Older community-dwelling adults do not benefit from calcium, vitamin D, or both regarding fracture prevention, according to a large new meta-analysis. Researchers combined 33 randomized, clinical trials that included more than 51,000 participants ≥ 50 years of age to determine whether calcium supplements, vitamin D, or the combination affected fracture incidence. The risk ratios (RR) vs. placebo were 1.53 for calcium alone, 1.21 for vitamin D alone, and 1.09 for the combination. No significant associations were found between calcium, vitamin D, or combined calcium and vitamin D supplements or the incidence of nonvertebral, vertebral, or total fractures. The results were consistent regardless of the dose of vitamin D or calcium, sex, fracture history, dietary calcium intake, or baseline serum 25-hydroxyvitamin D concentration. The authors concluded that “these findings do not support the routine use of these supplements in community-dwelling older people.” (JAMA 2017;318:2466-2482). Current practice guidelines recommend calcium and vitamin D, but with mounting evidence of no benefit and potential harm (coronary artery disease, kidney stones, etc.), those guidelines may change.
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