A review of 69 trials with 154,000 adults shows calcium and vitamin D supplements offer little benefit for preventing fractures or falls in most older adults.
A systematic review published in The BMJ examined 69 randomized controlled trials that together enrolled 153,902 adults. The trials compared calcium supplements, vitamin D supplements, or the two combined against placebo or no treatment and assessed outcomes of any fracture, hip fracture, and falls. The analysis found little to no clinically meaningful effect for any of the supplement strategies, with moderate‑certainty evidence for calcium (11 trials, 9,067 participants) and high‑certainty evidence for vitamin D (36 trials, 92,045 participants) and the combined regimen (15 trials, 51,126 participants).
The authors note that some subgroup analyses were based on relatively few trials or participants, so those specific findings should be interpreted cautiously. They also state the results may not apply to individuals with certain bone disorders or those receiving osteoporosis medication, although the overall pattern remained consistent across age, sex, prior fracture or fall history, and dietary calcium intake.
Based on these findings, the researchers argue that the evidence does not support routine supplementation with calcium, vitamin D, or both for fracture or fall prevention, and they call on clinicians, guideline panels, and regulatory agencies to re‑evaluate current recommendations. They suggest shifting attention toward interventions with demonstrated benefit, such as balance training and resistance exercise, possibly combined with hazard assessment and personalized education.
The review acknowledges uncertainty for high‑risk subpopulations and highlights the need for further well‑powered trials to determine whether supplementation might benefit specific groups.