ( BMD ) , and BMC adjusted for bone width , body weight , and height ( size-adjusted BMC ) were measured at the midshaft and distal radius . Each child received either 1000 mg Ca/d ( as calcium carbonate ) or a placebo 5 d/wk for 12 mo . Supplementation increased calcium intake from 342 to 1056 mg/d ( 8.6 to 26.4 mmol/d ) . RESULTS Calcium supplementation result ed in a higher BMC , BMD , and size-adjusted BMC ( & xmacr ; difference + /- SE ) : midshaft radius- BMC ( 3.0 + /- 1.4 % ; P = 0.034 ) , BMD ( 4.5 + /- 0.9 % ; P < /= 0.0001 ) , and size-adjusted BMC ( 4.6 + /- 0.9 % ; P < /= 0.0001 ) ; distal radius- BMC ( 8 . 4 + /- 3.2 % ; P = 0.009 ) , BMD ( 7.0 + /- 2.7 % ; P = 0.011 ) , and size-adjusted BMC ( 5.5 + /- 2.7 % ; P = 0.042 ) . Supplementation had no significant effect on height , weight , or bone width at the midshaft radius or distal radius . At the end of the study , the calcium group had a significantly lower mean plasma osteocalcin concentration than the placebo group after adjustment for baseline concentration , sex , and pubertal status ( -21.9 + /- 6.5 % ; P = 0.001 ) . CONCLUSIONS Increased calcium intake result ed in increased bone mineral status , possibly in association with a decreased bone remodeling space . Further studies are needed to determine whether an increased calcium intake has long-term benefits in Gambian children
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 .