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Calcium Supplementation and Bone Mineral Density in Adolescent Girls

Tom Lloyd, PhD; Mark B. Andon, PhD; Nan Rollings, RN; Juliann K. Martel, MS; J. Richard Landis, PhD; Laurence M. Demers, PhD; Douglas F. Eggli, MD; Kessey Kieselhorst, RD; Howard E. Kulin, MD
JAMA. 1993;270(7):841-844. doi:10.1001/jama.1993.03510070063037.
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Objective.  —To evaluate the effect of calcium supplementation on bone acquisition in adolescent white girls.

Design.  —A randomized, double-blind, placebo-controlled trial of the effect of 18 months of calcium supplementation on bone density and bone mass.

Subjects.  —Ninety-four girls with a mean age of 11.9+0.5 years at study entry.

Setting.  —University hospital in a small town.

Interventions.  —Calcium supplementation, 500 mg/d calcium as calcium citrate malate; controls received placebo pills.

Main Outcome Measures.  —Bone mineral density and bone mineral content of the lumbar spine and total body were measured by dual-energy x-ray absorptiometry and calcium excretion from 24-hour urine specimens.

Results.  —Calcium intake from dietary sources averaged 960 mg/d for the entire study group. The supplemented group received, on average, an additional 354 mg/d of calcium. The supplemented group compared with the placebo group had greater increases of lumbar spine bone density (18.7% vs 15.8%; P=.03), lumbar spine bone mineral content (39.4% vs 34.7%; P=.06), total body bone mineral density (9.6% vs 8.3%; P=.05), and 24-hour urinary calcium excretion (90.4 vs 72.9 mg/d; P=.02), respectively.

Conclusions.  —Increasing daily calcium intake from 80% of the recommended daily allowance to 110% via supplementation with calcium citrate malate resulted in significant increases in total body and spinal bone density in adolescent girls. The increase of 24 g of bone gain per year among the supplemented group translates to an additional 1.3% skeletal mass per year during adolescent growth, which may provide protection against future osteoporotic fracture.(JAMA. 1993;270:841-844)


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