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 .
Effects of 1α-hydroxyvitamin D3 on lumbar bone mineral density and vertebral fractures in patients with postmenopausal osteoporosis
The effects of 1α-hydroxyvitamin D3 [ 1α(OH)D3 ] on bone mineral density , fracture incidence , and bone metabolism were evaluated by a double-blind , placebo-controlled study . Eighty postmenopausal osteoporotic Japanese women ( 71.9±7.3 years , mean±SD ) were r and omly assigned to 1 μg of 1α(OH)D3 daily or inactive placebo for 1 year . All patients were given supplemental calcium ( 300 mg of elemental calcium daily ) . Lumbar ( L2–L4 ) bone mineral density ( BMD ) determined by dual energy X-ray absorptiometry increased 0.65 % with 1α(OH)D3 treatment and decreased 1.14 % with placebo ( P=0.037 ) . BMD in both the femoral neck and Ward 's triangle did not yield any significant differences between the two groups , whereas trochanter BMD in the 1α(OH)D3-treated group increased 4.20 % and decreased 2.37 % with placebo ( P=0.055 ) . X-ray analysis demonstrated that new vertebral fractures occurred in two patients with 1α(OH)D3 and in seven patients with placebo . The vertebral fracture rate in the treated group was significantly less ( 75/1000 patient years ) than in the control group ( 277/1000 patient years ; P=0.029 ) . Hypercalcemia ( 12.1 mg/100 ml ) occurred in one patient receiving 1α(OH)D3 ; however , the serum calcium level in this patient promptly decreased to the reference range after cessation of the treatment . There were no significant changes in serum creatinine level in either group . A significant increase in urinary excretion of calcium was found but there was no significant change in urinary excretion of hydroxyproline in the treated group . The serum level of bone-derived alkaline phosphatase activity significantly decreased by−26±26 ( mU/ml ) after the treatment ( P=0.003 ) . These results indicate that 1α(OH)D3 treatment is effective for maintaining trabecular bone mass and prevents further vertebral fractures without any serious adverse effects in postmenopausal osteoporosis
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 .