The effect of calcium supplementation in people under 35 years old: A systematic review and meta-analysis of randomized controlled trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 36164828 · doi:10.7554/eLife.79002
What was done
Systematic review and meta-analysis of randomized controlled trials searching nine databases (PubMed, Embase, ProQuest, CENTRAL, WHO Global Index Medicus, ClinicalTrials.gov, WHO ICTRP, CNKI, and Wanfang Data) up to April 2021. The study evaluated the effects of calcium supplementation (via supplements or high-calcium diet) on bone mineral density (BMD) and bone mineral content (BMC) in people aged 35 years or younger.
What was found
Analysis of 43 randomized trials (7,382 participants) with moderate certainty of evidence showed calcium supplementation improved femoral neck BMD (standardized mean difference [SMD] 0.627, 95% CI 0.338–0.915) and BMC (SMD 0.364, 95% CI 0.134–0.595), total body BMD (SMD 0.330, 95% CI 0.163–0.496) and BMC (SMD 0.149, 95% CI 0.006–0.291), and lumbar spine BMC (SMD 0.163, 95% CI 0.008–0.317). No significant effects were observed for lumbar spine BMD, total hip BMD, or total hip BMC. Femoral neck improvements were larger in adults aged 20–35 than in individuals under 20.
Why it matters
Targeting calcium intake during early adulthood (ages 20–35) enhances peak bone mass accretion, suggesting a potential preventative intervention window for reducing osteoporosis risk later in life.
Limits
Follow-up did not measure long-term clinical fracture outcomes in older age. Interventions mixed dietary calcium and supplements with variable dosages, and no significant improvement was observed for lumbar spine BMD or total hip parameters.
Cited by
- supports Peak muscle mass and peak bone density generally occur around 25 years of age before beginning to decline.