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In people over 50 who live in the community, vitamin D or calcium supplements, alone or combined, do not prevent fractures

Zhao JG, Zeng XT, Wang J, et al. Association Between Calcium or Vitamin D Supplementation and Fracture Incidence in Community-Dwelling Older Adults: A Systematic Review and Meta-analysis. JAMA. 2017;318:2466-82.

Review question

What are the effects of vitamin D or calcium supplements, alone or combined, on fractures in people over 50 years of age living in the community?


People don’t always get enough vitamin D and calcium in the food they eat. Vitamin D increases the uptake of calcium, which is the building block of bones, and it improves muscle function. Since both are important for bone health, people often take supplements with the goal of preventing broken bones (fractures).

How the review was done

The researchers did a systematic review, including studies up to July 2017. They found 33 randomized controlled trials that included 51, 154 healthy people over the age of 50 who were living in the community.

Vitamin D was studied in 17 trials, calcium in 14 trials, and vitamin D plus calcium in 13 trials.

The main results were number of hip fractures.

Vitamin D, with or without calcium, was compared with no treatment or placebo.

6 trials were high quality, 1 was low quality, and the rest were moderate quality.

What the researchers found

The findings are summarized in the Table below.


In people over 50 years of age who live in the community, vitamin D or calcium supplements, alone or combined, do not prevent fractures compared with placebo or no treatment.

Effect of vitamin D or calcium supplements, alone or combined, on hip fractures in community-dwelling people over 50 years of age


Number of trials (number of people)

Rate of hip fractures with supplement

Rate of hip fractures without supplement

Effect of supplement at 3 months to 7 years

Vitamin D

9 trials (20,672 people)



No difference in hip fractures*


6 trials (6703 people)



No difference in hip fractures*

Vitamin D plus calcium

7 trials (17,927 people)



No difference in hip fractures*

*Although the rates for the 2 groups look different, the differences were not statistically significant. This means that the difference could simply be due to chance rather than due to different treatments.


A harmless, inactive, and simulated treatment.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

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