Calcium and vitamin D supplements do little to prevent falls and fractures, study suggests | Canada Voices

For years, older adults have been told to take calcium and vitamin D to help prevent falls and fractures, based on promising findings from the 1990s and early 2000s.

But a growing body of evidence suggests these widely used supplements may do far less than once hoped.

Recent large reviews have found that calcium and vitamin D don’t meaningfully reduce the risk of fractures, with little or no consistent benefit for falls.

Now, a new major review reinforces the lack of benefit from calcium and vitamin D supplementation.

Here’s a breakdown of the latest findings, plus what they mean – and what they don’t – for calcium and vitamin D supplements.

Falls, a major health concern for older adults

Preventing falls and fractures is a global health priority.

According to Health Canada, 20 to 30 per cent of adults aged 65 and older experience at least one fall every year.

Falls can lead to hip fractures, chronic pain, reduced mobility, loss of independence and even death.

They’re also a leading cause of injury-related hospitalizations, with some estimates suggesting more than one-third of older Canadian adults require long-term care after a serious fall.

How to prevent falls and maintain independence as you age

About the latest research

For the study, published May 20 in The BMJ, Canadian researchers analyzed data from 69 randomized controlled trials, spanning several decades of research through February, 2025.

The trials, involving 153,902 adults, compared the effect of calcium supplements, vitamin D supplements or a combination of both with placebo or no treatment to assess their effects on the risk of fractures and falls.

The researchers reviewed each study to assess how reliable its results were and how confident they could be in the findings.

Overall, the analysis found little, if any, benefit of vitamin D and/or calcium supplements for reducing the risk of fractures, including hip fractures or preventing falls.

These findings were supported by moderate- and high-quality evidence.

The results were similar across different groups of participants, defined by age (under 65 versus over 65), vitamin D status, dietary calcium intake and previous bone fracture or falls.

There was a hint that taking both vitamin D and calcium might offer a small, but not clinically meaningful, reduction in fracture risk. (A clinically meaningful benefit is one large enough to make a difference in a person’s health or daily life.)

However, this apparent benefit was largely driven by trials in higher-risk populations, such as residents of long-term care and those with very low vitamin D levels or calcium intakes.

Based on the available evidence, the study authors concluded that routine supplementation with vitamin D and/or calcium is not supported for preventing falls or fractures in most older adults.

Strengths, caveats

To its credit, the study was large, including 69 trials and more than 150,000 participants, making it one of the most thorough analyses to date.

It also included recent large studies, giving a more complete and up-to-date picture than earlier reviews based on smaller or older trials.

As well, the researchers used high-quality methods and found consistent results across different groups of participants, suggesting the findings broadly apply to older adults who are not at high risk.

Of course, there were limitations.

Most trials included generally healthy, community-dwelling older adults.

The findings, therefore, may not fully apply to frail or high-risk individuals, including those receiving treatment for osteoporosis and people with certain bone disorders.

Many of the included trials enrolled participants with normal vitamin D levels and calcium intakes, which may have made it harder to detect a benefit from supplements.

The relatively short duration of many trials may also have made it difficult to detect small effects on fracture risk.

Takeaways

The results of this evidence review don’t diminish the importance of calcium and vitamin D for bone health.

Both nutrients are critical for normal bone metabolism and meeting daily requirements is still important.

A sufficient vitamin D level, for example, is needed to absorb calcium from your gut. Without adequate vitamin D, your body absorbs less calcium, which, over time, can lead to weakened bones.

Instead, the new study provides strong evidence that if you’re already vitamin D sufficient, taking additional vitamin D or calcium is unlikely to further reduce the risk of fractures or falls.

That said, supplements may still have a role in filling dietary gaps.

Supplementation can also help maintain adequate vitamin D levels in the winter months when, in countries like Canada, the sun’s UVB rays are too weak to trigger vitamin D synthesis in the skin.

Vitamin D and calcium supplements may also be appropriate in other situations, such as treating a deficiency or as a part of osteoporosis treatment.

In an accompanying editorial, researchers argued that attention should shift away from supplements and toward interventions actually proven to reduce falls, such as balance and resistance training, home safety measures and personalized fall prevention programs.

Leslie Beck, a Toronto-based private practice dietitian, is director of food and nutrition at Medcan.