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 retention in relation to calcium intake and postmenarcheal age in adolescent females.
Achievement of maximal calcium retention  during adolescence may influence the magnitude of peak bone mass and subsequently lower the risk of osteoporosis . Calcium retention is generally considered to reach a plateau at a certain calcium intake . To test this hypothesis , calcium balance was measured in 35 females with a mean ( + /-SD ) age of 12.7 + /- 1.2 y ( range : 12 - 15 y ) who consumed from 841 + /- 153 to 2173 + /- 149 mg Ca/d . Subjects ate a basal diet that included a fortified beverage containing different amounts of calcium citrate malate .  Twenty-one subjects were studied at two dietary calcium intakes with use of a crossover design . Results from a previous study in 14 subjects who were studied at only one calcium intake were included in the data analysis . Calcium retention was modeled as a nonlinear function of calcium intake that included a parameter representing mean maximal retention . Mean maximal calcium retention was 473 mg/d ( 95 % CI : 245 , 701 mg Ca/d ) . At higher postmenarcheal ages , maximal calcium retention was lower but the intake required to achieve this was not affected . Calcium intake explained 79 % and 6 % , respectively , of the variation in fecal and urinary calcium excretion . Intake of 1200 mg Ca/d , the recommended dietary allowance for calcium published in 1989 , result ed in a mean calcium retention that was 57 % of the maximal value ( 95 % CI : 25 % , 89 % ) . Intake of 1300 mg Ca/d was the smallest intake that allowed some adolescent females to achieve 100 % of maximal calcium retention ( 95 % CI : 26 % , 100 % ) . These data support the idea that calcium retention plateaus at a certain calcium intake although it continues to increase at intakes > 2 g/d
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 .