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 .
Benefits of milk powder supplementation on bone accretion in Chinese children
Low dietary calcium intake has been demonstrated to be a risk factor for hip and vertebral fractures in studies conducted among Hong Kong Chinese . Few studies have demonstrated the effect of milk supplementation in bone accretion in Chinese children . The aim was to examine the effects of milk powder supplementation in enhancing bone accretion in Chinese children . Three hundred and forty-four children , aged 9–10 years old , were r and omized to receive milk powder equivalent to 1300 mg and 650 mg calcium , and to a control group , respectively . Bone mineral density ( BMD ) at the proximal femur , lumbar spine and total body were measured at 6 months , 12 months and 18 months . The treatment effects were modeled using linear mixed effect models and compared using linear contrast F-tests , by intention-to-treat . Subjects r and omized to milk powder equivalent to 1300 mg calcium had significantly higher increase in BMD at both the total hip ( 7.4±0.4 % in treatment group versus 6.3±0.4 % in the control ) and the spine ( 8.4±0.5 % in the treatment group versus 7.0±0.5 % in the control group ) . Subjects r and omized to milk powder equivalent to 650 mg calcium had smaller increases in BMD at the total hip and spine , although the increase in BMD at the total body was significantly higher ( 3.1±0.3 % in treatment group versus 2.4±0.2 % in controls ) . It is concluded that supplementing the diet of Chinese children with milk powder was effective in enhancing bone accretion
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 .