Calcium-enriched foods and bone mass growth in prepubertal girls: A randomized, double-blind, placebo-controlled trial

Division of Bone Diseases, WHO Collaborating Center for Osteoporosis and Bone Disease, Geneva, Switzerland.
Journal of Clinical Investigation (Impact Factor: 13.22). 04/1997; 99(6):1287-94. DOI: 10.1172/JCI119287
Source: PubMed


High calcium intake during childhood has been suggested to increase bone mass accrual, potentially resulting in a greater peak bone mass. Whether the effects of calcium supplementation on bone mass accrual vary from one skeletal region to another, and to what extent the level of spontaneous calcium intake may affect the magnitude of the response has, however, not yet been clearly established. In a double-blind, placebo-controlled study, 149 healthy prepubertal girls aged 7.9+/-0.1 yr (mean+/-SEM) were either allocated two food products containing 850 mg of calcium (Ca-suppl.) or not (placebo) on a daily basis for 1 yr. Areal bone mineral density (BMD), bone mineral content (BMC), and bone size were determined at six sites by dual-energy x-ray absorptiometry. The difference in BMD gain between calcium-supplemented (Ca-suppl.) and placebo was greater at radial (metaphysis and diaphysis) and femoral (neck, trochanter, and diaphyses) sites (7-12 mg/cm2 per yr) than in the lumbar spine (2 mg/cm2 per yr). The difference in BMD gains between Ca-suppl. and placebo was greatest in girls with a spontaneous calcium intake below the median of 880 mg/d. The increase in mean BMD of the 6 sites in the low-calcium consumers was accompanied by increased gains in mean BMC, bone size, and statural height. These results suggest a possible positive effect of calcium supplementation on skeletal growth at that age. In conclusion, calcium-enriched foods significantly increased bone mass accrual in prepubertal girls, with a preferential effect in the appendicular skeleton, and greater benefit at lower spontaneous calcium intake.

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    • "In contrast to our results, it has been previously reported that tibia BMD increased in 3-week-old WT and PTH-deficient mice fed by dams who received a high-calcium diet compared to those on a normal-calcium diet (Cao et al. 2009; Shu et al. 2011). Skeletal site selectivity in response to calcium supplementation is well-documented in human studies during childhood and adolescence , but the mechanism of this site-specific effect remains to be elucidated (Bonjour et al. 1997; Chevalley et al. 2005). Although lumbar BMD increased significantly in response to a high-calcium diet in both Cldn-18 KO and heterozygous control mice, we did not find a significant change in either the trabecular or cortical bone parameters at LV 5, as measured by lCT. "
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    • "Another controversial area in LI research is whether this condition is associated with short stature. Although some investigators have suggested that adequate calcium intake during the growth period may be critical for reaching optimal bone growth during the growing years[9], others have provided evidence of short stature in children with LI, milk allergy, or those on milk-elimination diets[10-12]. Further studies in prepubertal children showed that long term avoidance of cow’s milk was associated with small stature and diminished bone health[6,10]. "
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