The effects of a high calcium dairy food on bone health in pre-pubertal children in New Zealand.Asia Pac J Clin Nutr 2004; 13(4):341-7AP
Childhood and adolescence is the period of most rapid skeletal growth in an individual's lifetime. A greater peak bone mass achieved in the first 2-3 decades of life, may protect against the risk of osteoporotic fracture in later life. The aim of this randomized, controlled study was to assess in pre-pubertal boys and girls (aged 8-10 years) the effect of 18 months of a calcium enriched, cocoa flavoured product on bone density, bone growth and bone size in New Zealand children. One hundred and fifty four pre-pubertal boys and girls (aged 8-10 years) were randomized to receive a high calcium dairy drink or a control drink reconstituted with water for 18 months. They were assessed at baseline and then every 6 months for the first 18 months, while they were having the supplement; they were then followed up 12 months after supplementation had finished. Bone mineral density and bone mineral content were assessed at the total body, hip and spine. Indicators of bone size (vertebral width and height) were also measured at the spine. Anthropometric data was collected, medical history questionnaires were administered (including the Tanner or pubertal stage questionnaire), dietary calcium intake was assessed with a calcium food frequency questionnaire and calcium supplement compliance was determined. There was no significant difference between the 2 groups for bone mineral density or bone mineral content at any time point. There was no difference in vertebral height or width at any stage of the study, indicating no additional influence on bone size at the lumbar vertebrae. There were no significant differences between height, weight, lean mass or fat mass at any time point. Both groups had higher habitual calcium intakes than recommended for this age group going into the study and throughout the study. In this 2(1/2) year study (18 months supplementation, 1 year follow-up) we did not observe a difference in bone mineral density in pre-pubertal children. This was probably due to their high habitual dietary calcium intake whereby minimal addition of calcium to the diet reached the threshold level where no further benefit was seen. There were no significant differences between the two groups in body composition. Growth and the mean height and weight remained between the 50th and 75th percentile for their age. We have shown calcium supplementation in children with high habitual dietary calcium intake appears not to have additional effects on bone mass. Calcium supplementation needs to be targeted in those children with low habitual dietary calcium intake.