The effect of prepubertal calcium carbonate supplementation on skeletal development in Gambian boys-a 12-year follow-up study.
BACKGROUND
Calcium intake during growth is essential for future bone health but varies widely between individuals and populations. The impact on bone of increasing calcium intake is unknown in a population where low calcium intake, stunting, and delayed puberty are common.


OBJECTIVE
To determine the effect of prepubertal calcium supplementation on mean age at peak velocity for bone growth and mineral accrual.


METHODS
Prospective follow-up of boys in rural Gambia, West Africa, who had participated in a double-blind, randomized, placebo-controlled trial of calcium supplementation.


METHODS
Eighty boys, initially aged 8.0-11.9 years, were followed up for 12 years.


METHODS
Subjects received 1 year of calcium carbonate supplementation (1000 mg daily, 5 d/wk).


METHODS
Dual-energy x-ray absorptiometry measurements were carried out for whole body (WB), lumbar spine, and total hip bone mineral content, bone area (BA), and WB lean mass. Super imposition by translation and rotation models was made to assess bone growth.


RESULTS
Age at peak velocity was consistently earlier in the calcium group compared to the placebo group, for WB bone mineral content (mean, -6.2 [SE, 3.1]; P = .05), WB BA (mean, -7.0 [SE, 3.2] mo; P = .03), lumbar spine and total hip BA. By young adulthood, supplementation did not change the amount of bone accrued (mineral or size) or the rate of bone growth.


CONCLUSIONS
Twelve months of prepubertal calcium carbonate supplementation in boys with a low calcium diet advanced the adolescent growth spurt but had no lasting effect on bone mineral or bone size. There is a need for caution when applying international recommendations to different populations.
Nutrition and Bone Health (K.A.W., M.A.L., A.P.), Medical Research Council Human Nutrition Research, Cambridge CB1 9NL, United Kingdom; Population, Policy and Practice Programme (T.J.C.), University College London, Institute of Child Health, London WC1N 1EH, United Kingdom; and Calcium, Vitamin D, and Bone Health (M.C., M.B.M., Y.S., A.P.), Medical Research Council, Keneba, The Gambia.
K A
KA
Ward
T J
TJ
Cole
M A
MA
Laskey
M
M
Ceesay
M B
MB
Mendy
Y
Y
Sawo
A
A
Prentice
D015502:Absorptiometry, Photon; D000293:Adolescent; D015519:Bone Density / Q000187:drug effects*; D001846:Bone Development / Q000187:drug effects*; D002119:Calcium Carbonate / Q000008:administration & dosage*; D002648:Child; D019587:Dietary Supplements; D004311:Double-Blind Method; D005500:Follow-Up Studies; D005714:Gambia; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000254:growth & development; D006801:Humans; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000254:growth & development; D008297:Male; D011446:Prospective Studies; D011627:Puberty; D016896:Treatment Outcome; D055815:Young Adult
D002119:Calcium Carbonate