My Healthcare News & Research — September 29, 2026 · Calcium and Vitamin D for Fractures and Falls: What the BMJ Review of 69 Trials Actually Found

On September 20, 2026, ScienceDaily ran a story under the headline “Millions take calcium and vitamin D for bone health. A major review finds little benefit.” The review it describes is real and it is large: a systematic review and meta-analysis of 69 randomised controlled trials and 153,902 adults, published in The BMJ on May 20, 2026 by a team of hospital pharmacists and pharmacy professors in Montréal. It asked one question: do calcium pills, vitamin D pills, or the two together prevent fractures and falls in people who are not already being treated for osteoporosis? Its answer, after weighing every trial it could find, was little to no benefit.

That answer matters because these two supplements are widely taken and widely recommended: a review of 34 guidelines published between 2010 and 2020, cited by the 2026 authors, found that 70 percent recommended or suggested vitamin D supplements for fracture prevention or general health. Two details are missing from the headline. First, the review is not new: the paper appeared in May, and the September story simply gave it a second wave of attention. Second, and more important, the review did find a statistically significant reduction in fractures when calcium and vitamin D were taken together — about 9 percent fewer fractures — and then judged that reduction too small to matter, using a yardstick the authors chose themselves and describe, in their own words, as “arbitrary.” That yardstick is where the published disagreement lies, and the sections below set out both readings.

What follows is a walk through the paper itself, not the press release: what it measured and in whom, the numbers for each comparison, the threshold that turned a positive result into a “no,” how the finding sits beside the Women’s Health Initiative, VITAL, the 2019 Oxford meta-analysis and the US Preventive Services Task Force, which groups fall outside the review’s conclusion, the harms on the other side of the ledger, and how the findings differ by group. In short, the review did not find that vitamin D is useless; it found that daily supplements, given mostly to people who were not deficient, did not measurably prevent fractures or falls. Those are different findings.

Table of Contents

  1. The Study at a Glance
  2. What Was Measured, and in Whom
  3. The Results, Number by Number
  4. Significant but “Not Meaningful”: the Threshold
  5. Why Bone Needs Both, and Why Pills Rarely Change the Ending
  6. How It Fits With Thirty Years of Evidence
  7. What the Review Cannot Tell You
  8. Groups Outside the Review’s Conclusion
  9. The Other Side of the Ledger: Harms
  10. What Supporters and Critics Are Saying
  11. What the Findings Show for Different Groups
  12. Sources and Primary Documents
  13. Key Research Papers
  14. Connections
  15. Featured Videos

The Study at a Glance

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What Was Measured, and in Whom

The Montréal team accepted any randomised trial in adults that compared calcium, vitamin D, or both against placebo or no treatment, provided the participants were not on drug treatment for osteoporosis, long-term steroids, or the “active” hormonal forms of vitamin D prescribed in kidney disease. Trials in which only one arm also received something else — an exercise programme, hormone therapy — were excluded, because then you cannot tell which ingredient did the work.

The primary outcome was the risk of any fracture. Secondary outcomes were hip, non-vertebral and vertebral fracture, the risk of falling at least once, and the total number of falls. Bone mineral density is not on the list: the review is about the events that hurt, not the number on a DEXA scan. This means the paper says nothing about whether supplements change bone density, a question other trials answer separately below.

The people in the trials were, on the whole, ordinary older adults. The median trial age was 71. Only 28 percent of trials studied a “high-risk” group, defined as a mean age of 80 or over, residential care, a history of fracture or falls, diagnosed osteoporosis, or a mean baseline vitamin D below 25 nmol/L (10 ng/mL) — frank deficiency. Just 9 trials (13 percent) took place in care homes. Of the 49 trials that reported baseline vitamin D, only two had a mean level in the deficient range, and 22 (32 percent of all 69 trials) had a mean below 50 nmol/L (20 ng/mL), the cut-off the review used for its second vitamin D subgroup. The typical participant was not deficient and lived at home — a different population from the frail, deficient care-home residents of the first positive trial.

