Subgroup analyses showed that these results were generally consistent regardless of the calcium or vitamin D dose , sex , fracture history , dietary calcium intake , and baseline serum 25-hydroxyvitamin D concentration .
Conclusions and Relevance In this meta- analysis of r and omized clinical trials , the use of supplements that included calcium , vitamin D , or both compared with placebo or no treatment was not associated with a lower risk of fractures  among community-dwelling older adults .
Importance The increased social and economic burdens for osteoporosis-related fractures worldwide make the prevention of such injuries a major public health goal .
Previous studies have reached mixed conclusions regarding the association between calcium , vitamin D , or combined calcium and vitamin D supplements and fracture incidence in older adults .
Objective To investigate whether calcium , vitamin D , or combined calcium and vitamin D supplements are associated with a lower fracture incidence in community-dwelling older adults .
Correcting calcium nutritional deficiency prevents spine fractures in elderly women.
We tested the spine antifracture and bone sparing efficacy of 1.2 g/day of oral calcium as carbonate in two groups of elderly women , one with prevalent fractures ( PF , n = 94 ) on entry and the other without ( NPF , n = 103 ) . It was a prospect i ve r and omized , double-blind , placebo-controlled trial in mostly rural communities in women over age 60 who were living independently and were consuming < 1 g/day of calcium .  We obtained annual lateral spine radiographs  and semiannual forearm bone density  over 4.3 + /- 1.1 years and determined vertebral fractures by radiographic morphometry augmented by physician assessment . In the PF group , 15 of 53 subjects on calcium had incident fractures , compared with 21 of 41 on placebo ( p = 0.023 , chi2 ) . Calcium did not reduce the rate of incident fractures in the NPF group . Those with a prevalent fracture on entry and not treated with calcium were 2.8 times more likely to experience an incident fracture than all others . Change in the forearm bone mass on placebo in the PF group was -1.24 + /- 2.41%/year compared with + 0.31 + /- 1.80%/year on calcium ( p < 0.001 ) . In the NPF group , the difference was less : -0.39 + /- 2.08%/year versus 0.00 + /- 1.64%/year ( p = 0.2 ) . We conclude that in elderly postmenopausal women with spine fractures and selfselected calcium intakes of < 1 g/day , a calcium supplement of 1.2 g/day reduces the incidence of spine fractures and halts measurable bone loss
Subgroup analyses showed that these results were generally consistent regardless of the calcium or vitamin D dose , sex , fracture history , dietary calcium intake , and baseline serum 25-hydroxyvitamin D concentration .
Conclusions and Relevance In this meta- analysis of r and omized clinical trials , the use of supplements that included calcium , vitamin D , or both compared with placebo or no treatment was not associated with a lower risk of fractures  among community-dwelling older adults .
Importance The increased social and economic burdens for osteoporosis-related fractures worldwide make the prevention of such injuries a major public health goal .
Previous studies have reached mixed conclusions regarding the association between calcium , vitamin D , or combined calcium and vitamin D supplements and fracture incidence in older adults .
Objective To investigate whether calcium , vitamin D , or combined calcium and vitamin D supplements are associated with a lower fracture incidence in community-dwelling older adults .