Recommended calcium intakes in children : have we set the bar too high?

Abstract

Increasing peak bone mass in childhood has the potential to reduce the impact of age-related bone loss, so identifying ways to improve childhood bone acquisition is important. Research into nutritional factors influencing childhood bone acquisition to date has focused on the role of calcium. Evidence from calcium balance studies supports the setting of recommended calcium intakes up to 800 mg/day for children and up to 1300 mg/day for adolescents. However, recent evidence from a meta-analysis of randomized controlled trials of calcium supplements in children suggests that increasing calcium intake to levels approaching recommended levels has only limited benefits for improving bone acquisition. Focusing on achieving high levels of calcium intake risks neglecting other potential lifestyle factors that could have greater benefits and possibly less potential for long-term adverse effects. While calcium remains important for skeletal health, it may be that high levels of recommended calcium intake are both unnecessary and unrealistic targets. The resources used to encourage and enable otherwise healthy individuals to meet these high levels may be better used in promoting other aspects of a healthy lifestyle for bone development and in researching alternative nutritional interventions to improve bone health. IBMS BoneKEy. 2008 February;5(2):59-68. ©2008 International Bone & Mineral Society