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Calcium supplementation for improving bone density in lactating women: a systematic review and meta-analysis of randomized controlled trials


Cai, G and Tian, J and Winzenberg, T and Wu, F, Calcium supplementation for improving bone density in lactating women: a systematic review and meta-analysis of randomized controlled trials, American Journal of Clinical Nutrition, 112, (1) pp. 48-56. ISSN 0002-9165 (2020) [Refereed Article]

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Copyright Statement

Copyright The Author(s) on behalf of the American Society for Nutrition 2020.

DOI: doi:10.1093/ajcn/nqaa103


Background: Clinical trials evaluating the effect of calcium supplementation on bone loss in lactating women have been small, with inconsistent results.

Objectives: We aimed to determine the effect of calcium supplementation on bone mineral density (BMD) in lactating women.

Methods: An electronic search of databases was conducted from inception to January 2020. Two authors screened studies, extracted data, and assessed the risk of bias of eligible studies. Percentage change in BMD was pooled using random-effects models and reported as weighted mean differences (WMDs) with 95% CIs. Risk of bias was assessed using the Cochrane risk of bias tool.

Results: Five randomized controlled trials including 567 lactating women were included. All had a high risk of bias. Mean baseline calcium intake ranged from 562 to 1333 mg/d. Compared with control groups (placebo/no intervention), calcium supplementation (600/1000 mg/d) had no significant effect on BMD at the lumbar spine (WMD: 0.74%; 95% CI: -0.10%, 1.59%; I2 = 47%; 95% CI: 0%, 81%; n = 527 from 5 trials) or the forearm (WMD: 0.53%; 95% CI: -0.35%, 1.42%; I2 = 55%; 95% CI: 0%, 85%; n = 415 from 4 trials). BMD at other sites was assessed in single trials: calcium supplementation had a small to moderate effect on total-hip BMD (WMD: 3.3%; 95% CI: 1.5%, 5.1%) but no effect on total body or femoral neck BMD.

Conclusions: Overall, the meta-analysis indicates that calcium supplementation does not provide clinically important benefits for BMD in lactating women. However, there was adequate dietary intake before supplementation in some studies, and others did not measure baseline calcium intake. Advising lactating women to meet the current recommended calcium intakes (with supplementation if dietary intake is low) is warranted unless new high-certainty evidence to the contrary from robust clinical trials becomes available. More research needs to be done in larger samples of women from diverse ethnic and racial groups.

Item Details

Item Type:Refereed Article
Keywords:bone mineral density, calcium supplementation, lactating women, risk of bias, systematic review
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Cai, G (Dr Guoqi Cai)
UTAS Author:Tian, J (Dr Jing Tian)
UTAS Author:Winzenberg, T (Professor Tania Winzenberg)
UTAS Author:Wu, F (Dr Feitong Wu)
ID Code:139362
Year Published:2020
Web of Science® Times Cited:3
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-06-11
Last Modified:2021-04-19
Downloads:7 View Download Statistics

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