Vitamin D does not prevent fractures and falls

doi:10.1136/bmjebm-2018-111129

Paper

Vitamin D does not prevent fractures and falls

Published Apr 3, 2019 · C. Heneghan, K. Mahtani

BMJ Evidence-Based Medicine

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Abstract

Whether vitamin D improves bone health has been unclear—that is until now. Early evidence suggested benefit, but a recent systemic review concludes there is no effect on fractures, falls or bone mineral density in primary prevention. ### EBM Verdict EBM Verdict on: effects of vitamin D supplementation on musculoskeletal health: a systematic review, meta-analysis, and trial sequential analysis. Lancet Diabetes Endocrinol 2018;6(11):847–58. doi: 10.1016/S2213-8587(18)30265-1. Many prominent bodies have recommended vitamin D supplementation in largely well people for the prevention of fractures.1 Whether this recommendation is correct, however, it has been unclear. That is until now. In 2016, the Public Health England advised everyone should consider taking a daily supplement of vitamin D in autumn and winter ‘to help …

Study Snapshot

Vitamin D supplementation does not prevent fractures, falls, or bone mineral density in primary prevention.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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Vitamin D does not prevent fractures and falls

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References

Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: US Preventive Services Task Force Recommendation Statement

The USPSTF finds insufficient evidence to assess the benefits and harms of vitamin D and calcium supplementation for the primary prevention of fractures in community-dwelling adults.

Public Health England recommends vitamin D supplements in autumn and winter

Daily supplements containing 10 micrograms of vitamin D in autumn and winter are recommended for bone and muscle health, as it is difficult to meet this intake from dietary sources.

Re: Urinary tract stone occurrence in the Women's Health Initiative (WHI) randomized clinical trial of calcium and vitamin D supplements.

Daily calcium and vitamin D supplementation for 7 years is associated with an increase in self-reported urinary tract stone occurrence.

Addressing the Musculoskeletal Components of Fracture Risk with Calcium and Vitamin D: A Review of the Evidence

Calcium and vitamin D supplementation effectively reduces osteoporotic fracture risk in the elderly by improving bone mineral density, reducing falls, and addressing musculoskeletal risk factors.

Why Most Published Research Findings Are False

Most published research findings are false due to study power, bias, and the number of other studies on the same question, with less likely findings in smaller studies, smaller effect sizes, and more flexible designs.

Citations

Lower 25-hydroxyvitamin D (25OHD) levels, diabetes and age are associated with foot and ankle fracture treatment complications

Lower 25-hydroxyvitamin D levels, diabetes, and age are associated with treatment complications in patients with foot and ankle fractures.

Calcium and vitamin D for increasing bone mineral density in premenopausal women.

Calcium and vitamin D supplementation does not show a clinical difference in bone mineral density improvement in premenopausal women compared to placebo.

Effects of vitamin D with or without calcium on pathological ossification: A retrospective clinical study

Vitamin D alone can alleviate pathological ossification in joints, while vitamin D combined with calcium may aggravate it, with the bidirectional action on bone metabolism depending on exogenous calcium supplementation.

Associations between Physical Activity, Sunshine Duration and Osteoporosis According to Obesity and Other Lifestyle Factors: A Nested Case–Control Study

Higher intensity of physical activity and long sunshine duration can decrease the risk of osteoporosis in most individuals, except males and underweight, and in young females, obese individuals, nonsmokers, and individuals with lower alcohol consumption.