Subgroup https://datingranking.net/fr/rencontres-asexuees/ analyses We achieved additional subgroup analyses when there have been 10 or even more examples inside an analysis and you can around three or more trials into the for every single subgroup

Fig 4 Haphazard effects meta-data away from aftereffect of calcium supplements towards the payment improvement in limbs nutrient occurrence (BMD) to own total stylish, forearm, and you will complete human anatomy regarding baseline within one year

Fig 5 Random outcomes meta-data away from effect of calcium into the fee improvement in bone mineral density (BMD) for lumbar lower back and you will femoral neck of baseline from the 2 yrs

There are no differences when considering the latest teams anytime part at the lumbar lower back, complete cool, or complete system

Fig 6 Random effects meta-research from aftereffect of calcium to your commission change in limbs nutrient occurrence (BMD) to possess total stylish, forearm, and you will full human anatomy off baseline at the two years

Fig seven Arbitrary effects meta-studies from effect of calcium supplements towards payment change in bones nutrient density (BMD) out of baseline from inside the studies one live over a few and a great half of many years

When we put Egger’s regression design and you can visual review out of harness plots of land, investigation searched skewed toward achievements with more calcium intake regarding dietary source otherwise medications in approximately half analyses you to integrated five or higher degree. The new asymmetry of the utilize spot is actually caused by more brief-moderate sized training reporting larger effects of calcium supplements towards the BMD than expected, increasing the likelihood of publication prejudice. 7 multi-case randomised managed examples integrated a dietary supply of calcium supplements sleeve and you will a calcium complement arm,17 19 20 21 22 twenty-six 28 and that anticipate a primary analysis of the treatments. There have been zero tall differences between teams in the BMD any kind of time webpages in any individual demonstration, so there was basically together with no tall differences between groups into the BMD any kind of time webpages or any moment reason for the fresh pooled analyses (table D, appendix dos). We also looked at to own differences when considering the results of one’s examples off fat loss sources of calcium supplements and examples of calcium of the researching the 2 groups during the subgroup analyses (desk cuatro ? ). On femoral neck, there have been better expands in the BMD at the one year on calcium supplements complement examples than in the fresh new dietary calcium supplements trials, however, at the a couple of years i located the opposite-that’s, better alter that have diet calcium than simply having calcium supplements. In the forearm, there are increases from inside the BMD in the calcium enhance examples but no effect from the examples from losing weight resources of calcium supplements.

Principal conclusions

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%). In the randomised controlled trials of calcium supplements, the increases in BMD were present by one year, but there were no further subsequent increases. 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.