A comprehensive review of 69 trials including about 154,000 participants finds that vitamin D, calcium, or their combination offer little to no protection against fractures or falls, calling into question routine supplementation for bone health.

The authors acknowledge that results may not apply to individuals with specific bone disorders or osteoporosis, leaving room for exceptions to the general finding.

They urge doctors, guideline panels, and regulators to re-evaluate broad calcium and vitamin D recommendations and advocate for personalized, targeted fall-prevention strategies instead of blanket supplementation.

The analysis discusses reverse causation, noting that people who take supplements may already engage in healthier lifestyles, which could have influenced observational links between supplementation and fractures.

Despite the evidence, some individuals still receive calcium and/or vitamin D prescriptions on NHS, prompting discussion of public health messaging in light of the new findings.

The study stresses that higher-risk groups warrant targeted research before definitive supplementation guidance can be issued.

Attention should shift toward proven fall-prevention measures, such as balance and resistance training and multifactorial programs tailored to individual risk.

Experts call for redirecting funding and efforts to interventions like home hazard reduction and structured exercise to reduce falls and support bone health.

Dietary sources of vitamin D and calcium are highlighted—vitamin D from oily fish, egg yolks, fortified foods; calcium from dairy, leafy greens, and fortified products—with occasional prescriptions pairing calcium and vitamin D.

Findings apply to specific fracture types like hip fractures and to falls, with analyses indicating moderate to high certainty of evidence across these endpoints.

Current NHS guidance advises vitamin D supplementation in autumn and winter due to limited sunlight, while calcium intake (about 700 mg daily for adults) should come from diet where possible, acknowledging vitamin D’s role in calcium balance.

Vitamin D helps regulate calcium and phosphate for bone and muscle health; deficiencies can cause rickets or osteomalacia, but supplementation alone may not prevent fractures according to recent evidence.