Vitamin D was given daily to monthly in 71 percent of the vitamin D trials and as intermittent or single very large doses in 29 percent. The authors compared daily doses under 1,000 IU, 1,000 to 2,000 IU and over 2,000 IU; D2 with D3; women-only with mixed trials; care-home with community trials; and deficient with replete populations. None of these subgroups behaved differently from the whole — a point that cuts both ways.

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The Results, Number by Number

A risk ratio of 0.91 means the supplemented group had 91 percent of the fractures the placebo group had — a 9 percent relative reduction. The 95% confidence interval is the range within which the true effect probably lies; when it includes 1.00, the result is not statistically significant. Certainty is the GRADE verdict on how much the pooled number can be trusted, from very low to high.

Calcium alone (15 trials, 9,435 participants, mean follow-up 2.8 years)

Vitamin D alone (46 trials, 96,296 participants, mean follow-up 2.0 years)

This is the most consistent result in the paper. Across more than ninety thousand people, vitamin D on its own did not move a single fracture or fall outcome, and the certainty is high for every one of them. A meta-regression — a statistical check of whether the effect depended on how low participants’ vitamin D levels were to begin with, or how high they were pushed — found no relationship either.

Calcium plus vitamin D (16 trials, 51,172 participants, mean follow-up 2.3 years)

So the combination produced three statistically significant reductions in fractures, including at the hip. The review nevertheless concludes that the combination offers “little to no benefit.” The bridge between those two statements is the subject of the next section. One more detail belongs here first: the authors’ sensitivity analyses showed that these absolute reductions were “largely explained by one trial conducted in a very high risk population” — the 1992 French care-home trial (with its 1994 three-year follow-up) described below. In a leave-one-out analysis, removing that trial moved the any-fracture risk ratio from 0.91 to 0.96 (0.91 to 1.01), hip fracture from 0.84 to 0.88 (0.75 to 1.05) and non-vertebral fracture from 0.87 to 0.90 (0.78 to 1.05), so none of the three remained statistically significant; the authors conclude that the differences “would likely be even smaller in the general population.”

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Significant but “Not Meaningful”: the Threshold

Modern evidence grading no longer stops at “is the p-value under 0.05.” It also asks whether the size of the effect, in absolute terms, is big enough that a patient would care, and for that you need a line: a minimal clinically important difference. The problem, which the authors state plainly, is that “with no established minimal clinically important differences for fractures and falls, we determined thresholds by author consensus.” They set them in advance (“a priori”): a 2 percentage-point absolute reduction for any, non-vertebral and vertebral fracture; 0.7 points for hip fracture; 3 points for the risk of falling; five falls per 100 person-years.

Against those lines, the combination’s 1.0-point reduction in any fracture, 0.3-point reduction in hip fracture and 1.6-point reduction in non-vertebral fracture all fall short. Hence “little to no benefit.”

Critics of the threshold make the opposite case. In the pooled trials the control-group risk of hip fracture was only 1.3 to 1.8 percent, so a 0.7-point threshold requires a supplement to prevent roughly 40 to 55 percent of hip fractures before the effect counts. A reader in bioengineering quoted by the UK Science Media Centre made this point: the authors are “implying that a ‘meaningful benefit’ could be more than halving the risk of hip fractures,” and “given that there are more than 70,000 hip fractures per year in the UK with care costs of approximately £2 billion, some might consider a much smaller reduction a meaningful benefit.” Two Sydney-based researchers wrote to The BMJ in August under the title “Population impact matters when evaluating calcium and vitamin D supplementation.” The combination’s hip-fracture risk ratio of 0.84 is a 16 percent relative reduction.

The authors acknowledge this. Their limitations section says they “did not involve patient partners in establishing minimally important differences,” that they “defined arbitrary absolute effect thresholds,” and that “different teams or clinicians may have alternative definitions.” The headline “finds little benefit” therefore rests on a judgement about thresholds as well as on the data. The data show no measurable effect of vitamin D alone or of calcium alone, and about one fracture prevented per hundred people given the combination over a mean of 2.3 years — an effect largely explained by one trial in a very high-risk population. Whether an effect of that size is meaningful is the point on which the commentators below disagree.

