# Does vitamin D supplementation prevent fractures in older adults?

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**Summary:** In generally healthy, non-deficient adults, vitamin D does not reduce fractures; deficient or osteoporotic groups differ.

In generally healthy, community-dwelling adults who are not vitamin D deficient, vitamin D supplementation does not reduce fractures. In the VITAL fracture analysis (>25,000 midlife and older adults), vitamin D3 2000 IU/day did not lower the risk of total, hip, or non-vertebral fractures versus placebo over a median ~5 years [1].

Results were consistent across baseline vitamin D levels, including participants with lower 25-hydroxyvitamin D, and were not modified by supplemental calcium [1]. Participants were not selected for osteoporosis or deficiency.

These findings argue against routine vitamin D supplementation for fracture prevention in the general non-deficient population. They do not address people with osteoporosis, overt vitamin D deficiency, malabsorption, or institutionalised older adults, where clinical judgement and other guidance apply [1].

## Limitations

- Participants were largely vitamin D–replete and not selected for osteoporosis or deficiency, so results may not generalise to deficient or high-risk groups.
- The trial tested a fixed dose (2000 IU/day) without co-administered calcium as an intervention arm.

## Sources

1. [IV / Randomised trial] Supplemental Vitamin D and Incident Fractures in Midlife and Older Adults (VITAL). New England Journal of Medicine (2022). PMID 35939577. https://pubmed.ncbi.nlm.nih.gov/35939577/

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