A major review published in The BMJ says calcium supplements, vitamin D supplements, and taking both together offer little to no clinically meaningful protection against fractures or falls for most older adults. The finding challenges long-standing advice that these supplements should be used routinely for bone health.
Falls remain a serious concern in older age, with nearly one in three people 65 and older experiencing at least one each year. Those incidents can lead to fractures, reduced independence, lower quality of life, and sometimes the need for long-term residential care.
What the analysis found
Researchers in Canada reviewed 69 randomized controlled trials involving 153,902 adults. The studies compared calcium, vitamin D, or both against placebo or no treatment to see whether they lowered the risk of falls and fractures.
Across the evidence, the team found little to no reduction in overall fracture risk from calcium alone, vitamin D alone, or combined supplementation. The analysis also showed little to no benefit for hip fractures or for preventing falls.
Consistency across groups
The results stayed broadly similar after accounting for age, sex, previous fractures, previous falls, and average calcium intake from food. That consistency strengthened confidence in the overall conclusions, even though some parts of the analysis included relatively few studies and participants.
The researchers also noted that the findings may not apply to people with certain bone disorders or to those already receiving medication for osteoporosis. Even so, they concluded that the evidence does not support routine supplementation with calcium or vitamin D to prevent fractures and falls.
What happens next
Vitamin D supplements, with or without calcium, are still widely recommended by healthcare providers, professional guidelines, and regulatory agencies. Prescriptions for these supplements have also increased considerably in recent years, despite earlier reviews that had already raised questions about their effectiveness.
In a linked editorial, researchers said more rigorous and well-powered clinical trials are still needed for people at higher risk of fractures or falls. Until then, they argued that resources may be better directed toward fall prevention strategies that have already shown benefit, including balance training, resistance exercise, and personalized programs that combine exercise, hazard assessment, and education.
