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Search Plan and Results

Question(s)

Is intake of calcium and/or dairy (milk and milk products) related to adiposity in children? (DGAC 2010)

Date Searched

9/19/2009

Inclusion Criteria

  • Publication date: January 2003 to August 2009
  • ADA search: January 1982 to June 2005
  • English language
  • Human subjects
  • Children (zero to 18 years)
  • Included at least one outcome measure of adiposity (e.g., body weight, body mass index, skinfolds, percent body fat).

Exclusion Criteria

  • Conducted in developed countries (based on United Nation’s Human Development Index, December 2008)
  • Published in journals that are not peer-reviewed
  • Included no measure of adiposity (e.g., body weight, body mass index, skinfolds, percent body fat)
  • Involved exclusively children less than two years old or adolescents over 18 years old
  • Treatment trial conducted for less than eight weeks (not including duration of follow-up)
  • Prevention trial conducted for less than six months (not including duration of follow-up)
  • Treatment trial involved fewer than 10 subjects total (or fewer than 10 in the intervention group)
  • Prevention trial involved fewer than 60 subjects total (or fewer than 30 in the intervention group)
  • Treatment trials involving pharmacological interventions (because of lack of research in these areas)
  • Cross-sectional studies.

Search Terms & Electronic Databases Used

("Calcium"[majr] OR "Calcium, Dietary"[majr] OR "Dairy Products"[majr]) AND ("Body Weights and Measures"[majr] OR "Body Mass Index"[majr] OR "Adiposity"[majr] OR "Overweight"[majr] OR "Obesity"[majr] OR "Weight Gain"[majr] OR “body composition”[mh])

PubMed.

Total hits from all electronic database searches: 254

Total articles identified to review from electronic databases: 66

Articles Identified Via Handsearch or Other Means

  • Articles included via Hand Search: One
  • Articles included from the ADA Evidence Review (1982 to 2004): Seven.

 


Summary of Articles Identified to Review

Number of Primary Articles Identified: 17

Number of Review Articles Identified: 3

Total Number of Articles Identified: 20

Number of Articles Reviewed but Excluded: 54

 




List of Included Articles for Evidence Analysis

Articles Identified via the NEL Search (13)

Abrams SA, Griffin IJ, Hawthorne KM, Ellis KJ. Effect of prebiotic supplementation and calcium intake on body mass index. J Pediatr. 2007 Sep; 151 (3): 293-298. Epub 2007 Jul 12. PMID: 17719942.

Barr SI. Increased dairy product or calcium intake: is body weight or composition affected in humans? J Nutr. 2003 Jan; 133 (1): 245S-248S. Review. PMID: 12514301.

Berkey CS, Rockett HR, Willett WC, Colditz GA. Milk, dairy fat, dietary calcium and weight gain: A longitudinal study of adolescents.  Arch Pediatr Adolesc Med. 2005 Jun;1 59 (6): 543-550. PMID: 15939853.

Boon N, Koppes LL, Saris WH, Van Mechelen W. The relation between calcium intake and body composition in a Dutch population: The Amsterdam Growth and Health Longitudinal Study.  Am J Epidemiol. 2005 Jul 1; 162 (1) :27-32. PMID: 15961583.

DeJongh ED, Binkley TL, Specker BL. Fat mass gain is lower in calcium-supplemented than in unsupplemented preschool children with low dietary calcium intakes. Am J Clin Nutr. 2006 Nov; 84 (5): 1, 123-1, 127. PMID: 17093165; PMCID: PMC1847400.

Dixon LB, Pellizzon MA, Jawad AF, Tershakovec AM. Calcium and dairy intake and measures of obesity in hyper- and normocholesterolemic children. Obes Res. 2005 Oct; 13 (10): 1, 727-1, 738. PMID: 16286520.

Fiorito LM, Ventura AK, Mitchell DC, Smiciklas-Wright H, Birch LL. Girls' dairy intake, energy intake and weight status. J Am Diet Assoc. 2006 Nov; 106 (11): 1, 851-1, 855. PMID: 17081836; PMCID: PMC2531154.

