Large review finds calcium and vitamin D supplements do little to prevent fractures or falls
A review of 69 randomized trials involving more than 153,000 older adults found that calcium and vitamin D supplements, alone or together, provide little meaningful protection against falls or broken bones. The researchers suggest that balance and resistance exercise may be more effective strategies for prevention.
The review analyzed 69 randomized controlled trials with over 153,000 older adult participants, comparing calcium, vitamin D, or combined supplements against placebos or no treatment. Researchers applied established methods to assess bias risk and evidence certainty. For vitamin D alone and combined supplementation, the evidence was rated high certainty across 36 and 15 trials respectively, while calcium-only findings drew from moderate certainty evidence across 11 trials.
The findings challenge routine supplementation practices, which remain common despite earlier reviews showing limited benefit for individual supplements. Falls affect nearly one in three adults aged 65 and older annually, making prevention strategies a public health priority. The researchers suggest balance and resistance exercise may offer more effective alternatives for reducing fall and fracture risk in older populations.
This review could reshape how clinicians and older adults approach bone health prevention. If routine supplementation offers little protection, millions may reconsider daily pill regimens, potentially reducing healthcare costs and supplement industry revenue. However, the findings may also create confusion, since some patients with diagnosed deficiencies or specific risk factors could still benefit. The emphasis on exercise as an alternative could encourage more active aging strategies, though access to structured balance and resistance programs varies widely across communities.