Vitamin D, calcium supplements do not reduce fracture risk in older adults

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Combined calcium and vitamin D supplementation was not significantly associated with hip fracture vs placebo or not treatment.
Combined calcium and vitamin D supplementation was not significantly associated with hip fracture vs placebo or not treatment.

Findings from a systematic review and meta-analysis of 33 studies published in JAMA do not support routine vitamin D and calcium supplementation in community-dwelling older adults for lowering the incidence of osteoporosis-related fractures. 

Existing data show varying conclusions on calcium and vitamin D supplementation with fracture incidence in the elderly. Researchers from China aimed to investigate whether calcium, vitamin D, or combined calcium/vitamin D supplements were tied to a reduced fracture incidence in community-dwelling older adults. They systematically searched databases to identify randomized clinical trials comparing calcium, vitamin D, or combined supplements with placebo or no treatment for fracture incidence in community-dwelling adults aged >50 years.

Thirty-three randomized trials (n=51,145) were identified that met the inclusion criteria. The primary outcome was risk of hip fracture; secondary outcomes included nonvertebral fracture, vertebral fracture, and total fracture. 

The results showed no significant association of calcium (RR 1.53, 95% CI: 0.97–2.42; ARD 0.01, 95% CI: 0.00-0.01) or vitamin D (RR 1.21, 95% CI: 0.99–1.47; ARD 0.00, 95% CI: -0.00 to 0.01) with risk of hip fracture vs placebo or no treatment. In addition, combined calcium and vitamin D supplementation was not significantly associated with hip fracture vs placebo or not treatment (RR 1.09, 95% CI: 0.85–1.39; ARD 0.00, 95% CI: -0.00 to 0.00). 

"No significant associations were found between calcium, vitamin D, or combined calcium and vitamin D supplements and the incidence of nonvertebral, vertebral, or total fractures," concluded lead author Jia-Guo Zhao, MD. These findings were also consistent in subgroup analyses regardless of supplement dose, gender, fracture history, dietary calcium intake, and baseline serum 25-hydroxyvitamin D concentration. 

Reference

Zhao J, Zeng X, Wang J, Liu L. Association between calcium or vitamin D supplementation and fracture incidence in community-dwelling older adults: A systematic review and Meta- analysis.  JAMA. 2017;318(24). doi:10.1001/jama.2017.19344


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