This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

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.

Abstract
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)

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).

Footnotes
Reprint requests to College of Medicine, The Pennsylvania State University, M. S. Hershey Medical Center, Hershey, PA 17033 (Dr Lloyd).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

A Mediterranean Dietary Style Improves Calcium Utilization in Healthy Male Adolescents
Seiquer et al.
J. Am. Coll. Nutr. 2008;27:454-462.
ABSTRACT | FULL TEXT  

Calcium supplementation and bone mineral accretion in adolescent girls: an 18-mo randomized controlled trial with 2-y follow-up
Lambert et al.
Am. J. Clin. Nutr. 2008;87:455-462.
ABSTRACT | FULL TEXT  

Effects of dietary calcium intake on body weight and prevalence of osteoporosis in early postmenopausal women
Varenna et al.
Am. J. Clin. Nutr. 2007;86:639-644.
ABSTRACT | FULL TEXT  

The effect of a low-protein diet in pregnancy on offspring renal calcium handling
Ashton et al.
Am. J. Physiol. Regul. Integr. Comp. Physiol. 2007;293:R759-R765.
ABSTRACT | FULL TEXT  

A Randomized Controlled Study of Effects of Dietary Magnesium Oxide Supplementation on Bone Mineral Content in Healthy Girls
Carpenter et al.
J. Clin. Endocrinol. Metab. 2006;91:4866-4872.
ABSTRACT | FULL TEXT  

YOUTH: A Health Plan-Based Lifestyle Intervention Increases Bone Mineral Density in Adolescent Girls
DeBar et al.
Arch Pediatr Adolesc Med 2006;160:1269-1276.
ABSTRACT | FULL TEXT  

Girls' Calcium Intake Is Associated with Bone Mineral Content During Middle Childhood
Fiorito et al.
J. Nutr. 2006;136:1281-1286.
ABSTRACT | FULL TEXT  

Optimizing Bone Health and Calcium Intakes of Infants, Children, and Adolescents
Greer et al.
Pediatrics 2006;117:578-585.
ABSTRACT | FULL TEXT  

Long-term protein intake and dietary potential renal acid load are associated with bone modeling and remodeling at the proximal radius in healthy children
Alexy et al.
Am. J. Clin. Nutr. 2005;82:1107-1114.
ABSTRACT | FULL TEXT  

Effects of calcium, dairy product, and vitamin D supplementation on bone mass accrual and body composition in 10-12-y-old girls: a 2-y randomized trial
Cheng et al.
Am. J. Clin. Nutr. 2005;82:1115-1126.
ABSTRACT | FULL TEXT  

Lack of a relation between vitamin and mineral antioxidants and bone mineral density: results from the Women's Health Initiative
Wolf et al.
Am. J. Clin. Nutr. 2005;82:581-588.
ABSTRACT | FULL TEXT  

Calcium Supplementation Increases Stature and Bone Mineral Mass of 16- to 18-Year-Old Boys
Prentice et al.
J. Clin. Endocrinol. Metab. 2005;90:3153-3161.
ABSTRACT | FULL TEXT  

Skeletal Site Selectivity in the Effects of Calcium Supplementation on Areal Bone Mineral Density Gain: A Randomized, Double-Blind, Placebo-Controlled Trial in Prepubertal Boys
Chevalley et al.
J. Clin. Endocrinol. Metab. 2005;90:3342-3349.
ABSTRACT | FULL TEXT  

Role of oestrogen in the regulation of bone turnover at the menarche
Eastell
J Endocrinol 2005;185:223-234.
ABSTRACT | FULL TEXT  

Effects of school milk intervention on cortical bone accretion and indicators relevant to bone metabolism in Chinese girls aged 10-12 y in Beijing
Zhu et al.
Am. J. Clin. Nutr. 2005;81:1168-1175.
ABSTRACT | FULL TEXT  

Is Peripuberty the Most Opportune Time to Increase Calcium Intake in Healthy Girls?
Bonjour
IBMS BoneKEy 2005;2:6-11.
FULL TEXT  

Calcium, Dairy Products, and Bone Health in Children and Young Adults: A Reevaluation of the Evidence
Lanou et al.
Pediatrics 2005;115:736-743.
ABSTRACT | FULL TEXT  

Sustained effect of short-term calcium supplementation on bone mass in adolescent girls with low calcium intake
Dodiuk-Gad et al.
Am. J. Clin. Nutr. 2005;81:168-174.
ABSTRACT | FULL TEXT  