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Why Bone Needs Both, and Why Pills Rarely Change the Ending

None of this contradicts the biology, which is settled. Calcium stiffens bone, and the blood level is defended so fiercely that when intake falls the parathyroid glands release hormone that dissolves bone to keep it up. Vitamin D is what lets the gut absorb calcium at all; without it, absorption collapses, parathyroid hormone rises, and bone is laid down but never properly mineralised — rickets in a child, osteomalacia in an adult. Correcting a genuine deficiency reverses these changes. The vitamin D deficiency pages are not in tension with this review, because the review did not study deficient people.

A fracture in an older adult usually has several causes beyond diet: decades of remodelling tipping towards resorption, loss of muscle and balance, a fall and the way a body lands. Bolland’s 2015 review (below) found that most cohort studies showed no association between dietary calcium intake and fracture. In the Women’s Health Initiative, 1,000 mg of calcium plus 400 IU of vitamin D a day left hip bone density 1.06 percent higher than placebo. A difference of about 1 percent in density is a small change in fracture risk, and a small change is hard to detect in trials lasting a few years, even with tens of thousands of participants.

Vitamin D is often described as having a plateau: once the blood level is out of the deficient range, more vitamin D adds little. The Calgary trial gave 311 healthy adults aged 55 to 70, with baseline levels of 30 to 125 nmol/L, 400, 4,000 or 10,000 IU a day for three years. Bone density at the radius ended lower with 4,000 and 10,000 IU than with 400 IU, at the tibia lower only with 10,000 IU, and estimated bone strength did not differ between the groups. Most participants in the 2026 review’s trials were not deficient at baseline, and its meta-regression found no association between vitamin D levels and treatment effect.

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How It Fits With Thirty Years of Evidence

The 2026 review follows more than three decades of trials and meta-analyses. Each landmark below was checked against its original abstract or, for the 2024 draft, the Task Force’s website.

1992 — the trial that started it (Chapuy, New England Journal of Medicine)

3,270 ambulatory French women, mean age 84, described by the 2026 authors as requiring residential care, took 1.2 g of calcium plus 800 IU of vitamin D3 a day or a double placebo for 18 months. Among the women who completed the 18 months, hip fractures were 43 percent lower and non-vertebral fractures 32 percent lower; femoral bone density, measured in 56 women, rose 2.7 percent on treatment and fell 4.6 percent on placebo. Citing the three-year results, the 2026 authors describe a 23 percent relative (2.5-point absolute) reduction in hip fracture and a 17 percent relative (3.2-point absolute) reduction in non-vertebral fracture, in women at high risk of hip fracture (11 percent over three years) with low vitamin D (mean 20 nmol/L by modern assays) and low dietary calcium (mean 513 mg a day), “many of whom may have had unrecognised osteomalacia.” This is the trial that, they say, “largely explained” the combination’s pooled benefit, and they add that its findings “were not replicated in subsequent trials.”

2006 — the Women’s Health Initiative (Jackson, NEJM)

36,282 healthy postmenopausal women, 1,000 mg calcium plus 400 IU vitamin D3 a day for an average of seven years. Hip bone density 1.06 percent higher on treatment. Hip fracture: hazard ratio 0.88 (0.72 to 1.08), not significant; among women who kept taking the pills, 0.71 (0.52 to 0.97). Kidney stones were more common on treatment: hazard ratio 1.17 (1.02 to 1.34), 449 women versus 381. Its doses, 400 IU of vitamin D and 1,000 mg of calcium, sit at the upper limit of the low-dose supplementation the US task force recommended against in postmenopausal women in 2018.

2015 — Bolland and colleagues, The BMJ

Calcium supplements reduced total fracture in 20 trials (relative risk 0.89, 0.81 to 0.96), but in the four trials at lowest risk of bias (44,505 people) there was no effect at any site, and most cohort studies found no association between dietary calcium, milk or dairy intake and fracture. Only one trial, in frail elderly women in residential care with low calcium intake and low vitamin D — a description that fits Chapuy’s — showed significant reductions in fracture.

