Contrary to popular belief, taking vitamin D supplements don’t help bone health. This is the conclusion of the largest meta-analysis to date, which includes data from 81 randomised controlled trials. Furthermore, the study found no differences in the effects of higher versus lower doses of vitamin D.
The authors conclude that there is little justification to use vitamin D supplements to maintain or improve musculoskeletal health, except for the prevention of rare conditions such as rickets and osteomalacia in high-risk groups, which can occur due to vitamin D deficiency after a prolonged lack of exposure to sunshine.
Vitamin D supplements have long been recommended for older people to treat or prevent osteoporosis, with some early evidence suggesting benefits for bone health. However, recent large-scale reviews have reported no effect of vitamin D supplementation on bone mineral density, falls or fractures.
“Since the last major review of the evidence in 2014, more than 30 randomised controlled trials on vitamin D and bone health have been published, nearly doubling the evidence base available. Our meta-analysis finds that vitamin D does not prevent fractures, falls or improve bone mineral density, whether at a high or low dose. Clinical guidelines should be changed to reflect these findings. On the strength of existing evidence, we believe there is little justification for more trials of vitamin D supplements looking at musculoskeletal outcomes,” said lead author Dr Mark J Bolland, University of Auckland, New Zealand.
There was no clinically meaningful effect of vitamin D supplementation on total fracture, hip fracture, or falls. There was reliable evidence that vitamin D does not reduce total fractures, hip fractures, or falls by 15% — a clinically meaningful threshold. Even when lower thresholds were assessed, there was still reliable evidence that vitamin D does not reduce falls by 7.5% and total fractures by 5%.
In secondary analyses looking at bone density, there were small differences for lumbar spine, femoral neck, and for total body, but none of these was clinically relevant. In addition, the authors conducted more than 60 subgroup analyses to verify their findings.
The findings have been published in The Lancet Diabetes & Endocrinology journal.
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