Subgroup analyses We achieved even more subgroup analyses when there have been 10 or maybe more examples into the an analysis and about three or more products when you look at the each subgroup
Fig cuatro Haphazard consequences meta-studies away from effect of calcium towards percentage change in bone mineral occurrence (BMD) getting full hip, forearm, and you will complete human body out-of baseline during the 12 months
Fig 5 Haphazard consequences meta-analysis out of effectation of calcium into percentage change in bone mineral density (BMD) having lumbar spine and you will femoral shoulder off baseline in the 2 years
There were no differences between the fresh new communities any time point within lumbar lower back, total hip, otherwise complete human body
Fig 6 Arbitrary outcomes meta-investigation regarding effect of calcium supplements with the commission improvement in bone nutrient occurrence (BMD) for total stylish, forearm, and you may complete human anatomy off baseline at 2 years
Fig seven Random effects meta-study out-of aftereffect of calcium into the percentage change in bones nutrient occurrence (BMD) of baseline inside the education you to lasted over a few and a great half ages
As soon as we made use of Egger’s regression model and you can artwork inspection from funnel plots, analysis looked skewed on the positive results with calcium consumption of slimming down provide or capsules in about half of analyses you to definitely provided four or maybe more degree. The latest asymmetry of one’s funnel area is caused by far more small-modest training revealing large effects of calcium to the BMD than https://datingranking.net/it/incontri-indu/ just asked, increasing the likelihood of book prejudice. Seven multiple-case randomised managed trials included a nutritional supply of calcium arm and you may a calcium supplements supplement arm,17 19 20 21 twenty two twenty six twenty eight which enjoy a direct review of your treatments. There had been no significant differences between groups in the BMD any kind of time webpages in every personal demo, there was also no tall differences when considering organizations into the BMD any kind of time site otherwise at any time point in this new pooled analyses (dining table D, appendix 2). I also checked to possess differences between the outcome of your trials of diet sources of calcium and the trials out-of calcium supplements from the researching the 2 communities inside subgroup analyses (dining table 4 ? ). In the femoral neck, there were higher expands inside the BMD on 1 year regarding calcium complement products compared to the fresh diet calcium supplements examples, however, on 24 months we receive the opposite-which is, deeper alter having dietary calcium supplements than having calcium supplements. In the forearm, there were expands into the BMD on the calcium supplements complement products but zero effect in the trials away from weight loss sourced elements 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.