One SR (systematic review) «Winzenberg TM, Shaw K, Fryer J ym. Calcium supplem...»1, «»1 has focused on the effect of calcium supplementation on bone health during the last 10 years.
This SR studied 19 trials included 2859 participants, of which 1367 were randomised to supplementation and 1426 to placebo. The participants were healthy children aged 3 to 18 years. There was no heterogeneity in the results of the main effects analyses to suggest that the studies were not comparable. There was no effect of calcium supplementation on femoral neck or lumbar spine BMD. There was a small effect on total body BMC (standardised mean difference (SMD) +0.14, 95 % CI +0.01, +0.27) and upper limb BMD (SMD +0.14, 95 % CI +0.04, +0.24). Only the effect in the upper limb persisted after supplementation ceased (SMD+0.14, 95 % CI +0.01, +0.28). This effect is approximately equivalent to a 1.7 % greater increase in supplemented groups, which at best would reduce absolute fracture risk in children by 0.1 - 0.2 % per annum. There was no evidence of effect modification by baseline calcium intake, sex, ethnicity, physical activity or pubertal stage. Adverse events were reported infrequently and were minor.
The authors concluded that “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 clinically 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 cannot be extrapolated to children with medical conditions affecting bone metabolism.”