Subgroup analyses I carried out most subgroup analyses whenever there were ten or maybe more samples inside an analysis and you may around three or more examples during the per subgroup
Fig cuatro Arbitrary effects meta-data out of effectation of calcium into commission improvement in bones nutrient thickness (BMD) to possess full stylish, forearm, and you can complete human body away from standard during the 12 months
Fig 5 Random effects meta-data off aftereffect of calcium supplements into fee change in bone nutrient density (BMD) having lumbar spine and femoral neck off standard in the a couple of years
There have been no differences when considering the communities when area from the lumbar lower back, complete hip, otherwise full body
Fig six Arbitrary consequences meta-research off effect of calcium supplements to your commission change in bone mineral occurrence (BMD) having overall hip, forearm, and full looks from baseline on 2 years
Fig seven Haphazard consequences meta-investigation away from effect of calcium into the commission change in limbs mineral density (BMD) off baseline when you look at the education one survived over two and you can a half decades
As soon as we used Egger’s regression design and you may graphic assessment out-of utilize plots, research searched skewed to your positive results with increased calcium consumption out-of fat reduction supply or medications in about half analyses you to definitely provided four or even more education. New asymmetry of your own use patch was considering even more small-moderate sized studies revealing larger ramifications of calcium supplements toward BMD than simply asked, improving the likelihood of publication bias. 7 multiple-arm randomised controlled samples included a diet way to obtain calcium supplements case and you may a good calcium supplements supplement case,17 19 20 21 twenty two twenty six 28 and that anticipate a direct testing of your treatments. There were no extreme differences between communities inside the BMD at any web site in virtually any personal demonstration, there was and additionally zero tall differences when considering groups for the BMD any kind of time site otherwise any time reason for the pooled analyses (table D, appendix 2). I also tested to Dating eines Katholiken own differences when considering the results of your own samples regarding losing weight types of calcium supplements plus the trials away from calcium from the researching both communities during the subgroup analyses (desk 4 ? ). In the femoral shoulder, there were greater increases for the BMD in the 1 year regarding calcium supplements enhance trials than in the newest weightloss calcium supplements samples, but at 2 years i discover the alternative-that’s, greater changes which have weightloss calcium than just that have calcium. At forearm, there have been develops for the BMD throughout the calcium complement products but no impact on the trials out of dietary resources of calcium supplements.
Principal results
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.