Calcium, Vitamin D Don't Prevent Fractures: BMJ Review — SkimNews
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- BMJ review of 69 randomized controlled trials involving 153,902 adults concluded that calcium, vitamin D, and combined supplementation provided little to no meaningful protection against fractures or falls in older people.
- Evidence certainty was high for vitamin D (36 trials, 92,045 participants) and for combined supplementation (15 trials, 51,126 participants), while calcium findings rested on moderate-certainty evidence from 11 trials involving 9,067 participants.
- Nearly one in three adults aged 65 and older falls annually, leading to fractures, chronic pain, loss of independence, reduced quality of life, and in some cases a move into residential care.
- Vitamin D prescriptions have risen substantially in recent years despite prior uncertain evidence, and the researchers argue clinicians, guideline panels, and regulatory agencies 'should re-evaluate their general recommendations for calcium and vitamin D supplementation.'
- Results remained broadly consistent when researchers accounted for age, sex, prior fractures, prior falls, and average calcium intake from food, strengthening confidence in the overall conclusions across hip fractures and falls specifically.
- The researchers caution that findings may not apply to people with certain bone disorders or those receiving medication for osteoporosis, who should not assume the conclusions apply directly to them.
- A linked editorial recommends shifting attention and funding toward approaches that have already shown meaningful benefits, including balance training, resistance exercise, and multi-component programs combining exercise with hazard assessment and personalized education.
Why it matters: For the millions of older adults routinely taking calcium and vitamin D, the BMJ review's high-certainty evidence — drawn from 92,045 participants on vitamin D alone and 51,126 on combined therapy — finds little meaningful protection against fractures or falls. The researchers directly call on clinicians, guideline panels, and regulatory agencies to re-evaluate general supplementation recommendations, with the linked editorial redirecting attention toward exercise-based fall prevention instead.
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