Studies of Gambian and UK children and adolescents: Insights into calcium requirements and adaptation to a low calcium intake

Currently there is concern about the low dietary calcium intakes common in some sub-groups of Western societies, including children and adolescents, and in many regions of the developing world. However, there is a lack of consensus about what level of dietary calcium intake will optimise bone health at different ages and in different environments. We have been conducting a series of studies in different populations to provide insights into calcium requirements and adaptation to a low calcium intake in different populations. These include calcium intervention studies among young people in Cambridge, an affluent university city in the UK and in Keneba, a poor rural village in The Gambia, West Africa. These studies have raised questions with implications for diet and nutrition policy including what aspects of bone growth and development need to be considered for the optimisation of skeletal health through diet, whether the influence of diet differs between the sexes and at different stages of childhood, and whether there are limitations to the adaptive response to a low calcium intake. Until we have a better understanding, our studies suggest that we should exercise caution before advocating higher population calcium intakes for children and adolescents than are currently recommended.