Lanou AJ, Barnard ND. Dairy and weight loss hypothesis: An evaluation of the clinical trials. Nutr Rev. 2008 May; 66 (5): 272-279. Review. PMID: 18454813. (Hand search)

Lappe JM, Rafferty KA, Davies KM, Lypaczewski G. Girls on a high-calcium diet gain weight at the same rate as girls on a normal diet: A pilot study. J Am Diet Assoc. 2004 Sep; 104 (9): 1, 361-1, 367. PMID: 15354150.

Lorenzen JK, Mølgaard C, Michaelsen KF, Astrup A. Calcium supplementation for one year does not reduce body weight or fat mass in young girls. Am J Clin Nutr. 2006 Jan; 83 (1): 18-23. PMID: 16400044.

Moore LL, Bradlee ML, Gao D, Singer MR. Low dairy intake in early childhood predicts excess body fat gain. Obesity (Silver Spring). 2006 Jun; 14 (6): 1, 010-1, 018. PMID: 16861606.

St-Onge MP, Goree LL, Gower B. High-milk supplementation with healthy diet counseling does not affect weight loss but ameliorates insulin action compared with low-milk supplementation in overweight children. J Nutr. 2009 May; 139 (5): 933-938. Epub 2009 Mar 25. PMID: 19321584; PMCID: PMC2714393.

Winzenberg T, Shaw K, Fryer J, Jones G. Calcium supplements in healthy children do not affect weight gain, height or body composition. Obesity (Silver Spring). 2007 Jul; 15 (7): 1, 789-1, 798. Review. PMID: 17636098.

Articles Identified from the ADA Evidence Review (Seven) 

Berkey CS, Rockett HRH, Field AE, Gillman MW, Colditz GA. Sugar-added beverages and adolescent weight change. Obes Res. 2004; 12: 778-788.

Carruth BR, Skinner JD. The role of dietary calcium and other nutrient in moderating body fat in preschool children. Int J Obes. 2001; 25: 559-566.

Fisher JO, Mitchell DC, Smiciklas-Wright H, Mannino ML, Birch LL. Meeting calcium recommendations during middle childhood reflects mother-daughter beverage choices and predicts bone mineral status. Am J Clin Nutr. 2004; 79 (4): 698-706.

Newby PK, Peterson KE, Berkey CS, Leppert J, Willett WC, Colditz GA. Beverage consumption is not associated with changes in weight and body mass index among low-income preschool children in North Dakota. J Am Diet Assoc. 2004; 104: 1, 086-1, 094.

Phillips SM, Bandini LG, Cyr H, Colclough-Douglas S, Naumova E, Must A. Dairy food consumption and body weight and fatness studied longitudinally over the adolescent period. Int J Obes Relat Metab Disord. 2003; 27 (9): 1, 106-1, 113.

Skinner JD, Bounds W, Carruth BR, Ziegler P. Longitudinal calcium intake is negatively related to children's body fat indexes. J Am Diet Assoc. 2003; 103 (12): 1, 626-1, 631.

Sugimori H, Yoshida K, Izuno T, Miyakawa M, Suka M, Sekine M, Yamagami T, Kagamimori S. Analysis of factors that influence body mass index from ages three to six years: A study based on the Toyama cohort study. Pediatr Int. 2004;46 (3): 302-310. 


List of Excluded Articles with Reason

Article (A-K) Reason for Exclusion

Abrams SA, Griffin IJ, Hawthorne KM, Liang L. Height and height Z-score are related to calcium absorption in five- to 15-year-old girls. J Clin Endocrinol Metab. 2005 Sep; 90 (9): 5, 077-5, 081. Epub 2005 May 17. PMID: 15899954.

Does not include adiposity as an outcome.

