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 .
Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older.
BACKGROUND Inadequate dietary intake of calcium and vitamin D may contribute to the high prevalence of osteoporosis among older persons . METHODS We studied the effects of three years of dietary supplementation with calcium and vitamin D on bone mineral density , biochemical measures of bone metabolism , and the incidence of nonvertebral fractures in 176 men and 213 women 65 years of age or older who were living at home . They received either 500 mg of calcium plus 700 IU of vitamin D3 ( cholecalciferol ) per day or placebo .  Bone mineral density was measured by dual-energy x-ray absorptiometry , blood and urine were analyzed every six months , and cases of nonvertebral fracture were ascertained by means of interviews and verified with use of hospital records . RESULTS The mean ( + /-SD ) changes in bone mineral density in the calcium-vitamin D and placebo groups were as follows : femoral neck , + 0.50+/-4.80 and -0.70+/-5.03 percent , respectively ( P=0.02 ) ; spine,+2.12+/-4.06 and + 1.22+/-4.25 percent ( P=0.04 ) ; and total body , + 0.06+/-1.83 and -1.09+/-1.71 percent ( P<0.001 ) . The difference between the calcium-vitamin D and placebo groups was significant at all skeletal sites after one year , but it was significant only for total-body bone mineral density in the second and third years . Of 37 subjects who had nonvertebral fractures , 26 were in the placebo group and 11 were in the calcium-vitamin D group ( P=0.02 ) . CONCLUSIONS In men and women 65 years of age or older who are living in the community , dietary supplementation with calcium and vitamin D moderately reduced bone loss measured in the femoral neck , spine , and total body over the three-year study period and reduced the incidence of nonvertebral fractures
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 .