Fig 4 Random outcomes meta-studies out-of aftereffect of calcium into fee improvement in bones nutrient occurrence (BMD) to own total stylish, forearm, and you will complete body regarding baseline on 12 months
Fig 5 Haphazard outcomes meta-study out-of aftereffect of calcium supplements towards the fee change in limbs mineral occurrence (BMD) to own lumbar spine and you can femoral shoulder regarding baseline at the a couple of years
From the randomised managed examples off calcium supplements, new increases inside the BMD was introduce because of the 1 year, but there are don’t further develops
Fig six Haphazard outcomes meta-study away from effect of calcium into percentage improvement in limbs mineral occurrence (BMD) to possess full hip, forearm, and you may total system off standard in the 24 months
Fig seven Haphazard outcomes meta-research of effect of calcium toward payment change in limbs mineral thickness (BMD) from baseline from inside the degree you to definitely endured over two and you can a beneficial 50 % of ages
Once we put Egger’s regression model and you may visual inspection of utilize plots of land, studies appeared skewed into the successes with an increase of calcium supplements intake regarding weightloss provide otherwise tablets in about half of analyses one incorporated four or even more studies. The brand new asymmetry of the harness area is actually due to significantly more brief-moderate sized training reporting big results of calcium supplements to your BMD than simply questioned, improving the chances of guide prejudice. Eight multi-sleeve randomised managed products incorporated a nutritional way to obtain calcium sleeve and an effective calcium supplements enhance arm,17 19 20 21 22 twenty-six twenty-eight and therefore greet a direct analysis of the interventions. There were zero extreme differences when considering teams inside the BMD any kind of time webpages in just about any private demonstration, so there was in fact as well as zero extreme differences between teams from inside the BMD any kind of time website or any moment point in new pooled analyses (dining table D, appendix 2). We also checked out getting differences when considering the results of your products out-of weightloss types of calcium and also the products out of calcium of the comparing the 2 communities into the subgroup analyses (table 4 ? ). There were zero differences between the latest teams any moment section at lumbar lower back, complete cool, or complete looks. Within femoral neck, there had been better develops into the BMD at the 1 year regarding the calcium supplements enhance examples than in the weight loss calcium trials, but in the 2 years we discover the contrary-that is, higher change having weight loss calcium than just which have calcium. In the forearm, there have been grows during the BMD throughout the calcium complement examples but no feeling from the samples from losing weight sources of calcium supplements.
Dominating findings
Increasing calcium intake from dietary sources slightly increased bone mineral density (BMD) (by 0.6-1.8%) over one to two years at all sites, except the forearm where there was no effect. Calcium supplements increased BMD to a similar degree at all sites and all time points (by 0.7-1.8%). Thus the increases from baseline at both two and over two and half years at each site were similar to the increases at one year. The increases in BMD with dietary sources of calcium were similar to the increases with calcium supplements, except at the forearm, in both direct comparisons of the two interventions in multi-arm studies and in indirect comparisons of the two interventions through subgroup analyses. The increases in BMD were similar in trials of calcium monotherapy and CaD, consistent with a recent meta-analysis reporting that vitamin D monotherapy had no effect on BMD.71 There were no differences in changes in BMD in our subgroup analyses between trials with calcium doses of ?1000 mg/day and <1000 mg/day or doses of ?500 mg/day and >500 mg/day, and in populations with baseline dietary calcium intake of <800 mg/day and ?800 mg/day. Overall, the results suggest that increasing calcium intake, whether from dietary sources or by taking calcium supplements, provides a small non-progressive increase in BMD, without any ongoing reduction in rates of BMD loss beyond one year. The similar effect of increased dietary intake and supplements suggests that the non-calcium components of the dietary sources of calcium do not directly affect BMD.