Vitamin D and Calcium Supplements Get Low Marks for Primary Prevention of Fractures
Recommendations from the US Preventive Services Task Force that seem counterintuitive.
Reference1. US Preventive Services Task Force. Vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319:1592-1599. doi:10.1001/jama.2018.3185
The US Preventive Services Task Force reviewed the evidence on vitamin D, calcium, and combined supplements for the primary prevention of fractures in community-dwelling adults and found insufficient evidence to recommend their use.1
Thumb through the slides for the details, full recommendations, and take-home messages for clinicians.
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Low bone mineral density, older age, and a history of falls are major risk factors for osteoporotic fractures.
Currently, about one-third of older men and women take a vitamin D supplement and/or calcium supplement.
Community-dwelling adults are those who do not live in a nursing home or an assisted-living facility.
Included in the review were 5900 men and 41,772 women.
Four of the vitamin D studies found no significant difference in any fracture outcome.
The USPSTF found insufficient evidence to assess the balance of the benefits and harms of daily supplementation with doses greater than 400 IU of vitamin D and greater than 1000 mg of calcium for the primary prevention of fractures in community-dwelling, postmenopausal women.
The recommendations do not apply to patients with a history of osteoporotic fractures, an increased risk of falls, or a diagnosis of osteoporosis or vitamin D deficiency.
While the evidence is insufficient for recommending doses of greater than 400 IU of vitamin D and greater than 1000 mg of calcium for fracture prevention in community-dwelling older men and postmenopausal women, supplementation may be appropriate in those with deficiencies or at high risk for fracture, such as those with previous fractures.
