Previous analyses of data from the VITAL trial also showed that vitamin D supplementation did not affect incident fall risk in the overall cohort of 25,871 participants or changes in bone mineral density or structure in a sub-cohort of 771 participants.3 Additionally, the VITAL trial did not identify substantial differences in adverse effects, such as hypercalcemia and kidney stones, between the groups.
Other previous randomized, controlled trials have investigated the effects of supplemental vitamin D on fracture outcomes and have yielded conflicting results.4,5
Sharon H. Chou, MD, an endocrinologist at Brigham and Women’s and a co-author of the recent study says, “For a long time, everybody believed that vitamin D supplements were beneficial for the bones. … I think what we are learning is that—for the general population—supplemental vitamin D does not reduce fractures.”
When the researchers performed exploratory analyses, they found no significant effect modification on fracture incidence between the vitamin D and placebo groups according to baseline clinically relevant 25-hydroxyvitamin D thresholds (i.e., <12, <20, <30, or ≥50 ng/mL). “We tried our best to see a threshold effect, and we couldn’t find one in this very large randomized controlled trial,” she says.
Dr. Chou notes that because the study was performed in generally healthy patients, the findings are not necessarily generalizable to patients typically seen by rheumatologists. She explains the results would not necessarily apply to individuals with osteoporosis or osteopenia or patients with long-term glucocorticoid use.
Lara C. Pullen, PhD, is a medical writer based in the Chicago area.
References
- LeBoff MS, Chou AH, Ratliff KA, et al. Supplemental vitamin D and incident fractures in midlife and older adults. N Engl J Med. 2022 Jul 28;387(4):299–309.
- Manson JE, Cook NR, Lee IM, et al. Vitamin D supplements and prevention of cancer and cardiovascular disease. N Engl J Med. 2019 Jan 3;380(1):33–44.
- LeBoff MS, Murata EM, Cook NR, et al. Vitamin D and omega-3 trial (VITAL): Effects of vitamin D supplements on risk of falls in the U.S. population. J Clin Endocrinol Metab. 2020 Sep 1;105(9):2929–2938.
- Trivedi DP, Doll R, Khaw KT. Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: Randomized double blind controlled trial. BMJ. 2003 Mar 1;326(7387):469.
- Sanders KM, Stuart AL, Williamson EJ, et al. Annual high-dose oral vitamin D and falls and fractures in older women: A randomized controlled trial. JAMA. 2010 May 12;303(18):1815–1822.