2016 — the National Osteoporosis Foundation meta-analysis (Weaver, Osteoporosis International)

The most favourable of the pooled analyses listed here: eight trials, 30,970 participants, calcium plus vitamin D cut total fractures 15 percent (0.85, 0.73 to 0.98) and hip fractures 30 percent (0.70, 0.56 to 0.87). It pooled fewer trials than the 2026 review, and its authors list as a limitation that it used data from a subgroup analysis of the Women’s Health Initiative. Its relative estimates are larger than the 2026 review’s (0.91 for any fracture, 0.84 for hip), and its authors concluded that the evidence supports the combination for fracture risk reduction in both community-dwelling and institutionalised middle-aged to older adults.

2018 — Bolland, Grey and Avenell, Lancet Diabetes & Endocrinology

81 trials of vitamin D, 53,537 people: total fracture 1.00 (0.93 to 1.07), hip 1.11 (0.97 to 1.26), falls 0.97 (0.93 to 1.02), and similar results for high versus low doses. The 2026 vitamin-D-alone estimates are close (1.00, 1.13 and 1.01), from an any-fracture analysis about twice the size (92,415 versus 44,790 participants) that includes several large trials, with 54,383 new participants, published since the earlier reviews.

2019 — Yao and colleagues, JAMA Network Open

Vitamin D alone (11 trials, 34,243 people): any fracture 1.06 (0.98 to 1.14), hip 1.14 (0.98 to 1.32). Vitamin D with calcium (6 trials, 49,282 people): any fracture 0.94 (0.89 to 0.99), hip 0.84 (0.72 to 0.97). The 2026 review’s hip estimate for the combination, 0.84 (0.74 to 0.96), has the same point estimate. Yao and colleagues called daily combined supplementation “a more promising strategy”; Massé and colleagues call an effect of the same relative size “little to no benefit.” Overlapping trials, a similar estimate, a different yardstick.

2022 — VITAL’s bone study (LeBoff, NEJM)

25,871 American men aged 50 and over and women aged 55 and over, not selected for deficiency or low bone mass, 2,000 IU of vitamin D3 a day or placebo for a median of 5.3 years, 1,991 fractures adjudicated from records. Total fractures: hazard ratio 0.98 (0.89 to 1.08). Hip 1.01 (0.70 to 1.47). No significant effect, and no modification of the effect by baseline vitamin D level. VITAL is one of the recent large trials that, the 2026 authors write, increased the statistical power and precision of their vitamin D estimates.

The US Preventive Services Task Force, 2018 and 2024

In April 2018 the Task Force recommended against 400 IU or less of vitamin D with 1,000 mg or less of calcium in community-dwelling postmenopausal women (a D grade), found the evidence insufficient for higher doses and for men and premenopausal women, and found adequate evidence that the combination increases kidney stones. Its review covered community-dwelling adults only, and the recommendations do not apply to people with a previous osteoporotic fracture, an increased risk of falls, osteoporosis or vitamin D deficiency. On December 17, 2024 it posted a draft update that goes further: against vitamin D with or without calcium to prevent fractures in community-dwelling postmenopausal women and men aged 60 and over (a D grade), and against vitamin D to prevent falls in the same group. The comment period closed on January 21, 2025, and the topic is still listed as in progress. The BMJ review and the American draft reach the same conclusion.

Across these papers the pattern is consistent: vitamin D alone did not reduce fractures in VITAL or in the 2018, 2019 and 2026 pooled analyses of mostly non-deficient adults; calcium plus vitamin D shows a small relative reduction that depends heavily on the trial in frail, deficient, institutionalised women; and the published disagreement centres less on the numbers than on whether a one-in-a-hundred absolute benefit justifies a general recommendation.

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What the Review Cannot Tell You

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Groups Outside the Review’s Conclusion

Reading the review against the trials it pooled, four groups stand apart from the “routine supplementation” the authors argue against.

  1. People with a documented deficiency. The review classed a mean blood 25-hydroxyvitamin D below 25 nmol/L (10 ng/mL) as deficiency, and only two of its trials had a population in that range, so it did not study this group and does not claim to. Severe deficiency is the setting of osteomalacia, and correcting it is treatment rather than prevention. A vitamin D test measures the level; the vitamin D deficiency page covers who is at risk.
  2. Frail older people in residential care, especially women over 80 with a poor diet. This is the Chapuy population, the setting of the trial that drove the combination’s pooled benefit in the 2026 review. The 2026 authors write that their absolute effects “may somewhat underestimate benefits for such populations, particularly for combined supplementation.”
  3. People on osteoporosis medication. Trials of bisphosphonates, denosumab, teriparatide and romosozumab nearly all gave calcium, vitamin D or both as background treatment, and some of these drugs can lower blood calcium sharply when vitamin D is low. In those trials the supplement was part of the treatment regimen, and the 2026 review excluded such patients by design.
  4. People on long-term corticosteroids or with specific bone disorders — named by the authors as outside the reach of their conclusion.