Calcium supplementation and bone mineral density in females from childhood to young adulthood: a randomized controlled trial
Matkovic et al.
Am. J. Clin. Nutr. 2005;81:175-188.
ABSTRACT | FULL TEXT  

Interaction between Calcium Intake and Menarcheal Age on Bone Mass Gain: An Eight-Year Follow-Up Study from Prepuberty to Postmenarche
Chevalley et al.
J. Clin. Endocrinol. Metab. 2005;90:44-51.
ABSTRACT | FULL TEXT  

Effect of habitual dietary calcium intake on calcium supplementation in 12-14-y-old girls
Molgaard et al.
Am. J. Clin. Nutr. 2004;80:1422-1427.
ABSTRACT | FULL TEXT  

Vitamin K, bone turnover, and bone mass in girls
Kalkwarf et al.
Am. J. Clin. Nutr. 2004;80:1075-1080.
ABSTRACT | FULL TEXT  

The Effect of Calcium Supplementation on Bone Density in Premenarcheal Females: A Co-Twin Approach
Cameron et al.
J. Clin. Endocrinol. Metab. 2004;89:4916-4922.
ABSTRACT | FULL TEXT  

Bone turnover during inpatient nutritional therapy and outpatient follow-up in patients with anorexia nervosa compared with that in healthy control subjects
Heer et al.
Am. J. Clin. Nutr. 2004;80:774-781.
ABSTRACT | FULL TEXT  

Nutrition Influences Skeletal Development from Childhood to Adulthood: a Study of Hip, Spine, and Forearm in Adolescent Females
Matkovic et al.
J. Nutr. 2004;134:701S-705.
ABSTRACT | FULL TEXT  

Associations of Adequate Intake of Calcium with Diet, Beverage Consumption, and Demographic Characteristics among Children and Adolescents
Storey et al.
J. Am. Coll. Nutr. 2004;23:18-33.
ABSTRACT | FULL TEXT  

Calcium supplementation provides an extended window of opportunity for bone mass accretion after menarche
Rozen et al.
Am. J. Clin. Nutr. 2003;78:993-998.
ABSTRACT | FULL TEXT  

Effect of a calcium and exercise intervention on the bone mineral status of 16-18-y-old adolescent girls
Stear et al.
Am. J. Clin. Nutr. 2003;77:985-992.
ABSTRACT | FULL TEXT  

Lignes directrices de pratique clinique 2002 pour le diagnostic et le traitement de l'osteoporose au Canada
Brown and Josse
CMAJ 2003;168:SF1-38.
ABSTRACT | FULL TEXT  

Diet in midpuberty and sedentary activity in prepuberty predict peak bone mass
Wang et al.
Am. J. Clin. Nutr. 2003;77:495-503.
ABSTRACT | FULL TEXT  

Milk intake during childhood and adolescence, adult bone density, and osteoporotic fractures in US women
Kalkwarf et al.
Am. J. Clin. Nutr. 2003;77:257-265.
ABSTRACT | FULL TEXT  

Increased Dairy Product or Calcium Intake: Is Body Weight or Composition Affected in Humans?
Barr
J. Nutr. 2003;133:245S-248.
ABSTRACT | FULL TEXT  

Dietary Chicory Inulin Increases Whole-Body Bone Mineral Density in Growing Male Rats
Roberfroid et al.
J. Nutr. 2002;132:3599-3602.
ABSTRACT | FULL TEXT  

2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada
Brown and Josse
CMAJ 2002;167:s1-34.
ABSTRACT | FULL TEXT  

Bone mineral contents and plasma osteocalcin concentrations of Gambian children 12 and 24 mo after the withdrawal of a calcium supplement
Dibba et al.
Am. J. Clin. Nutr. 2002;76:681-686.
ABSTRACT | FULL TEXT  

Abnormal Bone Mineral Accrual in Adolescent Girls with Anorexia Nervosa
Soyka et al.
J. Clin. Endocrinol. Metab. 2002;87:4177-4185.
ABSTRACT | FULL TEXT  

Self-Reported Calcium Intake and Bone Mineral Content in Children and Adolescents
Carter et al.
J. Am. Coll. Nutr. 2001;20:502-509.
ABSTRACT | FULL TEXT  

Calcium Intake and Bone Mass Development Among Israeli Adolescent Girls
Rozen et al.
J. Am. Coll. Nutr. 2001;20:219-224.
ABSTRACT | FULL TEXT  

