Table 2.
Summary of findings of calcium fortification (+minerals/other) by population group.
| Outcomes | Mean Difference (MD) of Fortified Versus Control Group * (95% CI) | No. of Participants (Studies) | Certainty of the Evidence (GRADE) |
|---|---|---|---|
| Calcium Intake (mg/day)—Children | MD 306.17 higher 198.97 higher to 413.38 higher) |
764 (4 RCTs) |
⨁⨁⨁◯ MODERATE a |
| Calcium Intake (mg/day)—Adults | MD 471.47 higher (266.51 higher to 676.42 higher) |
315 (3 RCTs) |
⨁⨁◯◯ LOW a,b |
| Calcium Intake (mg/day)—Postmenopausal Women | MD 1210 higher (1162.8 higher to 1257.2 higher) |
50 (1 RCT) |
⨁⨁◯◯ LOW c |
| Weight (kg)—Children | MD 0.22 higher (0.95 lower to 1.38 higher) |
667 (6 RCTs) |
⨁⨁⨁◯ MODERATE d |
| Weight (kg)—Adults | MD 1.85 higher (0.94 lower to 4.64 higher) |
150 (1 RCT) |
⨁⨁⨁◯ MODERATE e |
| Weight (kg)—Postmenopausal Women (Vit D cointervention in both groups) | MD 0.03 lower (4.11 lower to 4.05 higher) |
79 (1 RCT) |
⨁⨁⨁◯ MODERATE e |
| Height (cm)—Children | MD 0.83 higher (0 to 1.65 higher) |
1164 (7 RCTs) |
⨁⨁⨁◯ MODERATE f |
| BMD Femoral neck (g/cm2)—Children | MD 0.02 higher (0.01 higher to 0.04 higher) |
620 (5 RCTs) |
⨁⨁⨁◯ MODERATE f |
| BMD Femoral neck (g/cm2)—Adults | MD 0.01 lower (0.04 lower to 0.03 higher) |
150 (1 RCT) |
⨁⨁⨁◯ MODERATE g |
Quality of Evidence Symbol: ⨁⨁⨁◯ Moderate, ⨁⨁◯◯ Low. * Studies that compared the fortified food with similar unfortified food, with a food with lower content of calcium, with usual diet, or with supplement placebo; a. I2 > 70% but not important clinical heterogeneity; b. 2/3 studies with high Risk of Bias (RoB) for allocation concealment and blinding of participant and personnel; c. The only study for this subgroup has high RoB for allocation concealment and blinding of participant and personnel; d. 3 out of six studies present moderate or high RoB for most domains; e. Wide 95% confidence interval; f. Most studies present moderate or high RoB for many domains; g. This is a single study with high RoB in the domain incomplete outcome data. Effects in primary and secondary outcomes are presented in Table S1.