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Older community-dwelling adults do not benefit from calcium, vitamin D, or both regarding fracture prevention, according to a large new meta-analysis. Researchers combined 33 randomized, clinical trials that included more than 51,000 participants ≥ 50 years of age to determine whether calcium supplements, vitamin D, or the combination affected fracture incidence. The risk ratios (RR) vs. placebo were 1.53 for calcium alone, 1.21 for vitamin D alone, and 1.09 for the combination. No significant associations were found between calcium, vitamin D, or combined calcium and vitamin D supplements or the incidence of nonvertebral, vertebral, or total fractures. The results were consistent regardless of the dose of vitamin D or calcium, sex, fracture history, dietary calcium intake, or baseline serum 25-hydroxyvitamin D concentration. The authors concluded that “these findings do not support the routine use of these supplements in community-dwelling older people.” (JAMA 2017;318:2466-2482). Current practice guidelines recommend calcium and vitamin D, but with mounting evidence of no benefit and potential harm (coronary artery disease, kidney stones, etc.), those guidelines may change.
Financial Disclosure: To reveal any potential bias in this publication, and in accordance with Accreditation Council for Continuing Medical Education guidelines, Dr. Elliott, Ms. Coplin, Mr. Springston, and Editorial Group Manager Terrey L. Hatcher report no financial relationships relevant to this field of study.
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