Calcium, vitamin D, or combined supplementation to prevent fractures and falls: systematic review and meta-analysis
Authors' conclusion
Based on absolute risk reductions and thresholds considered clinically meaningful, this review found little to no benefits from use of calcium, vitamin D, or combined supplementation on the prevention of fractures and falls.
Study context
- Population
- Adults (≥18 years) not receiving drug treatment for osteoporosis; most trials community dwelling (87%) and not at high risk of fractures or falls (73%)
- Participants
- 153,902 adults69 trials
- Comparison
- Calcium, vitamin D, or combined supplementation vs placebo or no treatment
- Outcome
- Risk of any fracture
Methodological detailsrandom effects meta-analyses, GRADE appraisal with thresholds for important absolute effects, Cochrane risk of bias tool (second version), independent duplicate screening and extraction
- Random effects meta-analyses
- GRADE appraisal with thresholds for important absolute effects
- Cochrane risk of bias tool (second version)
- Independent duplicate screening and extraction
Pooled result
As reported in the abstract
Any fracture
Each group vs placebo or no treatmentRelative risk (95% CI)
Calcium11 trials, 9067 participants; moderate certainty
0.91(0.81–1.01)
Vitamin D36 trials, 92 045 participants; high certainty
1.00(0.95–1.06)
Combined15 trials, 51 126 participants; high certainty
0.91(0.84–0.99)
Further pooled results
Other fracture and fall outcomes (hip, non-vertebral, vertebral fracture; falling; number of falls)
- Little to no effect of calcium, vitamin D, or combined supplementation, based largely on moderate to high certainty of evidence
Subgroup analyses
- Findings remained robust across multiple subgroup analyses
Original publication
Calcium, vitamin D, or combined supplementation to prevent fractures and falls: systematic review and meta-analysis. BMJ. Published 20 May 2026. doi:10.
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