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Subgroup analyses We achieved even more subgroup analyses whenever there have been ten or maybe more trials inside a diagnosis and you may around three or more samples in the each subgroup

Fig cuatro Haphazard consequences meta-data off aftereffect of calcium supplements toward commission improvement in bones nutrient density (BMD) for total cool, forearm, and you may total body of baseline during the one year

Fig 5 Arbitrary consequences meta-research out-of aftereffect of calcium toward fee change in bones mineral thickness (BMD) for lumbar back and you may femoral shoulder out of standard at the a couple of years

There are no differences between the groups at any time part at lumbar lower back, complete stylish, otherwise full body

Fig six Haphazard effects meta-analysis out of aftereffect of calcium towards payment improvement in limbs nutrient occurrence (BMD) to own complete cool, forearm, and you can full body out-of baseline in the two years

Fig seven Haphazard consequences meta-analysis out of aftereffect of calcium towards percentage improvement in bones nutrient occurrence (BMD) off standard into the knowledge you to survived more than a few and you can a great 50 % of years

Once we used Egger’s regression design and visual evaluation regarding utilize plots, study appeared skewed to the successes with increased calcium intake from weight reduction supply otherwise pills in about half analyses you to definitely included four or higher training. New asymmetry of the harness area try as a result of even more brief-moderate sized knowledge reporting big outcomes of calcium to the BMD than just asked, improving the probability of guide bias. Seven multiple-case randomised regulated samples included a nutritional supply of calcium supplements case and a beneficial calcium supplement sleeve,17 19 20 21 twenty-two twenty-six 28 and this enjoy a primary review of the treatments. There were no extreme differences between organizations inside BMD at any web site in virtually any individual trial, and there were including no significant differences when considering teams from inside the BMD any kind of time web site or any time part of the pooled analyses (dining table D, appendix dos). We including checked to have differences between the outcome of trials out-of weight reduction sourced elements of calcium as well as the examples away from calcium by the comparing the 2 groups in the subgroup analyses (table cuatro ? ). On femoral shoulder, there were deeper increases from inside the BMD at the 12 months in the calcium supplements complement examples compared to new fat loss calcium supplements products, however, within a couple of years i discover the alternative-that is, higher change that have weight loss calcium than with calcium. Within forearm, there are grows in the BMD on the calcium supplements enhance samples but zero feeling throughout the samples out of weightloss types 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%). 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.

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