A 2026 systematic review and meta-analysis published in The BMJ evaluated whether calcium, vitamin D, or combined calcium and vitamin D supplementation can reduce fractures and falls in adults.
The review included 69 randomized controlled trials involving 153,902 participants. Most participants were community-dwelling adults and were not considered to be at high risk of fractures or falls.
Across the available evidence, the authors concluded that routine supplementation with calcium, vitamin D, or their combination provides little to no clinically meaningful benefit for preventing fractures or falls in the populations studied.
The analysis brought together evidence from 69 randomized controlled trials evaluating calcium, vitamin D, or combined supplementation.
More than 150,000 adults were represented across the included studies, providing a broad evidence base for evaluating fracture and fall outcomes.
The systematic review was published in The BMJ in 2026 and incorporated recent large-scale randomized trials.
Calcium supplementation alone was found to have little to no effect on the overall risk of fracture. Across 11 trials involving 9,067 participants, the relative risk for any fracture was 0.91 compared with placebo or no treatment.
Similar findings were reported for non-vertebral fractures, vertebral fractures, falls, and the total number of falls. Evidence regarding hip fracture was considered very uncertain.
Vitamin D supplementation alone showed little to no effect on fracture prevention. In 36 trials involving more than 92,000 participants, the relative risk for any fracture was 1.00.
The review also found little to no effect on hip fractures, non-vertebral fractures, vertebral fractures, the risk of falling, or the total number of falls.
Combined calcium and vitamin D supplementation produced small statistically significant reductions in several fracture outcomes. For any fracture, the relative risk was 0.91 across 15 trials involving 51,126 participants.
However, the authors determined that the absolute reductions were below the thresholds they had defined as clinically meaningful. The estimated absolute reduction was approximately 1% for fractures at any site, 0.3% for hip fractures, and 1.6% for non-vertebral fractures.
The authors concluded that calcium, vitamin D, and combined supplementation generally provide little to no clinically meaningful benefit for preventing fractures and falls when used routinely in the populations represented in these trials.
Importantly, the findings should not automatically be extended to every patient population. The authors noted that the results may not be generalizable to people with specific bone disorders, individuals receiving osteoporosis medications, or patients receiving long-term corticosteroid therapy.
Read the complete systematic review and meta-analysis for detailed methodology, subgroup analyses, fracture and fall outcomes, and the authors' interpretation of the current evidence.
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