The effect of calcium supplementation in people under 35 years old: A systematic review and meta-analysis of randomized controlled trials

Abstract

ABSTRACTBackground and objectiveThe effect of calcium supplementation on bone mineral accretion in people under 35 years old is inconclusive. To comprehensively summarize the evidence for the effect of calcium supplementation on bone mineral accretion in young populations (≤35 years).DesignThis is a systematic review and meta-analysis.Data sourcesThe Pubmed, Embase, ProQuest and CENTRAL databases were systematically searched from database inception to April 25, 2021.EligibilityRandomized clinical trials assessing the effects of calcium supplementation on bone mineral density (BMD) or bone mineral content (BMC) in people under 35 years old.ResultsThis systematic review and meta-analysis identified 43 studies involving 7382 subjects. Moderate certainty of evidence showed that calcium supplementation was associated with the accretion of BMD and BMC, especially on femoral neck (SMD 0.627, 95% CI 0.338 to 0.915; SMD 0.364, 95% CI 0.134 to 0.595; respectively) and total body (SMD 0.330, 95% CI 0.163 to 0.496; SMD 0.149, 95% CI 0.006 to 0.291), also with a slight improvement effect on lumbar spine BMC (SMD 0.163, 95% CI 0.008 to 0.317), no effects on total hip BMD and BMC and lumbar spine BMD were observed. Very interestingly, subgroup analyses suggested that the improvement of bone at femoral neck was more pronounced in the peri-PBM population (20-35 years) than the pre-PBM population (<20 years).ConclusionOur findings provided novel insights and evidence in calcium supplementation, which showed that calcium supplementation significantly improves bone mass, implying that preventive calcium supplementation before or around achieving PBM may be a shift in the window of intervention for osteoporosis.FundingThis work was supported by Wenzhou Medical University grant [89219029].