November 10, 2015.  An updated meta-analysis from the National Osteoporosis Foundation that was published online on October 28, 2015 in the journal Osteoporosis International supports the use of calcium and vitamin D supplements to reduce the risk of fracture in middle-aged to older men and women.

Acting on the publication of new data concerning the effect of supplementation on fracture risk, T. C. Wallace of the National Osteoporosis Foundation and colleagues selected eight randomized trials that compared calcium and vitamin D supplementation to a placebo among a total of 30,970 community-dwelling and institutionalized participants. Calcium doses used in the trials ranged as high as 1200 milligrams per day, and vitamin D doses were most often 800 international units (IU).

Over follow-up periods ranging from one to seven years, 2,231 fractures, including 195 hip fractures occurred. Supplementing with calcium and vitamin D was associated with a 15% reduction in fracture risk and 30% reduction in hip fracture risk in comparison with a placebo.

In their discussion, the authors note that vitamin D promotes calcium absorption in the gut and helps maintain adequate serum calcium concentrations, which promotes bone mineralization. They add that the vitamin is necessary for bone growth and remodeling by osteoblasts and osteoclasts and remark that the 400 IU dose used in the Women’s Health Initiative may not be high enough to influence fracture outcomes.

“Our analyses indicate that supplementation could decrease the risk of total and hip fractures by 15% and 30%, respectively, which could decrease the public health burden of osteoporotic fractures,” the authors conclude. “Additional clinical randomized clinical trials that address personal use of supplements and adherence to allocated interventions may better facilitate our understanding of the role of supplemental calcium plus vitamin D and vitamin D alone on fracture prevention. The findings from this quantitative assessment support the use of calcium plus vitamin D supplements as an intervention for fracture risk reduction in both community-dwelling and institutionalized middle-aged to older adults.”