Bottom Line: Supplements containing calcium, vitamin D or both did not appear to protect against hip fracture and other bone breaks in older adults.

Why The Research Is Interesting: Practice guidelines recommend calcium and vitamin D supplements for older people to prevent fractures in those with osteoporosis; previous studies have come to mixed conclusions about an association between supplements and fracture risk.

Who and What: 51,145 adults over 50 who lived in their communities and not institutions, such as nursing homes and residential care facilities; the adults participated in 33 randomized clinical trials comparing supplement use (calcium, vitamin D or both) with placebo or no treatment and new fractures.

How (Study Design): This was a meta-analysis. A meta-analysis combines the results of multiple studies identified in a systematic review and quantitatively summarizes the overall association between the same exposure (supplements containing calcium, vitamin D or both) and outcomes (fracture) across all studies.

Authors: Jia-Guo Zhao, M.D., Tianjin Hospital, Tianjin, China, and coauthors

Results: Supplements were not associated with less risk for new fractures, regardless of the dose, the sex of the patient, their fracture history, calcium intake in their diet or baseline vitamin D blood concentrations.

Study Limitations: Some trials included in the analysis didn't test baseline vitamin D blood concentration for all participants; the results for some subgroups might have been different if all individuals were tested.

Study Conclusions: These findings do not support routine use of supplements containing calcium, vitamin D, or both by older community-dwelling adults for prevention of fracture.

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