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 .
Bone mineral acquisition in low calcium intake children following the withdrawal of calcium supplement
Our recent 18‐month calcium supplementation trial demonstrated a significant increase in radial bone mineral mass in 7‐year‐old children with calcium intake ∼ 300 mg/day ( Am J Clin Nutr 1994 ; 60 : 744‐50 ) . The persistence of higher bone mass after cessation of calcium supplementation is unknown . This is a follow‐up study to investigate the lasting effect of calcium supplementation on bone acquisition . Subjects were 159 Chinese children aged 8.7 years . Distal one‐third radial bone mineral content ( BMC ) and bone width ( BW ) were measured by single‐photon absorptiometry . After 12 months , the significant difference in mean ± SD percentage radial BMC disappeared between the study and control groups ( 7.34 ± 6.77 % vs 8.67 ± 6.46 % . p > 0.05 )  . Dietary calcium intakes were similar between the groups . During the supplementation phase , the study group had 17.9 % greater BMC gain than that of controls . In the follow‐up phase , however , the study group had 16.1 % less BMC gain than that of controls . It appears that an increased acquisition rate during the supplementation phase was almost balanced by a reduced acquisition rate during follow‐up phase . Moreover , throughout the entire 30‐month period , the overall BMC acquisition rates of the study and control groups were 25 % and 23.8 % , respectively . Hence , the overall acquisition rate of the study group was only 5 % higher than that of controls . Therefore , the effect of calcium supplementation on bone mineral gain appears to reflect a transient reduction in bone turnover rate . Longer‐term calcium trials are necessary to confirm whether a sustainable higher calcium intake throughout childhood will enhance peak bone mass
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 .