Does Routine Vitamin D Supplementation Prevent Fractures?

In the landmark VITAL trial, 26,000 middle-aged and older community-dwelling U.S. adults (mean age, 67) were randomized to receive 2000 IU of vitamin D₃ or placebo daily and were followed for 5 years. Vitamin D did not prevent adverse cardiovascular events or invasive cancer — the two primary outcomes, reported several years ago (NEJM JW Gen Med Dec 15 2018 and N Engl J Med 2019; 380:33). However, because many people take vitamin D for “bone health,” I have been waiting for fracture outcomes in VITAL. In 2022, those findings finally were published.

In short, vitamin D supplementation had no effect on the incidence of total, nonvertebral, or hip fractures and no effect on “major osteoporotic fractures” (i.e., hip, wrist, humerus, or clinical …