Subgroup analyses I accomplished even more subgroup analyses whenever there are ten or higher samples within the an analysis and you will about three or more products when you look at the for every single subgroup
Fig cuatro Random consequences meta-data out of aftereffect of calcium to your commission improvement in limbs mineral density (BMD) to own complete hip, forearm, and you can complete human body out-of standard at the 12 months
Fig 5 Haphazard outcomes meta-studies regarding effectation of calcium supplements on the percentage improvement in limbs mineral density (BMD) to possess lumbar spine and femoral neck off standard from the a couple of years
There had been no differences when considering the new teams any moment section in the lumbar lower back, overall hip, or total muscles
Fig 6 Random consequences meta-analysis away from effectation of calcium supplements to your commission change in limbs mineral thickness (BMD) to possess total hip, forearm, and you may total body of standard during the 2 years
Fig eight Random consequences meta-study out of effect of calcium into commission change in limbs nutrient occurrence (BMD) off baseline in knowledge one to live over a few and you will a great half ages
As soon as we utilized Egger’s regression design and graphic assessment from utilize plots of land, analysis searched skewed to the success with additional calcium consumption regarding weight-loss provide otherwise drugs within half analyses one to incorporated four or higher education. The newest asymmetry of one’s funnel area was considering much more small-modest degree reporting huge negative effects of calcium towards BMD than just requested, improving the likelihood of guide prejudice. 7 multi-case randomised regulated products integrated a nutritional way to obtain calcium arm and you may a calcium complement case,17 19 20 21 twenty two 26 twenty eight and therefore greet a direct evaluation of your interventions. There are no tall differences when considering organizations when you look at the BMD any kind of time web site in any private trial, there have been also no extreme differences between groups for the BMD at any website or at any time reason for the latest pooled analyses (dining table D, appendix dos). I in addition to checked out for differences between the outcome of one’s examples away from losing weight resources of calcium and also the products out of calcium because of the evaluating both teams during the subgroup analyses (desk 4 ? ). In the femoral neck, there are deeper expands in BMD within 12 months from the calcium supplements supplement examples compared to the new losing weight calcium supplements trials, however, during the two years i discovered the contrary-that is, higher alter with fat loss calcium than just that have calcium supplements. Within forearm, there are expands inside BMD regarding the calcium supplements enhance trials but zero effect about examples away from weight reduction types of calcium supplements.
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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.