Not on the list: the generally healthy older adult with a normal diet, a normal blood level and no fracture, taking a daily calcium-and-D tablet “for her bones.” That is the population the review, WHI, VITAL and the US task force studied, and in it the evidence of benefit ranges from very small to none.

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The Other Side of the Ledger: Harms

The review’s discussion of harms centres on calcium tablets. For vitamin D at ordinary daily doses the evidence of harm is weaker: in VITAL, 2,000 IU a day for a median of 5.3 years produced no substantial between-group differences in adverse events.

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What Supporters and Critics Are Saying

The linked editorial. The BMJ paired the paper with an editorial by three Canadian authors (University of Alberta, University of Toronto, University of Montreal). The paper itself closes by saying that “clinicians, guideline panels, and regulatory agencies should re-evaluate their general recommendations.” According to the BMJ’s press release, the editorial says that rigorous, well-powered trials are needed to inform recommendations for higher-risk groups, and suggests that focus and funding be redirected towards interventions shown to prevent falls and fall-related injuries, such as balance and resistance exercise and programmes combining exercise, hazard assessment or education tailored to individual risk.

Supporters point to the consistency of the vitamin-D-alone null across 36 trials and 92,000 people, the pre-registration, the GRADE assessment, and the similarity of the estimates across independent pooled analyses. A professor of clinical endocrinology at King’s College London told the Science Media Centre that the review “is consistent with previous similar studies,” that the authors “performed appropriate subgroup analyses,” and that the combined effect on fracture risk “did reach statistical significance” but, as the authors highlight, “the absolute benefit was very small and not considered clinically meaningful.” The reader in bioengineering quoted above called it “a rigorous and well conducted meta-analysis of existing research.” A geriatrics commentary on McMaster University’s evidence service said the review “highlights an opportunity for deprescribing in some populations.”

Critics concentrate on three things. The thresholds: a 0.7-point hip-fracture line against a 1.3 to 1.8 percent background rate requires a very large relative effect, and three statistically significant results are set aside by thresholds the authors themselves call arbitrary. Population impact: a 16 percent relative reduction in hip fracture, applied to millions of older adults, would amount to a large absolute number — the point of the Science Media Centre comment on UK hip fractures and the subject of the August letter titled “Population impact matters.” Generalisability: the review’s trials were 87 percent community-dwelling and 73 percent not high-risk, and only two had a deficient population, so the evidence for the groups in whom supplementation was first tested is thin — a limitation the authors acknowledge in their caveats about care homes, osteoporosis drugs and specific bone disorders.

What neither side disputes is the vitamin-D-alone result. None of the commentary cited here argues that a daily vitamin D tablet, given to a non-deficient older adult, prevents fractures. The argument is about the pair, and about the frail.

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What the Findings Show for Different Groups

The evidence reads differently for three broad groups.

Generally healthy adults taking calcium and vitamin D without a measured deficiency, a fracture or a bone drug. This review, WHI, VITAL and the US task force all found little or no fracture benefit from the supplements in this group. The 2026 authors write that, apart from exercise and drug treatment for osteoporosis, few interventions with moderate or high certainty evidence have been consistently shown to reduce fractures; that in Cochrane reviews of fall prevention, exercise and environmental modifications “appear promising”; and they list dietary strategies, drug review, educational or behavioural approaches and multicomponent interventions as areas for future trials. Resistance and balance exercise has its own page. The US task force recommends osteoporosis screening, by bone density scan, for women 65 and older and for younger postmenopausal women at increased risk, and found the evidence insufficient for men; osteoporosis found this way is treated with drug therapy, one of the few interventions the 2026 authors list as reducing fractures. The fracture prevention page covers fall and fracture risk in more detail.

