Adapted from BMJ 30 May 2026
I have been prescribing calcium and vitamin D, and latterly just vitamin D, to my patients to prevent fractures. New evidence would suggest that this strategy has been a dead loss.
A study shows that taking any combination or singular element of calcium and vitamin D provides no clinically meaningful benefit over no supplementation. The study involved 69 clinical trials overing almost 154,000 participants. 87% lived in the community and 73% were not at high risk of fractures or falls.
About 30% of people aged 65 or older and over half of those living in nursing homes experience falls at least annually. 5% of these will result in a fracture. A fracture can be the end of that persons ability to live independently. This happens in 17% of adults who are admitted to hospital after a fracture after a fall.
Low body mass index and low bone density increase the risk of fractures from falls. Calcium and vitamin D supplements are a cheap and safe intervention. Sadly the study showed that these just did not work, even in a sub-group analysis of people aged 80 or over, living in a care home, who had a previous history of fractures or falls, osteoporosis, and low vitamin D levels.
In this study, the planners aimed to see if a 2% reduction in fractures, a 0.7% reduction in hip fractures and a 2% reduction in vertebral fractures could be achieved. They didn’t rely on “statistical significance”.
The authors suggest that interventions such as balance and resistance exercise, and hazard assessment, which have been shown to reduce falls and fractures, are undertaken instead of relying on supplementation.
