Many studies have demonstrated the positive effect of high calcium intake on bone mass, especially in pre-pubertal children (19,46). On the basis of longitudinal data, during the two years of peak bone accretion, the estimated calcium need increases to 1500 mg daily for girls and 1700 mg daily for boys (47). However, in many countries, even healthy adolescents of both sexes consume only 60% to 70% of the recommended amount of calcium, as the so-called "soft drinks" rapidly substitute traditional milk beverages (48).
Chronically ill children require at least the same amount of calcium as healthy subjects of the same sex and age. Low-calcium intake in childhood is associated with increased risk of fracture not only in later life but even in adolescence. Adult women with low milk intake during childhood and adolescence have a lesser bone mass and a greater risk of fracture, an effect independent of current milk or calcium intake (49).
Calcium-rich foods should be preferred, but when they cannot be taken, calcium supplements can be considered. However the long-term compliance with calcium salts in adolescents is low, mostly because of gastrointestinal side effects such as mild abdominal pain, meteorism and constipation.
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