People whose vitamin D level is unknown but may be low. Commonly listed risk factors for deficiency include little sun exposure, covered skin, dark skin at high latitudes (skin pigment and latitude both lengthen the sun exposure needed to make vitamin D), older age or being housebound, and coeliac disease, Crohn’s disease or bariatric surgery. A blood test measures the level. Correcting a deficiency is treatment, which this review did not study and does not argue against. On dosing, the trials above found more falls and fractures after a single annual 500,000 IU dose, and lower radial bone density after three years of 4,000 or 10,000 IU a day than of 400 IU.

People on an osteoporosis drug, on long-term steroids or with a diagnosed bone disorder, and people in residential care or with a previous fragility fracture. For the first three groups the authors state that their results “may not be generalisable”; for people in residential care and other high-risk groups they write that the evidence was limited and that their absolute effects may underestimate benefits. In the osteoporosis drug trials, calcium and vitamin D were part of the treatment regimen. Decisions about medicines and supplements belong with a clinician.

Two further findings apply across groups. Calcium from food — dairy, sardines with their bones, leafy greens, almonds — has been associated with fewer kidney stones in cohort studies, and the heart-attack signal discussed above concerns supplements rather than dietary calcium. Of the two main natural sources of vitamin D, sunlight and oily fish, synthesis in the skin is self-limiting: during prolonged exposure, previtamin D3 plateaus at about 10 to 15 percent of the skin’s 7-dehydrocholesterol and the excess is converted to biologically inert isomers. The review does not say the nutrients are unimportant. Its finding is that supplementing populations who were mostly not deficient did little to prevent fractures or falls, and its authors call on clinicians, guideline panels and regulatory agencies to re-evaluate their general recommendations.

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Sources and Primary Documents

Every number attributed to the review was taken from the open-access full text of the paper, not from the press release. Expert comments are attributed to the outlet that published them.

  1. Massé O, Mercurio CM, Dupuis S, Al Sahwi M, Arruda A, Dallaire G, Desforges K, Dugré N, Williamson D (2026). Calcium, vitamin D, or combined supplementation to prevent fractures and falls: systematic review and meta-analysis. BMJ 393:e088050. — doi:10.1136/bmj-2025-088050 · open-access full text at Europe PMC (PMC13188451) · PubMed PMID: 42161415
  2. Pillay J, Reynolds DL, Thériault G (2026). Calcium, vitamin D, or combined supplementation to prevent fractures and falls. BMJ 393:s913 (linked editorial). — doi:10.1136/bmj.s913
  3. BMJ Group press release, May 20, 2026. Recommendations for calcium and vitamin D supplementation should be re-evaluated, suggest researchers. bmjgroup.com
  4. ScienceDaily, September 20, 2026. Millions take calcium and vitamin D for bone health. A major review finds little benefit. sciencedaily.com
  5. Science Media Centre (UK), May 20, 2026. Expert reaction to meta-analysis looking at evidence for vitamin D supplementation and fracture and fall prevention in older people. sciencemediacentre.org
  6. Nguyen TV, Tran TS (2026). Population impact matters when evaluating calcium and vitamin D supplementation. BMJ 394:e100495 (letter, August 7, 2026). — doi:10.1136/bmj-2026-100495
  7. Avenell A, Grey A, Macleod AD, Bolland MJ (2026). Healthcare expenditure on vitamin D supplementation. BMJ 394:e100477 (letter, August 5, 2026). — doi:10.1136/bmj-2026-100477
  8. US Preventive Services Task Force (2018). Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: Recommendation Statement. JAMA. — doi:10.1001/jama.2018.3185
  9. US Preventive Services Task Force, December 17, 2024. Draft Recommendation Statement: Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Falls and Fractures in Community-Dwelling Adults (public-comment announcement). uspreventiveservicestaskforce.org
  10. McMaster Optimal Aging Portal. Evidence summary and clinician commentary on Massé et al. 2026. mcmasteroptimalaging.org

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Key Research Papers

The background literature discussed above. Each entry was checked against Crossref or PubMed before it was written down, and the abstract of each was read for the claim it supports.

