Vitamin D and calcium supplements do little to prevent broken bones or falls in older people – and the Government should urgently rethink its advice telling millions of Britons to take them, a bombshell study has found.
The landmark review, published in the prestigious British Medical Journal, found no clinically meaningful benefit from taking the supplements in reducing fractures or falls.
It directly challenges the long-standing NHS guidance that older adults should routinely take vitamin D to support bone health. The Health Service also recommends that those who do not get enough calcium in their diet should take a daily supplement.
Every year, NHS England spends more than £111million on vitamin D prescriptions alone – up from just £13million in 2001.
Almost a third of adults aged 65 and over suffer at least one fall a year, while half of all women will break a bone at some point in their lifetime.
Experts agree that both calcium and vitamin D, when consumed through natural means, are crucial for good bone health.
Calcium is found most abundantly in dairy products such as milk, cheese and yoghurt, as well as leafy green vegetables like kale and broccoli and oily fish.
Vitamin D is gained primarily through direct exposure to sunlight – and in smaller amounts from oily fish and egg yolks.
However, experts say there has long been scepticism over the benefits of vitamin D and calcium supplements – typically taken as daily tablets.
Vitamin D supplements and calcium may not help bone health, a major review has concluded
In an effort to assess the bone health benefit of these tablets, Canadian researchers, from CIUSSS du Nord-de-l’Île-de-Montréal, analysed the results of 69 clinical trials involving more than 153,900 adults.
They compared the effects of calcium supplements, vitamin D, or both combined, against a placebo or no treatment at all.
The verdict was damning. Calcium supplements showed little to no effect on fracture risk.
Vitamin D alone fared no better – with evidence from 36 trials involving more than 92,000 patients showing no meaningful benefit. Combining both supplements made no difference.
Crucially, the supplements failed to protect even those already diagnosed with osteoporosis – the brittle bone disease that affects some three million people in the UK.
Lead author Olivier Massé, a clinical pharmacologist, said: ‘Our review found little to no benefits from use of calcium, vitamin D, or combined supplementation on the prevention of fractures and falls.’
The team is now calling on the NHS to fundamentally reassess recommendations for both supplements.
Experts say the money spent on the pills would be far better directed towards exercise programmes and lifestyle interventions, which have been shown to make a real difference.
‘Apart from exercise and drug treatments for osteoporosis, few interventions have been consistently shown to reduce the risk of fractures,’ the researchers warned.
Experts are now looking to the government to ditch its advice for all adults over the age of 65 to take the supplement to support bone health
‘Clinicians, guideline panels, and regulatory agencies should re-evaluate their general recommendations for calcium and vitamin D supplementation in light of current evidence.’
The team also flagged that calcium supplements are poorly tolerated by many older adults, frequently causing bloating, constipation and abdominal pain, and should only be taken when absolutely necessary.
However, some experts warn that scrapping supplement advice could do more harm than good.
Public health nutritionist Dr Emma Derbyshire, from the Health and Food Supplements Information Service, argues that supplements are often crucial for patients who are dangerously deficient in vitamin D and calcium.
Around one in six adults and a fifth of children are believed to be severely-deficient in vitamin D.
Studies show that calcium deficiency is also worryingly high in young women – with a fifth of 11 to 18-year-old females consuming less than the recommended amount.
‘With vitamin D intakes from food well below recommended levels and a substantial proportion of young people already showing deficiency, alongside notable calcium intakes below safe thresholds, there is a clear and ongoing public health concern,’ says Dr Derbyshire.
‘These issues are also highly relevant in older adults, where inadequate intake can further accelerate age-related declines in bone health.
‘Those with dietary shortfalls such as vitamin D and Calcium, should carry on bridging gaps with supplementation.’
Dr Richard Abel, a musculoskeletal expert at Imperial College London, added: ‘The message is not “stop calcium and vitamin D”.
‘The message is that routine supplements should not be mistaken for proper fracture prevention. Osteoporosis is a serious, preventable and treatable disease.
‘The best way to help patients is to identify the people who are genuinely at high risk and those who may benefit from calcium and vitamin D because they are deficient or have low intake, and those who need proven osteoporosis medicines because their fracture risk is high.’
NHS England and the National Institute for Health and Care Excellence have been approached for comment.
