Subgroup analyses We carried out even more subgroup analyses whenever there had been ten or maybe more samples for the an analysis and you may around three or maybe more products during the for each subgroup
Fig 4 Arbitrary outcomes meta-studies of effect of calcium supplements towards the fee change in bone mineral occurrence (BMD) to own full hip, forearm, and you may complete looks of baseline from the 12 months
Fig 5 Random outcomes meta-data away from aftereffect of calcium to your fee improvement in limbs nutrient thickness (BMD) to possess lumbar back and you can femoral neck off standard within 2 yrs
There are zero differences between the brand new communities any time part within lumbar spine, total cool, otherwise overall body
Fig six Haphazard effects meta-data away from effectation of calcium towards the commission change in bones mineral density (BMD) to own full hip, forearm, and full system out of baseline from the couple of years
Fig eight Arbitrary effects meta-analysis off aftereffect of calcium towards the payment change in bone nutrient density (BMD) out of standard for the studies you to lasted more than a couple and you can a beneficial 1 / 2 of age
When we made use of Egger’s regression model and you will visual examination out of utilize plots of land, studies appeared skewed toward successes with an increase of calcium consumption away from losing weight supplies otherwise pills within half of analyses you to integrated five or higher knowledge. New asymmetry of the utilize plot are considering way more small-moderate sized knowledge reporting larger outcomes of calcium for the BMD than just asked, raising the possibility of guide prejudice. Seven multi-arm randomised regulated samples integrated a nutritional way to obtain calcium arm and you will a calcium supplements supplement case,17 19 20 21 twenty two twenty six twenty eight which enjoy an immediate evaluation of interventions. There were no extreme differences between teams when you look at the BMD at any website in any personal demonstration, so there had been together with zero extreme differences between groups in the BMD at any webpages or any moment point in the fresh new pooled analyses (table D, appendix dos). We in addition to checked-out to own differences when considering the outcome of one’s trials off slimming down types of calcium supplements and also the examples regarding calcium from the comparing the 2 communities for the subgroup analyses (desk cuatro ? ). On femoral shoulder, there have been deeper develops from inside the BMD within one year throughout the calcium supplements supplement examples than in the fresh fat reduction calcium supplements trials, but at 2 years i discovered the opposite-which is, better change having fat loss calcium than simply that have calcium. From the forearm, there were expands within the BMD regarding calcium supplements supplement samples but no effect regarding the samples out-of weightloss sources of calcium supplements.
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 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.