SUPPLEMENTATION TRIALS WITH CALCIUM CITRATE MALATE - EVIDENCE IN FAVOR OF INCREASING THE CALCIUM RDA DURING CHILDHOOD AND ADOLESCENCE

The vast majority of peak adult bone mass is accumulated by the time l ongitudinal growth is complete. As peak bone mass is an important dete rminant of future fracture risk, the goal of the current calcium recom mended dietary allowance during youth is to provide a calcium intake t hat allows individuals to reach their full genetic potential for acqui ring skeletal mass. The advent of controlled trials of calcium supplem entation and total body bone mass measurements in children and adolesc ents provide the first direct way of determining the amount of calcium necessary to achieve optimal skeletal accretion. These studies indica te 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 childhoo d and 1450 mg during adolescence. These values are consistent with est ablished calcium balance intake thresholds for growth during pre-adole scence and adolescence.