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Calcium supplementation provides an extended window of opportunity for bone mass accretion after menarche^1,2,3

¹ From the Department of Clinical Nutrition (GSR and GD), the Metabolic Bone Diseases Unit (RPD-G and SI-S), and the Endocrine Laboratory (BR), Rambam Medical Center Haifa, Haifa, Israel; and the Departments of Community Medicine & Epidemiology (GR and HSR) and Pediatrics (NI-S), Carmel Medical Center, Haifa, Israel.

Background: High calcium intakes during adolescence may increase bone acquisition. The magnitude of the effect of dietary calcium supplementation and the timing of its administration to achieve significant effects on bone health are still incompletely defined.

Objective: The objective of this study was to assess the effect of calcium supplementation on bone mass accretion in postmenarcheal adolescent girls with low calcium intakes.

Design: A double-blind, placebo-controlled calcium supplementation study was implemented. One hundred girls with a mean (± SD) age of 14 ± 0.5 y with habitual calcium intakes < 800 mg/d completed a 12-mo protocol. The treatment group received a daily supplement containing 1000 mg elemental calcium. Bone mineral density (BMD) and bone mineral content (BMC) of the total body, lumbar spine, and femoral neck were determined at inclusion, 6 mo, and 12 mo. Also measured were serum concentrations of biochemical markers of bone turnover (osteocalcin and deoxypyridinoline), parathyroid hormone, and vitamin D.

Results: The calcium-supplemented group had greater accretion of total-body BMD and lumbar spine BMD but not BMC than did the control group. Calcium supplementation appeared selectively beneficial for girls who were 2 y postmenarcheal. Calcium supplementation significantly decreased bone turnover and decreased serum parathyroid hormone concentrations.

Conclusion: Calcium supplementation of postmenarcheal girls with low calcium intakes enhances bone mineral acquisition, especially in girls > 2 y past the onset of menarche.

Key Words: Calcium supplementation • double-blind study • adolescents • bone density • postmenarcheal girls

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