Affenito SG, Thompson DR, Barton BA, Franko DL, Daniels SR, Obarzanek E, Schreiber GB, Striegel-Moore RH. Breakfast consumption by African-American and white adolescent girls correlates positively with calcium and fiber intake and negatively with body mass index. J Am Diet Assoc. 2005 Jun; 105 (6): 938-945. PMID: 15942545

Study did not answer the question; did not examine the relationship between calcium and dairy and adiposity.

Albala C, Ebbeling CB, Cifuentes M, Lera L, Bustos N, Ludwig DS. Effects of replacing the habitual consumption of sugar-sweetened beverages with milk in Chilean children. Am J Clin Nutr. 2008 Sep; 88 (3): 605-611. PMID: 18779274;  PMCID: PMC2583441.

Study population not from a developed country.  

Anderson JW, Hoie LH. Weight loss and lipid changes with low-energy diets: Comparator study of milk-based versus soy-based liquid meal replacement interventions. J Am Coll Nutr. 2005 Jun; 24 (3): 210-216. PMID: 15930487.

Study subjects are adult.

Arenz S, Von Kries R. Protective effect of breast-feeding against obesity in childhood: Can a meta-analysis of published observational studies help to validate the hypothesis? Adv Exp Med Biol. 2009; 639: 145-152. Review. PMID: 19227541.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Bailey BW, Sullivan DK, Kirk EP, Hall S, Donnelly JE. The influence of calcium consumption on weight and fat following nine months of exercise in men and women. J Am Coll Nutr. 2007 Aug; 26 (4): 350-355. PMID: 17906187.

Study subjects are adults.

Baird J, Poole J, Robinson S, Marriott L, Godfrey K, Cooper C, Inskip H, Law C; Southampton Women's Survey Study Group. Milk feeding and dietary patterns predict weight and fat gains in infancy. Paediatr Perinat Epidemiol. 2008 Nov; 22 (6): 575-586. PMID: 19000296.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Barba G, Troiano E, Russo P, Venezia A, Siani A. Inverse association between body mass and frequency of milk consumption in children. Br J Nutr. 2005 Jan; 93 (1): 15-19. PMID: 15705220.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Barton BA, Eldridge AL, Thompson D, Affenito SG, Striegel-Moore RH, Franko DL, Albertson AM, Crockett SJ. The relationship of breakfast and cereal consumption to nutrient intake and body mass index: The National Heart, Lung, and Blood Institute Growth and Health Study. J Am Diet Assoc. 2005 Sep; 105 (9): 1, 383-1, 389. PMID: 16129079

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Bogen DL, Hanusa BH, Whitaker RC. The effect of breast-feeding with and without formula use on the risk of obesity at four years of age. Obes Res. 2004 Sep; 12 (9): 1, 527-1, 535. Erratum in: Obes Res. 2004 Oct;12(10): A3. PMID: 15483218.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Chan GM, McElligott K, McNaught T, Gill G. Effects of dietary calcium intervention on adolescent mothers and newborns: A randomized controlled trial. Obstet Gynecol. 2006 Sep; 108(3 Pt 1): 565-571. PMID: 16946216.

Study subjects are pregnant.

Deheeger M, Bellisle F, Rolland-Cachera MF. The French longitudinal study of growth and nutrition: Data in adolescent males and females. J Hum Nutr Diet. 2002 Dec; 15 (6): 429-438. PMID: 12460151.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Dietz WH. Sugar-sweetened beverages, milk intake and obesity in children and adolescents. J Pediatr. 2006 Feb; 148 (2): 152-154. PMID: 16492420.

Study is an editorial.

Dodiuk-Gad RP, Rozen GS, Rennert G, Rennert HS, Ish-Shalom S. Sustained effect of short-term calcium supplementation on bone mass in adolescent girls with low calcium intake. Am J Clin Nutr. 2005 Jan; 81 (1): 168-174. PMID:15640477.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

dos Santos LC, de Pádua Cintra I, Fisberg M, Martini LA. Calcium intake and its relationship with adiposity and insulin resistance in post-pubertal adolescents. J Hum Nutr Diet. 2008 Apr; 21 (2): 109-116. PMID: 18339051.

