Effect of calcium supplementation on bone mineral accretion in gambian children accustomed to a low-calcium diet.
BACKGROUND
Rural Gambian children have poor growth, delayed puberty, a low bone mineral content, and a low calcium intake.


OBJECTIVE
We investigated the effect of a calcium supplement on bone mineral accretion in rural Gambian children.


METHODS
A randomized, double-blind, placebo-controlled study was conducted in 160 children (80 boys, 80 girls) aged 8.3-11.9 y. Bone mineral content (BMC), bone mineral density (BMD), and BMC adjusted for bone width, body weight, and height (size-adjusted BMC) were measured at the midshaft and distal radius. Each child received either 1000 mg Ca/d (as calcium carbonate) or a placebo 5 d/wk for 12 mo. Supplementation increased calcium intake from 342 to 1056 mg/d (8.6 to 26.4 mmol/d).


RESULTS
Calcium supplementation resulted in a higher BMC, BMD, and size-adjusted BMC (&xmacr; difference +/- SE): midshaft radius-BMC (3.0 +/- 1.4%; P = 0.034), BMD (4.5 +/- 0.9%; P </= 0.0001), and size-adjusted BMC (4.6 +/- 0.9%; P </= 0.0001); distal radius-BMC (8. 4 +/- 3.2%; P = 0.009), BMD (7.0 +/- 2.7%; P = 0.011), and size-adjusted BMC (5.5 +/- 2.7%; P = 0.042). Supplementation had no significant effect on height, weight, or bone width at the midshaft radius or distal radius. At the end of the study, the calcium group had a significantly lower mean plasma osteocalcin concentration than the placebo group after adjustment for baseline concentration, sex, and pubertal status (-21.9 +/- 6.5%; P = 0.001).


CONCLUSIONS
Increased calcium intake resulted in increased bone mineral status, possibly in association with a decreased bone remodeling space. Further studies are needed to determine whether an increased calcium intake has long-term benefits in Gambian children.
Dibba
B
B
MRC Keneba, The Gambia, and MRC Human Nutrition Research (formerly MRC Dunn Nutritional Laboratory), Cambridge, United Kingdom.
Prentice
A
A
Ceesay
M
M
Stirling
D M
DM
Cole
T J
TJ
Poskitt
E M
EM
D000886:Anthropometry; D001827:Body Height / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D015519:Bone Density; D001846:Bone Development / Q000187:drug effects; D001842:Bone and Bones / Q000033:anatomy & histology / Q000187:drug effects* / Q000378:metabolism; D002118:Calcium / Q000097:blood / Q000494:pharmacology*; D002136:Calcium, Dietary / Q000008:administration & dosage*; D002648:Child; D019587:Dietary Supplements; D005260:Female; D005714:Gambia; D006801:Humans; D008297:Male; D015675:Osteocalcin / Q000097:blood; D011884:Radius
D002136:Calcium, Dietary; D015675:Osteocalcin; D002118:Calcium