The Consequences of Calcium Underconsumption among Children and Adolescents: A Systematic Review and

Introduction

Calcium is a crucial nutrient for the growth and development of children and adolescents, particularly for bone health. Adequate calcium intake during these formative years is essential to ensure optimal bone mineral density (BMD) and reduce the risk of fractures later in life. This synthesis reviews the consequences of calcium underconsumption among children and adolescents based on multiple research studies.

Key Insights

Calcium Intake and Bone Mineral Density (BMD)
- Increased calcium intake, particularly through supplementation, has been shown to improve BMD in children and adolescents, especially in prepubertal children .
- The combined intervention of physical activity and calcium intake significantly enhances bone mineral content and BMD, particularly in children with low baseline calcium intake and those in early puberty .
Calcium Absorption and Retention
- Studies suggest that calcium intake of 240 to 400 mg/day promotes optimal calcium absorption with minimal loss in infants, with human milk leading to greater absorption and retention efficacy compared to formula or solid foods.
Long-term Effects and Sustainability
- While calcium supplementation increases BMD during the intervention period, the long-term sustainability of these gains is uncertain. Some studies indicate that the effects on BMD may not persist after supplementation ceases.
Interaction with Physical Activity
- Weight-bearing physical activity combined with calcium intake interventions consistently show positive effects on bone mass gains, particularly in the lumbar spine and total body bone sites. However, the effects on femoral neck sites are more pronounced with physical activity alone .
Public Health Implications
- Despite the small positive effects of calcium supplementation on BMD, the overall impact on reducing fracture risk in healthy children is minimal. Therefore, routine calcium supplementation as a public health intervention is not supported for healthy children.

Conclusion

Adequate calcium intake is essential for optimal bone health in children and adolescents, particularly when combined with physical activity. While calcium supplementation can improve BMD, especially in prepubertal children, the long-term benefits and sustainability of these gains are uncertain. The combined approach of physical activity and calcium intake is most effective, but routine supplementation in healthy children is not recommended as a public health measure due to its minimal impact on fracture risk.

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The Consequences of Calcium Underconsumption among Children and Adolescents: A Systematic Review and

Summary

Introduction

Key Insights

Conclusion

Sources and full results

Calcium Intake and Metabolism in Infants and Young Children: A Systematic Review of Balance Studies for Supporting the Development of Calcium Requirements

Calcium intake of 240 to 400 mg/d may promote optimal absorption and retention in infants aged 0-6 months, with human milk leading to greater absorption and retention efficacy than formula or solid foods.

Combined effects of physical activity and calcium on bone health in children and adolescents: a systematic review of randomized controlled trials

Regular physical activity combined with high calcium intake improves bone mineral density in children and adolescents, especially when baseline calcium intake is low and during early puberty stages.

Calcium supplementation and increases in bone mineral density in children.

Calcium supplementation in prepubertal children with adequate dietary calcium intake can increase bone mineral density and reduce fracture risk.

Increasing weight-bearing physical activity and calcium intake for bone mass growth in children and adolescents: a review of intervention trials.

Increases in weight-bearing physical activity or calcium intake positively impact bone mass gains in children and adolescents.

Calcium supplementation for improving bone mineral density in children.

Calcium supplementation in children has a small effect on upper limb bone mineral density, but its clinical significance remains unclear.

Vitamin D and calcium: a systematic review of health outcomes.

High calcium intake may increase the risk of prostate cancer, while vitamin D and calcium supplementation may improve bone health in postmenopausal women.

Effects of Dairy Product Consumption on Height and Bone Mineral Content in Children: A Systematic Review of Controlled Trials.

Dairy product consumption significantly increases bone mineral content in children, but the relationship between consumption and linear growth remains inconclusive.

Effect of maternal calcium intake during pregnancy on children's blood pressure: A systematic review of the literature

Higher maternal calcium intake during pregnancy is associated with a reduction in offspring blood pressure, but more research is needed to confirm these findings.

Combined effects of interaction between physical activity and nutrition on bone health in children and adolescents: a systematic review.

Exercise has the potential to improve bone health in children and adolescents when combined with adequate calcium intake.

Nutrient and food intakes in early life and risk of childhood fractures: a systematic review and meta-analysis.

Some nutritional factors, such as milk avoidance, high energy intake, cheese intake, sugar-sweetened beverages, and no breastfeeding, may increase fracture risk in children.

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