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August 18, 1993

Calcium Supplementation and Bone Mineral Density in Adolescent Girls

Author Affiliations

From the Departments of Obstetrics and Gynecology (Dr Lloyd and Ms Rollings), Pathology (Dr Demers), Radiology (Dr Eggli), Clinical Nutrition (Ms Kieselhorst), and Pediatrics (Dr Kulin), and the Center for Biostatistics and Epidemiology (Ms Martel and Dr Landis), College of Medicine, The Pennsylvania State University, M. S. Hershey Medical Center, Hershey and Procter and Gamble Co, Miami Valley Laboratories, Cincinnati, Ohio (Dr Andon).

JAMA. 1993;270(7):841-844. doi:10.1001/jama.1993.03510070063037

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)