Study population not from a developed country.

dos Santos LC, Martini LA, Cintra Ide P, Fisberg M. Relationship between calcium intake and body mass index in adolescents. Arch Latinoam Nutr. 2005 Dec; 55 (4): 345-349. PMID: 16640197.

Study population not from a developed country.

Forshee RA, Storey ML. Total beverage consumption and beverage choices among children and adolescents. Int J Food Sci Nutr. 2003 Jul; 54 (4): 297-307. PMID: 12850891.

Study design is cross-sectional.

García-Lorda P, Salas-Salvadó J, Fernàndez Ballart J, Murphy MM, Bulló M, Arija V. Dietary calcium and body mass index in a Mediterranean population. Int J Vitam Nutr Res. 2007 Jan; 77 (1): 34-40. PMID: 17685093.

Study subjects are adults.

Gibbons MJ, Gilchrist NL, Frampton C, Maguire P, Reilly PH, March RL, Wall CR. The effects of a high calcium dairy food on bone health in pre-pubertal children in New Zealand. Asia Pac J Clin Nutr. 2004; 13 (4): 341-347. PMID:15563438.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Henderson NK, Price RI, Cole JH, Gutteridge DH, Bhagat CI. Bone density in young women is associated with body weight and muscle strength but not dietary intakes. J Bone Miner Res. 1995 Mar; 10 (3): 384-393. PMID: 7785459.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Jirapinyo P, Wongarn R, Limsathayourat N, Maneenoy S, Somsa-Ad K, Thinpanom N, Vorasanta P. Adolescent height: Relationship to exercise, milk intake and parents' height. J Med Assoc Thai. 1997 Oct; 80 (10): 642-646. PMID: 10904567.

Study population not from a developed country.

Juzwiak CR, Amancio OM, Vitalle MS, Szejnfeld VL, Pinheiro MM. Effect of calcium intake, tennis playing and body composition on bone-mineral density of Brazilian male adolescents. Int J Sport Nutr Exerc Metab. 2008 Oct; 18 (5): 524-538. PMID: 19033613.

Study population not from a developed country.

Kranz S, Lin PJ, Wagstaff DA. Children's dairy intake in the United States: Too little, too fat? J Pediatr. 2007 Dec; 151 (6): 642-646, 646.e1-2. Epub 2007 Jul 24. PMID: 18035145.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

 

Article (L-S) Reason for Exclusion

Laitinen J, Kiukaanniemi K, Heikkinen J, Koiranen M, Nieminen P, Sovio U, Keinänen-Kiukaanniemi S, Järvelin MR. Body size from birth to adulthood and bone mineral content and density at 31 years of age: Results from the northern Finland 1966 birth cohort study. Osteoporos Int. 2005 Nov;16(11): 1, 417-1, 424. Epub 2005 Mar 22. PMID: 15782283.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Lee WT, Leung SS, Leung DM, Tsang HS, Lau J, Cheng JC. A randomized double-blind controlled calcium supplementation trial and bone and height acquisition in children. Br J Nutr. 1995 Jul; 74 (1): 125-139. PMID: 7547823.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Lukaszuk JM, Luebbers P, Gordon BA. Preliminary study: Soy milk as effective as skim milk in promoting weight loss. J Am Diet Assoc. 2007 Oct; 107 (10): 1, 811-1, 814. PMID: 17904943.

Study subjects are adult.

Mai XM, Becker AB, Sellers EA, Liem JJ, Kozyrskyj AL. Infrequent milk consumption plus being overweight may have great risk for asthma in girls. Allergy. 2007 Nov; 62 (11): 1, 295-1, 301. PMID: 17919145.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Mardones F, Urrutia MT, Villarroel L, Rioseco A, Castillo O, Rozowski J, Tapia JL, Bastias G, Bacallao J, Rojas I. Effects of a dairy product fortified with multiple micronutrients and omega-3 fatty acids on birth weight and gestation duration in pregnant Chilean women. Public Health Nutr. 2008 Jan;11(1):30-40. Epub 2007 Jun 13. PMID: 17565762.

