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The results of 19 randomized clinical trials with vitamin D with or without calcium show varying results: a decreased fracture incidence in 7, neutral in 10 trials, whereas 2 trials with a high dose of vitamin D once per year showed an increased fracture incidence. In one of these trials, a statistically significant fracture reduction was observed in nursing home residents having severe vitamin D deficiency, low calcium intake and good compliance. Thirteen meta-analyses were done, and 11 of these showed a significantly decreased fracture incidence in the supplemented groups.
Analyses for vertebral fractures were negative in all cases.
Abstract
Vitamin D deficiency is associated with fractures. The results of 19 randomized clinical trials with vitamin D with or without calcium show varying results: a decreased fracture incidence in 7, neutral in 10 trials, whereas 2 trials with a high dose of vitamin D once per year showed an increased fracture incidence.
In three out of four well-powered trials that used recommended doses of vitamin D 700–1000 IU per day, vitamin D supplementation did not significantly influence fracture risk. In one of these trials, a statistically significant fracture reduction was observed in nursing home residents having severe vitamin D deficiency, low calcium intake and good compliance. Thirteen meta-analyses were done, and 11 of these showed a significantly decreased fracture incidence in the supplemented groups.
Evidence-Based Answer:
14 meta-analysis of 15 trials (quasi-random and RCT) with a total of 28,271 patients that compared the effect of vitamin D on fracture risk with placebo or no treatment, found no benefit for vitamin D supplementation (TABLE).1 Patients lived in community and nursing home settings and ranged in age from 50 to 85 years; 24% to 100% were female. Only 3 trials required patients to have had a previous fracture. Vitamin D analogs generally have no benefit either
The same meta-analysis compared vitamin D analogs to placebo or no treatment (8 trials, quasi-random and RCT, 1743 patients) on the risk of fracture, again finding no benefit in all but one case.
Included patients were mostly by referral to tertiary or university hospitals and outpatient community settings.
Calcium And Vitamin D: A Partnership
Calcium and vitamin D is the dynamic duo that works together to strengthen and protect your bones. “Calcium supplements can increase calcification in the arteries and predispose people, especially women, to heart disease,” he says.
“That’s why we always prefer dietary calcium. However, some people get adequate dietary calcium but are low in vitamin D.”.