Calcium and vitamin D are practically synonymous with bone health. That has made the supplements feel less like an optional extra and more like something older adults should be taking to keep a fall from becoming a fracture.
For most older adults, however, routinely taking the supplements to ward off fractures may provide less protection than expected.
In a new review published in The BMJ, researchers combined results from 69 trials involving nearly 154,000 adults and found that calcium, vitamin D, or the two together did little to prevent fractures or falls. The finding carries particular weight because nearly one in three adults aged 65 and older falls each year. When those falls result in fractures, the effects can include lasting pain, reduced independence, and the need for residential care.
Calcium and Vitamin D Supplements Did Little to Prevent Fractures
The trials compared people taking calcium, vitamin D, or both supplements with those receiving a placebo or no treatment. Most participants were older adults living independently, and nearly three-quarters were not already considered at high risk of falling or breaking a bone.
Across 36 trials involving more than 92,000 people, those taking vitamin D alone were just as likely to experience a fracture as those who were not. It also made little to no difference to hip fractures, spinal fractures, the chance of falling, or the total number of falls.
Although the researchers found a possible increase in hip fractures among people taking calcium alone, the evidence was too uncertain to find that the supplement caused harm.
Taking calcium and vitamin D together appeared to lower the risk of some fractures, but the actual differences were small. About 100 people would need to take the two supplements to prevent one fracture of any kind. Roughly 333 would need to take them to prevent one hip fracture.
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One High-Risk Study Drove Much of the Apparent Benefit
Some of the apparent benefit from combining the supplements came from a study published in the early 1990s. It followed women living in residential care who had an average age of 84, very low vitamin D levels, low calcium intake, and a high risk of hip fracture.
That group was quite different from the independently living older adults included in most of the later trials. When the researchers removed the residential-care study from their calculations, the reductions in fractures became smaller and were no longer statistically clear.
The researchers also looked for signs that the supplements worked better under certain conditions. They compared results based on age, sex, previous fractures or falls, vitamin D levels, calcium intake, dosage, and length of treatment. No particular group consistently received greater protection.
There was less evidence available for people at very high risk of fractures, including those in residential care. The researchers note that the findings may therefore underestimate the benefit for some vulnerable patients.
Preventing a Fall Goes Beyond Bone Health
The findings do not mean calcium and vitamin D are unnecessary. Supplements may still be appropriate for people with diagnosed deficiencies or certain bone conditions, and the review did not include people taking osteoporosis medication, who are often prescribed both nutrients alongside treatment. The results also apply to supplements, not calcium and vitamin D obtained through food.
Falls involve far more than bone strength. Muscle weakness, poor balance, eyesight, medications, footwear, and hazards around the home can all contribute.
In an accompanying editorial, experts called for greater attention to measures with clearer benefits, including balance and resistance exercises, home safety checks, and prevention plans tailored to each person’s risks.
The researchers concluded that guidelines recommending routine supplements to prevent falls and fractures should be reconsidered. The pills may still have a place, but for most older adults, they are not a substitute for a broader prevention plan.
This article is not offering medical advice and should be used for informational purposes only.
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Article Sources
Our writers at Discovermagazine.com use peer-reviewed studies and high-quality sources for our articles, and our editors review for scientific accuracy and editorial standards. Review the sources used below for this article:
- This article references information from a study published in The BMJ: Calcium, vitamin D, or combined supplementation to prevent fractures and falls: systematic review and meta-analysis
- This article references information from the BMJ Group: Calcium and vitamin D supplements offer little to no meaningful benefit on fracture and fall prevention