Study population not from a developed country.

Matkovic V, Goel PK, Badenhop-Stevens NE, Landoll JD, Li B, Ilich JZ, Skugor M, Nagode LA, Mobley SL, Ha EJ, Hangartner TN, Clairmont A. Calcium supplementation and bone mineral density in females from childhood to young adulthood: A randomized controlled trial. Am J Clin Nutr. 2005 Jan; 81 (1): 175-188. PMID: 15640478.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Michels KB, Willett WC, Graubard BI, Vaidya RL, Cantwell MM, Sansbury LB, Forman MR. A longitudinal study of infant feeding and obesity throughout life course. Int J Obes (Lond). 2007 Jul; 31 (7): 1, 078-1, 085. Epub 2007 Apr 24. PMID: 17452993.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Miralles O, Sánchez J, Palou A, Picó C. A physiological role of breast milk leptin in body weight control in developing infants. Obesity (Silver Spring). 2006 Aug; 14 (8): 1, 371-1, 377. PMID: 16988079.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Moore LL, Singer MR, Qureshi MM, Bradlee ML. Dairy intake and anthropometric measures of body fat among children and adolescents in NHANES. J Am Coll Nutr. 2008 Dec; 27 (6): 702-710.PMID: 19155429

Study design is cross-sectional.

Moreira P, Padez C, Mourão I, Rosado V. Dietary calcium and body mass index in Portuguese children. Eur J Clin Nutr. 2005 Jul; 59 (7): 861-867.PMID: 15915159

Study design is cross-sectional.

Murphy MM, Douglass JS, Johnson RK, Spence LA. Drinking flavored or plain milk is positively associated with nutrient intake and is not associated with adverse effects on weight status in US children and adolescents. J Am Diet Assoc. 2008 Apr; 108 (4): 631-639.PMID: 18375219

Study design is cross-sectional.

Nicklas TA. Calcium intake trends and health consequences from childhood through adulthood. J Am Coll Nutr. 2003 Oct; 22 (5): 340-356. Review. PMID: 14559926

Study is a narrative review.

Novotny R, Daida YG, Acharya S, Grove JS, Vogt TM. Dairy intake is associated with lower body fat and soda intake with greater weight in adolescent girls. J Nutr. 2004 Aug; 134 (8): 1, 905-1, 909. PMID: 15284374

Study design is cross-sectional.

Oddy WH, Sherriff JL, de Klerk NH, Kendall GE, Sly PD, Beilin LJ, Blake KB, Landau LI, Stanley FJ. The relation of breastfeeding and body mass index to asthma and atopy in children: A prospective cohort study to age six years. Am J Public Health. 2004 Sep; 94 (9): 1, 531-1, 537. PMID: 15333310; PMCID: PMC1448489.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Okada T. Effect of cow milk consumption on longitudinal height gain in children. Am J Clin Nutr. 2004 Oct; 80 (4): 1, 088-1, 089; author reply 1089-90. PMID: 15447933.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Olsen SF, Halldorsson TI, Willett WC, Knudsen VK, Gillman MW, Mikkelsen TB, Olsen J; NUTRIX Consortium. Milk consumption during pregnancy is associated with increased infant size at birth: Prospective cohort study. Am J Clin Nutr. 2007 Oct; 86 (4): 1, 104-1, 110. PMID: 17921389.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Palacios C, Benedetti P, Fonseca S. Impact of calcium intake on body mass index in Venezuelan adolescents. P R Health Sci J. 2007 Sep; 26 (3): 199-204. PMID: 18035811.

Study population not from a developed country.