  1. Chapuy MC, Arlot ME, Duboeuf F, et al. (1992). Vitamin D3 and Calcium to Prevent Hip Fractures in Elderly Women. New England Journal of Medicine 327(23):1637-1642. — doi:10.1056/NEJM199212033272305
  2. Jackson RD, LaCroix AZ, Gass M, et al.; Women’s Health Initiative Investigators (2006). Calcium plus Vitamin D Supplementation and the Risk of Fractures. New England Journal of Medicine 354(7):669-683. — doi:10.1056/NEJMoa055218
  3. Wallace RB, Wactawski-Wende J, O’Sullivan MJ, et al. (2011). Urinary tract stone occurrence in the Women’s Health Initiative (WHI) randomized clinical trial of calcium and vitamin D supplements. American Journal of Clinical Nutrition 94(1):270-277. — doi:10.3945/ajcn.110.003350
  4. Sanders KM, Stuart AL, Williamson EJ, et al. (2010). Annual High-Dose Oral Vitamin D and Falls and Fractures in Older Women: A Randomized Controlled Trial. JAMA 303(18):1815-1822. — doi:10.1001/jama.2010.594
  5. Bolland MJ, Leung W, Tai V, et al. (2015). Calcium intake and risk of fracture: systematic review. BMJ 351:h4580. — doi:10.1136/bmj.h4580
  6. Weaver CM, Alexander DD, Boushey CJ, et al. (2016). Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporosis International 27(1):367-376. — doi:10.1007/s00198-015-3386-5
  7. Bolland MJ, Grey A, Avenell A (2018). Effects of vitamin D supplementation on musculoskeletal health: a systematic review, meta-analysis, and trial sequential analysis. Lancet Diabetes & Endocrinology 6(11):847-858. — doi:10.1016/S2213-8587(18)30265-1
  8. Burt LA, Billington EO, Rose MS, Raymond DA, Hanley DA, Boyd SK (2019). Effect of High-Dose Vitamin D Supplementation on Volumetric Bone Density and Bone Strength: A Randomized Clinical Trial. JAMA 322(8):736-745. — doi:10.1001/jama.2019.11889
  9. Yao P, Bennett D, Mafham M, et al. (2019). Vitamin D and Calcium for the Prevention of Fracture: A Systematic Review and Meta-analysis. JAMA Network Open 2(12):e1917789. — doi:10.1001/jamanetworkopen.2019.17789
  10. LeBoff MS, Chou SH, Ratliff KA, et al. (2022). Supplemental Vitamin D and Incident Fractures in Midlife and Older Adults. New England Journal of Medicine 387(4):299-309. — doi:10.1056/NEJMoa2202106
  11. Chapuy MC, Arlot ME, Delmas PD, Meunier PJ (1994). Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women. BMJ 308(6936):1081-1082. — PubMed PMID: 8173430
  12. Holick MF, MacLaughlin JA, Doppelt SH (1981). Regulation of cutaneous previtamin D3 photosynthesis in man: skin pigment is not an essential regulator. Science 211(4482):590-593. — PubMed PMID: 6256855
  13. Curhan GC, Willett WC, Speizer FE, Spiegelman D, Stampfer MJ (1997). Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women. Annals of Internal Medicine 126(7):497-504. — PubMed PMID: 9092314
  14. US Preventive Services Task Force; Grossman DC, Curry SJ, Owens DK, et al. (2018). Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: US Preventive Services Task Force Recommendation Statement. JAMA 319(15):1592-1599. — PubMed PMID: 29677309
  15. US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. (2025). Screening for Osteoporosis to Prevent Fractures: US Preventive Services Task Force Recommendation Statement. JAMA 333(6):498-508. — PubMed PMID: 39808425
  16. Massé O, Mercurio CM, Dupuis S, Al Sahwi M, Arruda A, Dallaire G, Desforges K, Dugré N, Williamson D (2026). Calcium, vitamin D, or combined supplementation to prevent fractures and falls: systematic review and meta-analysis. BMJ 393:e088050. — PubMed PMID: 42161415

PubMed Topic Searches

  1. PubMed: Calcium and vitamin D supplementation for fracture prevention, meta-analyses
  2. PubMed: Vitamin D supplementation and falls in older adults
  3. PubMed: Calcium supplements, kidney stones and cardiovascular risk

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Connections

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