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 .
Identification of Early Postmenopausal Women with No Bone Response to HRT: Results of a Five-Year Clinical Trial
Abstract : Hormone replacement therapy ( HRT ) prevents postmenopausal bone loss and fractures . However , the occurrence of women with no bone response to HRT  has not been widely examined . We identified the densitometric nonresponders to long-term HRT and investigated some characteristics and biochemical variables as possible predictors of densitometric nonresponse in postmenopausal women . The study population was a sub sample of the Kuopio Osteoporosis Study ( n= 14.220 ) . A total of 464 early postmenopausal women were r and omized into four treatment groups : ( 1 ) HRT ( sequential combination of 2 mg estradiol valerate and 1 mg cyproterone acetate ) ; ( 2 ) vitamin D3 ; ( 3 ) HRT + Vitamin D3 combined ; and ( 4 ) placebo . In this study , the data from HRT and placebo groups were analyzed . Lumbar ( L2–4 ) and femoral neck bone mineral density ( BMD ) were determined by dual-energy X-ray absorptiometry ( DXA ) at baseline and after 5 years of treatment . A densitometric nonresponder was defined as a woman whose 5-year BMD change was similar to the mean BMD change ( + 95 % CI ) of the placebo group or worse . Altogether , 74 women in the HRT group and 104 women in the placebo group complied with the treatment . According to spinal BMD analysis , 11 % of the women were classified as densitometric nonresponders ; the corresponding proportion for femoral BMD analysis was 26 % . Both smoking ( p= 0.003 ) and low body weight ( p= 0.028 ) were significant risk factors for densitometric nonresponse to HRT . After 6 months of treatment the densitometric nonresponders ( hip ) had a significantly higher mean serum follicle stimulating hormone ( FSH ) level ( p= 0.038 ) and lower increases in serum estradiol levels ( p= 0.006 ) than the densitometric responders . The mean changes in serum FSH and alkaline phosphatase levels were significantly lower among the densitometric nonresponders ( spine ) than responders ( p= 0.043 and 0.017 , respectively ) . In conclusion , this prospect i ve study shows that especially current smokers and women with low body weight are at increased risk of poor bone response to HRT .  Repeated serum FSH , estradiol and alkaline phosphatase measurements during the first months of long-term HRT may be helpful in identifying the women with no bone response to HRT
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 .