A comprehensive scientific review has concluded that vitamin D supplements do not prevent falls or fractures in older individuals, contradicting long-standing health advice. The NHS currently recommends that people in the UK take vitamin D supplements during autumn and winter to maintain bone health, as the body cannot produce enough from sunlight alone.
Study Findings
The review, published in the British Medical Journal, analyzed 69 clinical trials involving 153,902 participants. Researchers found that vitamin D, calcium, or combined supplementation had "little to no effect" on the risk of any fracture, including hip fractures, or on falls. They stated their findings "do not support" routine use of these supplements for fracture prevention.
Expert Commentary
Lead researcher Olivier Massé, a pharmacy expert at CIUSSS du Nord-de-l'Île-de-Montréal in Canada, said: "The findings show that calcium, vitamin D, or combined supplementation does not prevent fractures or falls. Efforts and funding should be redirected from supplementation to ensuring access to proven interventions."
The research team noted that about 30% of people aged 65 and older, and over half of nursing home residents, experience falls annually, with 5% resulting in fractures. They emphasized that supplements were once seen as an "effortless and inexpensive solution to a complex problem."
Role of Vitamin D
Vitamin D helps regulate calcium and phosphate levels in the body, which are essential for healthy bones, teeth, and muscles. A deficiency can lead to bone deformities like rickets in children and osteomalacia in adults. However, the review suggests that supplementation may not be effective for the general population.
The researchers acknowledged that their findings might not apply to individuals with specific bone disorders or osteoporosis. They also warned that people who take supplements may have healthier lifestyles overall, a phenomenon known as "reverse causation," which could explain why earlier observational studies suggested benefits.
Alternative Ways to Support Bone Health
Experts recommend exercise, particularly resistance training, to boost muscle and bone health. Additionally, conducting a "hazard assessment" of homes could help prevent falls.
Good Sources of Vitamin D and Calcium
While the body produces vitamin D from sunlight, during the UK's autumn and winter months, dietary sources become crucial. Foods rich in vitamin D include:
- Oily fish such as salmon, sardines, trout, herring, or mackerel
- Red meat
- Egg yolks
- Fortified foods like fat spreads and breakfast cereals
- Liver
For calcium, the NHS recommends a daily intake of 700mg for adults aged 19 to 64. Good sources include dairy products, leafy greens, and fortified foods. If supplements are necessary, doctors often prescribe combined calcium and vitamin D tablets to support bone health and prevent osteoporosis.
