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 .
Superiority of alfacalcidol compared to vitamin D plus calcium in lumbar bone mineral density in postmenopausal osteoporosis
In a r and omized multicenter , double-blind , double-dummy , parallel group study a comparison of the efficacy and safety of 1 μg alfacalcidol to 880 IU vitamin D plus calcium carbonate ( 1 g calcium ) once daily per os was performed on 148 postmenopausal osteoporotic Caucasian patients with normal vitamin D serum levels for 18 months .  Bone mineral density ( BMD ) was measured at baseline , 12 and 18 months . Safety parameters were followed during the entire study period . Sixty-nine ( 90.8 % ) in the alfacalcidol group and 67 ( 93.1 % ) in the vitamin D group were included in the ITT analysis . Lumbar BMD in the alfacalcidol group increased by 0.017 g/cm2 ( 2.33 % ) and 0.021 g/cm2 ( 2.87 % ) from baseline ( P<0.001 ) at 12 and 18 months , respectively , whereas in the vitamin D plus calcium group the increase was 0.005 g/cm2 ( 0.70 % ) from baseline ( N.S. ) at both 12 and 18 months . The higher changes from baseline in the alfacalcidol group , as compared to the changes in the vitamin D plus calcium group at both 12 and 18 months , were found to be statistically significant ( P=0.018 , 0.005 ) . A small increase of mean femoral BMD was achieved in both groups ( N.S. ) . Adverse events were similar in both groups . No significant differences were noted between the groups in serum calcium . In conclusion , alfacalcidol was found to be superior in significantly increasing lumbar BMD as compared to vitamin D plus calcium while safety characteristics were found to be similar in both treatments
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 .