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 .
Calcium Plus Vitamin D Supplementation Has Limited Effects on Femoral Geometric Strength in Older Postmenopausal Women: The Women’s Health Initiative
Calcium plus vitamin D ( CaD ) supplementation has a modest but significant effect on slowing loss of femoral bone mass and reducing risk of hip fractures in adherent postmenopausal women . The goal of this study was to determine if CaD supplementation influences hip structural parameters that are associated with fracture risk . We studied 1,970 postmenopausal women enrolled in the Women ’s Health Initiative r and omized controlled trial of CaD at one of three bone mineral density ( BMD ) clinical centers . Hip structural analysis software measured BMD and strength parameters on DXA scans at three regions : femoral narrow neck , intertrochanter , and shaft . R and om effects models were used to test the average differences in hip BMD and geometry between intervention and placebo . There was greater preservation of hip BMD at the narrow neck with CaD relative to placebo across 6 years of intervention . CaD also altered the underlying cross-sectional geometry at the narrow neck in the direction of greater strength , with small increases in cross-sectional area and section modulus and a decrease in buckling ratio with CaD relative to placebo . While trends at both the intertrochanter and shaft regions were similar to those noted at the narrow neck , no significant intervention effects were evident . There was no significant interaction of  CaD and age or baseline calcium levels for hip structural properties . CaD supplementation is associated with modest beneficial effects on hip structural features at the narrow neck , which may explain some of the benefit of CaD in reducing hip fracture risk
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 .