Role of calcium in bone health during childhood.

A discussion of observational and longitudinal studies examining the effect of early-life calcium intake on bone health is provided. A critical analysis of pediatric calcium supplementation trials is conducted by determining annualized percent changes in bone mineral density (BMD). The focus of the analysis is to identify consistent findings at specific bone sites, determine whether effects differed by the age of children studied, and establish the relationship between bone changes and baseline calcium intake. We found that increases in BMD owing to higher calcium intake among children appear to occur primarily in cortical bone sites, are most apparent among populations with low baseline calcium intakes, and do not seem to persist beyond the calcium supplementation period. Older (e.g., pubertal) children appear to have greater annual increases in lumbar BMD than younger (e.g., prepubertal) children. The annual percent increase in midradius BMD appears to be greater at higher intakes among the older children, but such a relationship is less apparent among the younger children.