There is high quality evidence that vitamin D plus calcium is associated with a statistically significant reduction in incidence of new non-vertebral fractures .
Vitamin D alone is unlikely to prevent fractures in the doses and formulations tested so far in older people .
Supplements of vitamin D and calcium may prevent hip or any type of fracture .
There was a small but significant increase in gastrointestinal symptoms and renal disease associated with vitamin D and calcium .
This review found that there was no increased risk of death from taking calcium and vitamin
BACKGROUND Vitamin D and related compounds have been used to prevent  osteoporotic fractures in older people .
This is the third up date of a Cochrane review first published in 1996 .
OBJECTIVES To determine the effects of vitamin D or related compounds , with or without calcium , for preventing  fractures in post-menopausal women and older men .
Additive impact of alfacalcidol on bone mineral density and bone strength in alendronate treated postmenopausal women with reduced bone mass.
OBJECTIVES Assessment of additive impact of alfacalcidol 1 μg daily ( Alfa ) on bone mineral density ( BMD ) and on bone strength in postmenopausal women treated with alendronate 70 mg weekly + 500 mg calcium daily . SUBJECTS AND METHODS In a r and omized , double-blind , placebo controlled study , 279 postmenopausal women with osteoporosis or osteopenia participated ( intention to treat analysis [ ITT ] ; aged 73.6∓4.7 years ) and were treated with 70 mg alendronate ( ALN ) weekly and 500 mg calcium daily for 36 months . In addition , these patients received either 1 μg alfacalcidol ( Alfa ) or placebo ( PLC ) daily . BMD was measured with Dual-Energy-X-ray-Absorptiometry ( DXA ) at the lumbar spine and proximal femur and at forearm and tibia with peripheral quantitative computed tomography ( pQCT ) at regular intervals for 36 months . RESULTS DXA-BMD of lumbar spine ( L1 - 4 ) increased after 36 months , by 6.65 % ( p<0.0001 ) in the Alfa/ALN group versus 4.17 % ( p<0.0001 ) in the PLC/ALN group . Group difference was significant after 3 years ( p=0.026 ) . At the end of the study , significant differences were found in favor of the Alfa/ALN group in trabecular density ( tibia ) ( p=0.002 ) , cortical density ( midshaft tibia ) ( p=0.043 ) , and bone strength ( p=0.001 ) . The remaining parameters showed no differences between the treatment arms , apart cortical bone density at midshaft radius . CONCLUSIONS Alfacalcidol significantly increases the efficacy of alendronate treatment in osteopenic/osteoporotic postmenopausal women  on spinal DXA-BMD , cortical and trabecular BMD of the tibia and also bending stiffness of the tibia
There is high quality evidence that vitamin D plus calcium is associated with a statistically significant reduction in incidence of new non-vertebral fractures .
Vitamin D alone is unlikely to prevent fractures in the doses and formulations tested so far in older people .
Supplements of vitamin D and calcium may prevent hip or any type of fracture .
There was a small but significant increase in gastrointestinal symptoms and renal disease associated with vitamin D and calcium .
This review found that there was no increased risk of death from taking calcium and vitamin
BACKGROUND Vitamin D and related compounds have been used to prevent  osteoporotic fractures in older people .
This is the third up date of a Cochrane review first published in 1996 .
OBJECTIVES To determine the effects of vitamin D or related compounds , with or without calcium , for preventing  fractures in post-menopausal women and older men .