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 .
Long-term effects of calcium-vitamin-D3-fortified milk on bone geometry and strength in older men.
The long-term effects of calcium and vitamin D supplementation on bone material and structural properties in older men are not known . The aim of this study was to examine the effects of high calcium ( 1000 mg/day)- and vitamin-D(3 ) ( 800 IU/day)-fortified milk on cortical and trabecular volumetric BMD ( vBMD ) and bone geometry at the axial and appendicular skeleton in men aged over 50 years . One hundred and eleven men who were part of a larger 2-year r and omized controlled trial had QCT scans  of the mid-femur and lumbar spine ( L(1)-L(3 ) ) to assess vBMD , bone geometry and indices of bone strength [ polar moment of inertia ( I(polar ) ) ] . After 2 years , there were no significant differences between the milk supplementation and control group for the change in any mid-femur or L(1)-L(3 ) bone parameters for all men aged over 50 years . However , the mid-femur skeletal responses to the fortified milk varied according to age , with a split of < or=62 versus > 62 years being the most significant for discriminating the changes between the two groups . Subsequent analysis revealed that , in the older men ( > 62 years ) , the expansion in mid-femur medullary area was 2.8 % ( P < 0.01 ) less in the milk supplementation compared to control group , which helped to preserve cortical area in the milk supplementation group ( between group difference 1.1 % , P < 0.01 ) . Similarly , for mid-femur cortical vBMD and I(polar ) , the net loss was 2.3 and 2.8 % less in the milk supplementation compared to control group ( P < 0.01 and < 0.001 , respectively ) . In conclusion , calcium-vitamin-D(3)-fortified milk may represent an effective strategy to maintain bone strength by preventing endocortical bone loss and slowing the loss in cortical vBMD in elderly men
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 .