USPSTF advises against vitamin D, calcium to prevent fractures in adults

After its recent review, the US Preventive Services Task Force (USPSTF) could not recommend supplementation with vitamin D and calcium for the primary prevention of fractures in healthy adults.

The USPSTF made its recommendations in the May 7, 2013, issue of the Annals of Internal Medicine. The study was led by Virginia A. Moyer, MD, MPH, on behalf of the USPSTF.

The organization commissioned 2 systematic evidence reviews and a meta-analysis on vitamin D supplementation with or without calcium, to assess the effects of supplementation on bone health outcomes in community-dwelling adults. It also assessed the adverse effect of supplementation.

The USPSTF considered 6 randomized trials that evaluated the use of vitamin D and calcium supplementation. The trials were conducted with “community-dwelling adults,” fewer than 26% of whom had a history of fractures. Study researchers found no statistically signficant reduction in fractures.

In the largest study of 36,282 healthy postmenopausal women, dubbed WHI, nearly 30% of study participants were already taking 500 or more mg of calcium daily before the state of the trial.

The USPSTF stated in the Annals of Internal Medicine, “The USPSTF could not generalize the results of the WHI trial beyond the specific dose, preparation, and population studied.”

As a result, “The USPSTF concludes that the current evidence is insufficient to assess the balance of the benefits and harms of daily supplementation with greater than 400 IU of vitamin D and 1,000 mg or less of calcium for the primary prevention of fractures in noninstitutionalized postmenopausal women.”

The USPSTF recommends against daily supplementation with 400 IU or less of vitamin D and 1,000 mg or less of calcium for the primary prevention of fractures in noninstitutionalized postmenopausal women.

However, the USPSTF previously concluded in a separate recommendation that vitamin D supplementation is effective in preventing falls in community-dwelling adults 65 years of age or older who are at increased risk for falls.