Taking vitamin D and calcium does not prevent falls and fractures in older people

ingest vitamin d supplementswith or without calciumThe risk of falls and fractures in older adults will not be reduced, according to draft recommendations released today by the US Preventive Services Task Force (USPSTF).

Vitamin D and calcium are essential for bone health and other functions. However, for men over 60 or postmenopausal women, supplements do not reduce the likelihood of falls or fractures.

The recommendation excluded people who reside in nursing homes and other managed care facilities and who may have health conditions that make them more prone to falls. Instead, the task force focused on whether vitamin D and calcium supplements can prevent falls and fractures in adults living independently.

According to the Centers for Disease Control and Prevention (CDC), about a quarter of people 65 and older report at least one fall in the past year. Falls remain the leading cause of injury-related deaths in this group.

“These falls pose a risk of fractures and can have serious health implications. Therefore, the expert panel is very concerned about whether there is a way to prevent such falls and fractures in the general elderly population. I'm interested,” he said. Dr. John Lewis, He is a member of the task force that co-led the report and is a professor in the psychology department at the University of Arizona.

“For otherwise healthy older adults, taking supplements with or without calcium had no effect,” Lewis added.

The USPSTF typically reviews the evidence behind its recommendations every five years. that Grades Its recommendations are based on the certainty of the evidence and how beneficial the intervention appears to be.

This latest recommendation earned a D grade. This means that there is “a moderate or high degree of certainty that the service has no net benefit or that the harms outweigh the benefits.” The draft guidelines are available on the USPSTF website and public comments will be accepted until January 21, 2025.

What does the evidence show?

The task force considered evidence from 19 new randomized clinical trials. When researchers combined the results of these studies, they found a risk ratio (a number used to understand effect size) of 0.99. This means there was essentially no difference between those who took the supplement and those who did not, Lewis explained.

“Essentially there was no difference at all,” Lewis said. “It's actually quite rare to see a resource that shows such clear results. Basically, taking supplements didn't help anyone with their fractures.”

In 2018, a task force recommended against daily supplementation of less than 400 IU of vitamin D and less than 1,000 mg of calcium, primarily to prevent falls in postmenopausal women. At that time, there was not enough evidence to recommend doses below these levels for older women or for men.

A recent review considered sufficient evidence to conclusively conclude that there is no dose level that effectively prevents falls and fractures in older adults.

Lewis said evidence shows there is no real harm in taking vitamin D supplements with or without calcium, apart from a “very small risk” of kidney stones.

Do I still need to take vitamin D supplements?

The National Academy of Medicine recommends daily intake. Vitamin D 600 IU – 800 IU and Calcium 1,000 mg to 1,200 mg.

Vitamin D helps bones develop properly and stay strong. It also has other health benefits that are important for aging, such as reducing inflammation and supporting immune function. Calcium supplements may also contain vitamin D. This is because vitamin D helps the body absorb calcium and supports bone health.

“Adequate intake of vitamin D and calcium is important for bone and overall health, and this will continue to be the case.” Manije Berenzi, MD, MPH“I'm not sure if it's safe,” the physician, board certified in occupational, environmental, and preventive medicine, and a fellow of the American College of Preventive Medicine, told Berrywell via email.

Berenzi, who is not on the task force, said people should talk to their health care provider if they are concerned about their calcium and vitamin D intake. Taking large amounts of these supplements can do more harm than good, she said.

What can you do to protect your bones and reduce your risk of falls?

Taking daily vitamin D or calcium tablets won't reduce your risk of falls or fractures, but there are other measures that have been proven to be effective.

Lewis said the best prevention is adequate physical activity and exercise. resistance trainingFor example, it can improve bone density and prevent muscle loss, and jumping exercises can improve balance and coordination.

“[Exercise] “Not only does it help strengthen your body against falls, but it also helps strengthen your body for better balance to avoid falling in the first place,” Lewis said.

The task force also recommends that older adults be evaluated for their risk of infection. osteoporosis. Some people have a genetic predisposition that increases their risk of falls and fractures. Regular health checkups can help these people identify preventative measures that can help them stay healthy.