Calcium supplements, vitamin D supplements and taking both together appear to do little to prevent fractures or falls in most older adults, according to a comprehensive review published in The BMJ.
Researchers in Canada pooled results from 69 randomized controlled trials involving 153,902 adults and found little to no clinically meaningful benefit from calcium, vitamin D or the combination for reducing overall fracture risk, specific fractures such as hip fractures, or falls. The findings cut against a long-standing habit in medicine: vitamin D supplements, with or without calcium, remain widely recommended for bone health even though the evidence reviewed here did not show a meaningful payoff for most people.
The review compared calcium supplements, vitamin D supplements and combined treatment with placebo or no treatment. Across the evidence base, the researchers found little to no reduction in fracture risk from calcium alone, little to no reduction from vitamin D alone, and little to no reduction from using both together. They also found little to no benefit for preventing falls, a serious concern for older adults, nearly one in three of whom experiences a fall each year.
That matters because falls are a major route to fractures in people 65 and older, and because prescriptions for these supplements have risen considerably in recent years. Yet the weight of the evidence in this review suggests routine use is not doing the work many patients and clinicians have assumed it does. For a wider discussion of the findings, see Calcium supplements offer little fracture protection in major BMJ review.
The researchers said the results do not support routine supplementation with calcium or vitamin D, or with both together, to prevent fractures and falls. They suggested clinicians, guideline panels and regulatory agencies should re-evaluate broad recommendations in light of current evidence.
The unresolved question is narrower, but still important: the findings may not apply to people with certain bone disorders or to those taking medication for osteoporosis. For everyone else, the conclusion is straightforward. As a general strategy for preventing fractures and falls in older adults, calcium supplements are not backed by meaningful benefit.
