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Supplementation Trials with Calcium Citrate Malate: Evidence in Favor of Increasing the Calcium RDA During Childhood and Adolescence^1,2,

Mark B. Andon, Tom Lloyd^* and Velimir Matkovic

The Procter & Gamble Company, Sharon Woods Technical Center, 11450 Grooms Rd., Cincinnati, OH 45242 ^* Department of Obstetrics and Gynecology, College of Medicine, The Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA 17033 Bone & Mineral Metabolism Laboratory, Department of Physical Medicine, The Ohio State University, Columbus, OH 43210

The vast majority of peak adult bone mass is accumulated by the time longitudinal growth is complete. As peak bone mass is an important determinant of future fracture risk, the goal of the current calcium recommended dietary allowance during youth is to provide a calcium intake that allows individuals to reach their full genetic potential for acquiring skeletal mass. The advent of controlled trials of calcium supplementation and total body bone mass measurements in children and adolescents provide the first direct way of determining the amount of calcium necessary to achieve optimal skeletal accretion. These studies indicate that the current RDAs are insufficient to support optimal bone mass gain during growth and development. Based on the recent intervention trials, recommendations are made for an RDA of 1250 mg during childhood and 1450 mg during adolescence. These values are consistent with established calcium balance intake thresholds for growth during pre-adolescence and adolescence.

KEY WORDS: • bone mass • calcium • childhood • recommended dietary allowance • calcium requirement • citrate malate

¹ This work was supported by USPHS grants R01-HD-25973, AG-05793, RR 750, R01-AR-40736-01A1 and grants from the Procter & Gamble Company.

² Presented as part of the symposium "Required Versus Optimal Intakes: A Look at Calcium" given at the Experimental Biology '93 meeting, New Orleans, LA, March 28–April 1, 1993. This symposium was sponsored by the American Institute of Nutrition and was supported by grants from the National Dairy Council and Land O'Lakes, Inc. Guest editor for this symposium was G. D. Miller, National Dairy Council, Rosemont, IL.

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