Prentice A, Ginty F, Stear SJ, Jones SC, Laskey MA, Cole TJ. Calcium supplementation increases stature and bone mineral mass of 16- to 18-year-old boys. J Clin Endocrinol Metab. 2005 Jun; 90 (6): 3, 153-3, 161. Epub 2005 Mar 8. PMID: 15755856.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Rockell JE, Williams SM, Taylor RW, Grant AM, Jones IE, Goulding A. Two-year changes in bone and body composition in young children with a history of prolonged milk avoidance. Osteoporos Int. 2005 Sep; 16 (9): 1, 016-1, 023. Epub 2004 Nov 23. PMID: 15565350

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Rodríguez-Artalejo F, García EL, Gorgojo L, Garcés C, Royo MA, Martín Moreno JM, Benavente M, Macías A, De Oya M; Investigators of the Four Provinces Study. Consumption of bakery products, sweetened soft drinks and yogurt among children aged six to seven years: Association with nutrient intake and overall diet quality. Br J Nutr. 2003 Mar; 89 (3): 419-429. PMID: 12628036

Study design is cross-sectional.

Rose D, Bodor JN, Chilton M. Has the WIC incentive to formula-feed led to an increase in overweight children? J Nutr. 2006 Apr; 136 (4): 1, 086-1, 090. PMID:16549484.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Stettler N, Stallings VA, Troxel AB, Zhao J, Schinnar R, Nelson SE, Ziegler EE, Strom BL. Weight gain in the first week of life and overweight in adulthood: A cohort study of European American subjects fed infant formula. Circulation. 2005 Apr 19; 111 (15): 1, 897-1, 903. PMID: 15837942.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

 

 
Article (T-Z) Reason for Exclusion

Teegarden D. Calcium intake and reduction in weight or fat mass. J Nutr. 2003 Jan; 133 (1): 249S-251S. Review. PMID: 12514302

Study subjects are animals or adult.

Teegarden D, Lyle RM, Proulx WR, Johnston CC, Weaver CM. Previous milk consumption is associated with greater bone density in young women. Am J Clin Nutr. 1999 May; 69 (5): 1, 014-1, 017. PMID: 10232644.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Vatanparast H, Baxter-Jones A, Faulkner RA, Bailey DA, Whiting SJ. Positive effects of vegetable and fruit consumption and calcium intake on bone mineral accrual in boys during growth from childhood to adolescence: The University of Saskatchewan Pediatric Bone Mineral Accrual Study. Am J Clin Nutr. 2005 Sep; 82 (3): 700-706. PMID: 16155286.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Venti CA, Tataranni PA, Salbe AD. Lack of relationship between calcium intake and body size in an obesity-prone population. J Am Diet Assoc. 2005 Sep; 105 (9): 1, 401-1, 407. PMID: 16129081

Study design is cross-sectional.

von Kries R, Koletzko B, Sauerwald T, von Mutius E. Does breast-feeding protect against childhood obesity? Adv Exp Med Biol. 2000; 478: 29-39. PMID: 11065058.

Study design is cross-sectional.

Weyermann M, Brenner H, Rothenbacher D. Adipokines in human milk and risk of overweight in early childhood: A prospective cohort study. Epidemiology. 2007 Nov; 18 (6): 722-729. PMID: 18062063.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Wiley AS. Consumption of milk, but not other dairy products, is associated with height among US preschool children in NHANES 1999-2002. Ann Hum Biol. 2009 Mar-Apr; 36 (2): 125-138. PMID: 19241191.

Study did not answer the question; did not examine the relationship between calcium and or dairy and adiposity.

Wiley AS. Does milk make children grow? Relationships between milk consumption and height in NHANES 1999-2002. Am J Hum Biol. 2005 Jul-Aug; 17 (4): 425-441. PMID: 15981182.

Study did not answer the question; did not examine the relationship between calcium or dairy and adiposity.

Zhu K, Du X, Greenfield H, Zhang Q, Ma G, Hu X, Fraser DR. Bone mass in Chinese premenarcheal girls: The roles of body composition, calcium intake and physical activity. Br J Nutr. 2004 Dec; 92 (6): 985-993. PMID: 15613261.

Study population not from a developed country.