Nutrition and bone: is there more to it than just calcium and vitamin D?
Reid and Macdonald
QJM 2001;94:53-56.
FULL TEXT  

Methodology of Concern
Williams
Arch Pediatr Adolesc Med 2001;155:201-201.
FULL TEXT  

Maternal Milk Consumption Predicts the Tradeoff between Milk and Soft Drinks in Young Girls' Diets
Fisher et al.
J. Nutr. 2001;131:246-250.
ABSTRACT | FULL TEXT  

Changes in Calcium Kinetics in Adolescent Girls Induced by High Calcium Intake
Wastney et al.
J. Clin. Endocrinol. Metab. 2000;85:4470-4475.
ABSTRACT | FULL TEXT  

Hormonal Determinants and Disorders of Peak Bone Mass in Children
Soyka et al.
J. Clin. Endocrinol. Metab. 2000;85:3951-3963.
FULL TEXT  

Calcium requirements of physically active people
Weaver
Am. J. Clin. Nutr. 2000;72:579S-584.
ABSTRACT | FULL TEXT  

Adult Female Hip Bone Density Reflects Teenage Sports-Exercise Patterns But Not Teenage Calcium Intake
Lloyd et al.
Pediatrics 2000;106:40-44.
ABSTRACT | FULL TEXT  

Nutrition in Bone Health Revisited: A Story Beyond Calcium
Ilich and Kerstetter
J. Am. Coll. Nutr. 2000;19:715-737.
ABSTRACT | FULL TEXT  

Teenaged Girls, Carbonated Beverage Consumption, and Bone Fractures
Wyshak
Arch Pediatr Adolesc Med 2000;154:610-613.
ABSTRACT | FULL TEXT  

Calcium, Dairy Products and Osteoporosis
Heaney
J. Am. Coll. Nutr. 2000;19:83S-99.
ABSTRACT | FULL TEXT  

Effect of calcium supplementation on bone mineral accretion in Gambian children accustomed to a low-calcium diet1
Dibba et al.
Am. J. Clin. Nutr. 2000;71:544-549.
ABSTRACT | FULL TEXT  

The Effects of Anorexia Nervosa on Bone Metabolism in Female Adolescents
J. Clin. Endocrinol. Metab. 1999;84:4489-4496.
ABSTRACT | FULL TEXT  

Enhancing the Nutrition of America's Youth
McBean and Miller
J. Am. Coll. Nutr. 1999;18:563-571.
ABSTRACT | FULL TEXT  

Calcium Requirements of Infants, Children, and Adolescents
Committee on Nutrition
Pediatrics 1999;104:1152-1157.
ABSTRACT | FULL TEXT  

The New Dietary Reference Intakes for Calcium: Implications for Osteoporosis
Bryant et al.
J. Am. Coll. Nutr. 1999;18:406S-412.
ABSTRACT | FULL TEXT  

Whole body bone mineral accretion in healthy children and adolescents
Mølgaard et al.
Arch. Dis. Child. 1999;81:10-15.
ABSTRACT | FULL TEXT  

Adolescent Nutrition in the Prevention of Postmenopausal Osteoporosis
Weaver et al.
J. Clin. Endocrinol. Metab. 1999;84:1839-1843.
FULL TEXT  

Dietary Caffeine Intake Is Not Correlated with Adolescent Bone Gain
Lloyd et al.
J. Am. Coll. Nutr. 1998;17:454-457.
ABSTRACT | FULL TEXT  

Body Composition Development of Adolescent White Females: The Penn State Young Women's Health Study
Lloyd et al.
Arch Pediatr Adolesc Med 1998;152:998-1002.
ABSTRACT | FULL TEXT  

Determinants of axial and peripheral bone mass in Chinese adolescents
Cheng et al.
Arch. Dis. Child. 1998;78:524-530.
ABSTRACT | FULL TEXT  

Milk intake and bone mineral acquisition in adolescent girls: randomised, controlled intervention trial
Cadogan et al.
BMJ 1997;315:1255-1260.
ABSTRACT | FULL TEXT  

Calcium Intake and the Incidence of Forearm and Hip Fractures among Men
Owusu et al.
J. Nutr. 1997;127:1782-1787.
ABSTRACT | FULL TEXT  

Peak Bone Mineral Density in Young Women
Recker and Heaney
JAMA 1993;270:2926-2926.
ABSTRACT  

CALCIUM SUPPLEMENTS BOOST BONE DENSITY IN ADOLESCENT GIRLS
JWatch General 1993;1993:2-2.
FULL TEXT