Calcium, vitamin D, or combined supplementation to prevent fractures and falls: systematic review and meta-analysis
Massé O, Mercurio CM, Dupuis S, Al Sahwi M, Arruda A, Dallaire G, et al.
Published in BMJ, Vol. 393, pp. e088050
Methodology
Systematic review and random-effects meta-analysis of randomised controlled trials comparing calcium, vitamin D or both with placebo or no treatment in adults not taking osteoporosis drugs, searched to February 2025. Risk of bias assessed with Cochrane RoB 2 and certainty with GRADE, using thresholds for clinically important absolute effects.
Key Findings
69 trials, 153,902 participants, 87% community dwelling. Any fracture: calcium alone RR 0.91 (95% CI 0.81 to 1.01; 11 trials, 9,067 people; moderate certainty); vitamin D alone RR 1.00 (0.95 to 1.06; high certainty); calcium plus vitamin D RR 0.91 (0.84 to 0.99; 15 trials, 51,126 people; high certainty). Little to no effect on hip, non-vertebral or vertebral fractures or falls.
Conclusions
Judged against clinically meaningful absolute effects, calcium, vitamin D or both gave little to no benefit for preventing fractures and falls.
Limitations
Most participants were not at high fracture risk (73%); evidence for high-risk people and residents of care homes was limited, especially for calcium alone. People already on osteoporosis drugs were excluded.
Supplements Studied
little to no effect was found from use of calcium supplements
Related Health Concerns
Study Details
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