Cholecalciferol plus calcium and hip fracture in older people
What it found
In people over 65, taking 800 IU of cholecalciferol plus 1200 mg of calcium daily was linked to fewer hip and other non-spine fractures.
The same dose did not improve bone density at the hip.
What they found
Studies in people
Hip fracture overall
Across seven trials, older people taking cholecalciferol plus calcium had about 25% fewer hip fractures than those taking a placebo or no supplement.
Higher calcium dose
Three trials giving 800 IU of cholecalciferol plus 1200 mg of calcium found about 31% fewer hip fractures. This dose was more effective than 800 IU of cholecalciferol plus 1000 mg of calcium, which showed no clear benefit.
Other non-spine fractures
The same supplements were linked to about 20% fewer non-spine fractures across the seven trials. The higher calcium dose was linked to about 27% fewer.
Hip fracture in women
In five trials of women over 65, daily cholecalciferol plus calcium was linked to about 30% fewer hip fractures.
Hip bone density
Three trials measured bone density at the hip. The supplements made no clear difference to femoral neck bone mineral density.
What the authors conclude
“Daily oral supplementation 800 IU of vitamin D3 plus 1200 mg of calcium reduces hip fracture and non-vertebral fracture in older people.”
Also in their conclusions
- They conclude that daily oral supplementation of 800 IU of vitamin D3 plus 1200 mg of calcium reduces hip fracture and non-vertebral fracture in older people.
- They say that vitamin D3 and calcium supplements had no effect in increasing femoral neck bone mineral density.
- They advise that this is only one essential element in fracture prevention, and that efforts to prevent bone loss should begin from an early age with a healthy lifestyle, enough calcium and vitamin D3, good nutrition, sunlight and exercise.
How it was done
Hip fractures reduce quality of life and increase the risk of death in older people. The authors wanted to see whether daily cholecalciferol plus calcium could prevent them.
They pooled seven randomised controlled trials that gave older adults daily cholecalciferol plus calcium, or a placebo or no supplement. The trials lasted 18 to 62 months and included 12,620 people, mostly women over 65.
What it can’t tell you
- The review cannot show whether calcium and vitamin D work separately, because all the included trials gave them together.
- It cannot show how baseline vitamin D levels affect the results, because none of the trials reported this.
- All the trials were in developed countries and published in English, so the findings may not apply everywhere.
Who paid
- Conflicts
- There is no conflict of interest.
- Authors work at
- University of Medicine and Health Sciences, Ireland; Connolly Hospital, Ireland
The paper
- Title
- What is the impact of daily oral supplementation of vitamin D3 (cholecalciferol) plus calcium on the incidence of hip fracture in older people? A systematic review and meta-analysis
- Type
- Systematic review and meta-analysisThe authors follow a set, published method to find every relevant study, then combine the numbers from them into one result.
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Manoj P, Derwin R, George S (2023). What is the impact of daily oral supplementation of vitamin D3 (cholecalciferol) plus calcium on the incidence of hip fracture in older people? A systematic review and meta-analysis. International journal of older people nursing. doi:10.1111/opn.12492Free full textPubMed 35842938DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error