Taking extra vitamin D and calcium will not prevent fractures in seniors

Surprising new research has found that taking vitamin D or calcium does not help prevent repeat fractures in elderly people. In two studies by teams at Aberdeen and York universities, researchers looked at people who had already had a fracture due to osteoporosis, a condition which increases a person's risk of bone fractures.

Many older people take vitamin D and calcium to try to protect their bones, but the study found those taking supplements did not have fewer fractures. Osteoporosis campaigners however say taking supplements of Vitamin D and calcium are not harmful, but do advise elderly people concerned about their bone health to eat a healthy balanced diet. Vitamin D can be obtained from foods including fatty fish like salmon, and milk products.

Professor Adrian Grant and his researchers, randomly assigned the 5,300 people over 70 taking part in the study, recruited from 21 hospitals across the UK, either to take a dummy pill, a daily supplement of vitamin D, calcium or both supplements together.

They were then followed up for between 24 and 62 months. In that time a total of 698 people experienced a fracture, but the incidence of fracture did not differ between the groups.

A second study looked at 3,314 women aged 70 and over at high risk of hip fracture, half were given calcium and vitamin D tablets to take daily, the rest just received a leaflet on diet and prevention of falls. All were monitored for an average of two years and fracture rates in the two groups were not significantly different.

The studies only examined the effect of taking vitamin D and/or calcium on people who had already had a fracture, but were taking no other medication. They did not look at people taking bisphosphonates, drugs which stop further loss of bone mass, or people living in care homes. According to previous studies both these groups do benefit from taking vitamin D and calcium.

Professor Adrian Grant, who led the research, said older, frailer people were more likely to have vitamin D deficiency and therefore to benefit from supplements. He says their study indicates that routine supplementation with calcium and vitamin D, either alone or in combination, is not effective in the prevention of further fractures. The research also confirms that the use of bone active drugs may be a more appropriate approach.

Grant said people should not be worried if they take the supplements as Vitamin D and calcium are not harmful, and there are no adverse effects, though calcium can be very hard to chew and swallow and may cause stomach upsets and indigestion.

But Professor Philip Sambrook of the University of Sydney, does point out that the Aberdeen study found only two thirds of people were still taking their pills after two years, and patients in this study were younger than in other research which had shown a benefit from taking vitamin D.

Jackie Parrington, deputy chief executive of the National Osteoporosis Society, says the results shows that the benefits of calcium and vitamin D as a treatment option to prevent further fractures are uncertain.

Parrington says better knowledge about what are the most effective types of drug treatments to give to people at certain ages is helpful, and older people who feel they are at risk of breaking a bone because of osteoporosis should consider eating a healthy, well mixed diet to ensure they get the full range of vitamins and minerals. She says they would encourage everyone to get vital nutrients from food rather than buying supplements. They should also discuss their risks with their GP.