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A new review found that vitamin D and calcium supplements provided little to no reduction in the risk of falls or fractures.
The findings align with U.S. guidance recommending against the supplements to prevent falls and fractures.
However, experts stress that the nutrients are still essential for bone health.
Calcium and vitamin D have long been go-to supplements for older adults hoping to prevent falls and bone fractures, but a recent review suggests the duo may offer less protection than once thought. The analysis, published in The BMJ, found that among generally healthy older adults, taking vitamin D and calcium supplements provided little to no meaningful reduction in the risk of fractures and falls.
What Prompted the New Review?
For years, many doctors recommended calcium and vitamin D supplements to help prevent falls and fractures after studies linked low dietary calcium intake and low vitamin D levels to poor bone health, the researchers noted. People often take the nutrients together because vitamin D helps the body absorb calcium, which helps keep bones strong and healthy.
However, many of those earlier studies were observational, meaning they couldn’t prove cause and effect. More recent research has found little benefit, prompting the U.S. Preventive Services Task Force in 2024 to issue draft guidelines recommending against routine calcium and vitamin D supplementation to prevent falls and fractures in most adults aged 60 and older.
For the new review, researchers wanted to analyze the latest evidence on supplements for preventing falls and fractures—an important question because bone loss accelerates with age, particularly among women, and falls are the leading cause of injury-related death among older adults in the U.S.
What Did Researchers Find?
The new review included 69 randomized controlled trials published between 2014 and 2025 that evaluated the use of calcium, vitamin D, or a combination of the two on fall and fracture risk. Most participants, whose median age was 71, lived independently and were not considered high-risk for either outcome.
After analyzing the data, the researchers found that neither calcium nor vitamin D alone provided a clinically meaningful benefit in preventing fractures or falls. They did find that those taking calcium and vitamin D together had a roughly 9% lower risk of fractures, which was considered statistically significant but a small benefit.
The authors noted, however, that because the review included generally healthy adults, the findings might not apply to people at high risk of falls or fractures.
Are Vitamin D and Calcium Still Important For Bone Health?
The findings don’t mean that calcium and vitamin D aren’t important for bone health. Both are critical for strong bones, and inadequate intake of either can contribute to bone loss and osteoporosis over time, said Lauren Manaker, MS, RD, a registered dietitian based in South Carolina.
“The study simply refines who benefits most from supplementing, not whether the nutrients matter,” said Fady Hannah-Shmouni, MD, medical director of Eli Health and an endocrinologist at the University of British Columbia.
Adults need 1,000 mg to 1,200 mg of calcium and 600 IU (international units) to 800 IU of vitamin D daily, depending on age and sex. Instead of relying on supplements, Manaker recommends getting calcium from food whenever possible. Good sources include dairy products, calcium-set tofu, leafy greens, and fish with edible bones.
Sunlight is the primary source of vitamin D, though fatty fish and fortified foods like milk and cereals provide some. If you’re worried that you’re not getting enough vitamin D, it’s worth talking to your doctor about whether a supplement is right for you.
Who Should Still Take Supplements to Prevent Falls and Fractures?
For generally healthy older adults, calcium and vitamin D supplements may not be all that helpful for preventing falls and fractures. But experts say certain groups of people should still consider supplementing.
According to Hannah-Shmouni, this includes:
People with diagnosed nutrient deficiencies
People with osteoporosis or taking osteoporosis medications
Older adults in long-term care
People with malabsorption disorders such as celiac disease or inflammatory bowel disease
People with a history of bariatric surgery or using long-term corticosteroids
People with limited sun exposure or a restrictive diet
That said, if you’re already taking calcium, vitamin D, or both, it’s important not to stop without consulting your healthcare provider.
What Else Keeps Bones Strong as You Age?
Along with calcium and vitamin D, adequate protein intake is also important for maintaining both bone and muscle strength, Manaker said. She noted that older adults are generally recommended to consume 1.0 to 1.2 grams of protein per kilogram of body weight each day.
Beyond getting enough nutrients, certain lifestyle habits can help keep your skeleton strong as you age.
Amjad and Hannah-Shmoudi recommend quitting smoking, limiting alcohol intake, and incorporating resistance and balance training into your daily routine. It’s also important to reduce your risk of falls at home and get a bone density screening starting at age 65, when it’s recommended for most adults.
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