The study, "Effects of vitamin D supplementation on musculoskeletal health: a systematic review, meta-analysis, and trial sequential analysis,” aimed to determine the effect of vitamin D supplementation on fractures, falls, and bone density.
In this systematic review, random-effects meta-analysis, and trial sequential analysis, the researchers used findings from literature searches in previously published meta-analyses, along with findings from PubMed, Embase, and Cochrane Central. They assessed randomized controlled trials of adults (>18 years) that compared vitamin D with untreated controls, placebo, or lower-dose vitamin D supplements. Eligible studies included outcome data for total or hip fractures, falls, or bone mineral density measured at the lumbar spine, total hip, femoral neck, total body, or forearm.
In pooled analyses, the researchers found vitamin D had no effect on total fracture (36 trials; n=44 790, relative risk 1·00, 95% CI 0·93–1·07), hip fracture (20 trials; n=36 655, 1·11, 0·97–1·26), or falls (37 trials; n=34 144, 0·97, 0·93–1·02). Results were similar in randomized controlled trials of high-dose versus low-dose vitamin D and in subgroup analyses of randomized controlled trials using doses greater than 800 IU per day. In pooled analyses, there were no clinically relevant between-group differences in bone mineral density at any site (range −0·16% to 0·76% over 1–5 years).
The researchers concluded these findings suggest that vitamin D supplementation does not prevent fractures or falls, or have clinically meaningful effects on bone mineral density, and that there is little justification to use vitamin D supplements to maintain or improve musculoskeletal health.
“We were shocked when this study came out because of its total disregard for the wealth of scientific research and medical guidance in the U.S. and around the world. Vitamin D is critical to supporting bone mineral density and a daily supplement at the advice of a doctor is an excellent way for people to get the right amount,” said Daniel Fabricant, PhD, president and CEO of the Natural Products Association (NPA).
According to the National Osteoporosis Foundation, “too many Americans fall short of getting the amount of calcium they need every day and that can lead to bone loss, low bone density and even broken bones.”
NPA added that health organizations in the U.S. and around the world advocate for sufficient vitamin D intake:
- The United States Food and Drug Administration guidance allowed on vitamin D supplements states that “adequate calcium throughout life, as part of a well-balanced diet, may reduce the risk of osteoporosis.”
- The 2011 Dutch Guideline on Osteoporosis and Fracture Prevention (CBO Guideline) advises in the case of patients taking medication to prevent fractures to aim for a total calcium intake (diet and supplements) of 1,000- 1,200 mg calcium per day and an intake of vitamin D supplements of 800 IU per day.
- Canadian guidelines advise intake of 1,200 mg calcium daily in women 50 years and older and men 70 years and older. The vitamin D intake in elderly persons should be 1,000-1,200 IU daily.
- The Australian guideline advises for women over 50 years of age a calcium intake of 1,300 mg per day and a vitamin D intake of 800 IE.