Supplemental Calcium or Vitamin D Doesn't Lower Fracture Risk in Community-Dwelling Adults

Several guidelines recommend calcium, vitamin D, or both types of supplementation to prevent fractures in older adults (focusing mostly on frail elders and those living in institutions; Osteoporos Int 2010; 21:1151). In this meta-analysis, researchers identified 33 randomized controlled trials that involved community-dwelling adults (age, ≥50; total patients, 51,145). The trials comprised 44 separate studies (14 of calcium supplementation alone, 17 of vitamin D supplementation alone, and 13 of combined supplementation). Studies that involved patients with corticosteroid-induced osteoporosis, and those in which other drugs or dietary interventions were combined with vitamin D or calcium supplementation were excluded.

The pooled analyses for all three study clusters showed no benefit for any supplementation intervention in reducing relative risk for hip fracture (the primary outcome). Secondary outcomes (vertebral, nonvertebral, and total fractures) also were not affected by any of the interventions. The overall results applied to subgroups with 25-hydroxyvitamin D levels lower than 20 ng/mL or daily dietary calcium intake lower than 900 mg, to women, and to people with previous fractures.