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 .
Low-dose calcitriol versus calcium in established postmenopausal osteoporosis.
An ongoing r and omized clinical trial of 3 years duration is being undertaken to evaluate the recurrent fracture rate and safety profile associated with low-dose calcitriol versus calcium supplementation in women with at least 3 years postmenopausal osteoporosis who are under the age of 80 years . A total of 856 patients were su bmi tted for possible inclusion in the study by 123 primary care physicians , and 636 met all entry requirements . Each patient was r and omly allocated to receive either 0.25 micrograms of calcitriol twice daily or calcium supplementation of 1,000 mg/d . If significant hypercalcemia developed ( greater than 2.6 mmol/L ) or a deterioration in renal function was observed , the dose of trial medication was to be halved or stopped if laboratory values did not return to normal . Patients were given no specific instructions regarding dietary calcium intake . To date , 528 patient-years experience with calcitriol  and 527 patient-years experience with calcium the calcium supplementation have been accumulated . Thus far , low-dose calcitriol has not been observed to cause hypercalcemia , deterioration in renal function , or nephrocalcinosis . At 1 year , a loss in total anterior height ( P less than .05 ) has been detected in the calcium-treated group compared with the calcitriol-treated group . Thus , calcitriol appears to preserve spinal height . Long-term follow-up of all patients for 2 or 3 years will be continued
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 .