A recent investigation published by the British Medical Journal (BMJ) raises significant concerns about the effectiveness of calcium and vitamin D supplementation in preventing bone fractures and falls. This comprehensive review synthesised data from 69 trials conducted between 2014 and February 2025, encompassing a total of 153,902 participants. A notable 87 per cent of these individuals were community-dwelling, and 73 per cent were classified as not being at a heightened risk of such injuries.
Study Findings Challenge Long-Standing Beliefs
The research concluded that there is minimal to no advantage in using calcium, vitamin D, or a combination of both to avert fractures and falls. “Based on absolute risk reductions and thresholds considered clinically meaningful, this review found little to no benefits from the use of calcium, vitamin D, or combined supplementation on the prevention of fractures and falls,” the authors stated. They further noted that aside from exercise and pharmaceutical treatments for osteoporosis, few interventions with moderate to high evidence certainty have consistently demonstrated an ability to reduce fracture risk.
Olivier Massé, a pharmacist affiliated with CIUSSS du Nord-de-l’île-de-Montréal and a co-author of the study, expressed that these findings align with a growing body of work questioning the routine supplementation practices in adults. “Our findings actually align with a growing body of evidence over the last decade that has cast doubt on the usefulness of routine supplementation in adults,” Massé conveyed in a communication with Global News.
The Importance of Individual Health Context
Massé emphasised that the study’s results should not dissuade individuals from taking their calcium and vitamin D supplements outright. “There are still many valid indications for taking calcium and vitamin D, such as when on osteoporosis medication, long-term corticosteroids, or for certain bone or endocrine diseases, particularly following bariatric surgery,” he clarified.
David Goltzman, a professor of medicine and physiology at McGill University, underscored a crucial takeaway from the study: “If you’re already vitamin D sufficient, you don’t need more vitamin D and calcium.” He pointed out that a lack of vitamin D would hinder calcium absorption, which is vital for bone health. However, many individuals are unaware of their vitamin D status, as routine checks are not commonly performed.
Seasonal Variability and Its Impact
Goltzman further noted that seasonal changes can affect vitamin D levels. “During the winter months, there is less exposure to sun, and vitamin D levels may go down, only to rise again in the summer months when sun exposure increases,” he explained. While this fluctuation does not imply that everyone in Canada is vitamin D deficient during winter, it does highlight the need for awareness around individual vitamin D levels.
The study advocates for future research to explore interventions beyond calcium and vitamin D supplementation for fracture and fall prevention. Potential avenues for investigation could include dietary approaches, drug reviews, educational initiatives, and innovative digital tools aimed at fall prevention.
Recommendations for Maintaining Bone Health
Both Massé and Goltzman agree on the importance of regular physical activity and a nutrient-rich diet to support adequate levels of vitamin D and calcium. “Once they have a diagnosis or they’ve had a fracture, then everything changes,” Goltzman cautioned, suggesting that preventative measures should be prioritised.
Why it Matters
The implications of this study are profound, as they challenge a widely accepted paradigm in preventive health strategies for older adults. With an ageing population, the need for effective interventions to prevent fractures and falls is crucial. The findings suggest that healthcare providers may need to reassess the routine recommendation of calcium and vitamin D supplements, redirecting focus towards more effective strategies like exercise and dietary adjustments. This pivotal shift could herald a new era in how we approach bone health, ultimately enhancing the quality of life for countless individuals.
