Calcium and Vitamin D Supplements Provide Little Overall Protection Against Fractures and Falls

A comprehensive systematic review and meta-analysis involving 69 randomized controlled trials and 153,902 adults found that calcium supplements, vitamin D supplements, or their combination offer little to no clinically meaningful benefit in preventing fractures or falls in adults not taking osteoporosis medications. Most participants were community-dwelling individuals (87%) and were not considered at high risk for fractures or falls (73%). For the primary outcome of any fracture, calcium supplementation alone showed a non-significant trend toward benefit (risk ratio [RR] 0.91), while vitamin D alone showed no effect at all (RR 1.00). Combined calcium and vitamin D supplementation modestly reduced fracture risk (RR 0.91). Similarly, there was little to no benefit for hip fractures, vertebral fractures, non-vertebral fractures, falls, or total number of falls across the included studies. The conclusions were supported by moderate- to high-certainty evidence and remained stable across extensive subgroup and sensitivity analyses. Evidence for individuals at particularly high fracture risk or those living in residential care facilities remained limited, especially for calcium monotherapy and combined supplementation. Overall, the findings do not support routine use of calcium or vitamin D supplementation for fracture and fall prevention in the general adult population. Source: https://www.bmj.com/