A major new review has concluded that vitamin D and calcium supplements provide little to no benefit in preventing broken bones or falls among older people, prompting calls for the Government to urgently reconsider its current advice. The landmark study, published in the British Medical Journal, found no clinically meaningful effect from taking these supplements on fracture or fall risk.
Challenging long-standing NHS guidance
The findings directly challenge NHS recommendations that older adults should routinely take vitamin D to support bone health. The health service also advises those with insufficient dietary calcium to take daily supplements. Currently, NHS England spends over £111 million annually on vitamin D prescriptions alone, a dramatic rise from just £13 million in 2001.
Almost a third of adults aged 65 and over experience at least one fall each year, while half of all women will suffer a fracture at some point in their lives. Experts agree that naturally obtained calcium and vitamin D are vital for bone health. Calcium is abundant in dairy products, leafy greens, and oily fish, while vitamin D is primarily synthesised through sunlight exposure, with smaller amounts from oily fish and egg yolks.
Review of 69 clinical trials
Canadian researchers from CIUSSS du Nord-de-l'Île-de-Montréal analysed 69 clinical trials involving over 153,900 adults. They compared the effects of calcium supplements, vitamin D, or both combined, against a placebo or no treatment. The results were unequivocal: calcium supplements showed little to no effect on fracture risk, and vitamin D alone performed no better, with evidence from 36 trials involving more than 92,000 patients showing no meaningful benefit. Combining both supplements made no difference.
Importantly, the supplements failed to protect even those diagnosed with osteoporosis, a brittle bone condition affecting around three million people in the UK. Lead author Olivier Massé, a clinical pharmacologist, stated: 'Our review found little to no benefits from use of calcium, vitamin D, or combined supplementation on the prevention of fractures and falls.'
Calls for policy change
The research team urges the NHS to fundamentally reassess its recommendations. They argue that the money spent on pills would be better directed towards exercise programmes and lifestyle interventions proven 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. 'Clinicians, guideline panels, and regulatory agencies should re-evaluate their general recommendations for calcium and vitamin D supplementation in light of current evidence.'
The study also highlighted that calcium supplements are poorly tolerated by many older adults, frequently causing bloating, constipation, and abdominal pain, and should only be used when absolutely necessary.
Counterarguments from nutrition experts
However, some experts caution that abandoning supplement advice could cause harm. Public health nutritionist Dr Emma Derbyshire from the Health and Food Supplements Information Service argues that supplements are crucial for patients severely 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, and calcium deficiency is worryingly high among young women, with a fifth of 11 to 18-year-old females consuming less than recommended amounts.
'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.'
NHS England and the National Institute for Health and Care Excellence have been approached for comment.
