Researchers have called for a more targeted approach to the use of calcium and vitamin D supplements for bone health following a major scientific review that found limited evidence of benefit for routine supplementation among most older adults.
The review, which analysed data from nearly 154,000 participants across numerous clinical studies, concluded that regular use of calcium and vitamin D supplements does not significantly reduce the risk of bone fractures in community-dwelling older adults who do not have diagnosed deficiencies or underlying bone disorders.
The findings challenge long-standing assumptions that routine supplementation alone is an effective strategy for preventing osteoporosis-related fractures and maintaining bone strength in the ageing population.
According to the researchers, while calcium and vitamin D remain essential nutrients for healthy bone development and maintenance, the evidence suggests that supplements should be recommended primarily for individuals with clinically confirmed deficiencies or those identified as being at increased risk of osteoporosis and fractures.
The study found little difference in the occurrence of hip, vertebral and other major fractures between participants who received calcium, vitamin D, or a combination of both supplements and those who received placebo or no supplementation.
Researchers explained that many healthy adults are able to obtain sufficient calcium through dairy products, leafy green vegetables, fortified foods and other dietary sources, while vitamin D can be produced naturally through moderate exposure to sunlight and obtained from foods such as fatty fish, egg yolks and fortified milk products.
Health experts noted that supplementation remains important for certain groups, including older adults living in care facilities, individuals with osteoporosis, people with limited exposure to sunlight, patients with malabsorption disorders and those diagnosed with vitamin D deficiency.
They warned that unnecessary or excessive use of calcium supplements could increase the risk of kidney stones in some individuals and advised the public against self-prescribing supplements without professional medical guidance.
The researchers recommended that efforts to improve bone health should focus on a comprehensive lifestyle approach, including regular weight-bearing and muscle-strengthening exercises, balanced nutrition, maintaining a healthy body weight, avoiding tobacco use, limiting excessive alcohol consumption and implementing measures to reduce the risk of falls.
Medical professionals also stressed the importance of routine health assessments for older adults to identify those who may benefit from personalised treatment plans, including supplementation where clinically indicated.
The researchers called for updated clinical guidelines that prioritise individual risk assessment over routine supplementation for the general population, saying such an approach would ensure resources are directed to those most likely to benefit.
They added that further studies are needed to determine which specific populations derive the greatest benefit from calcium and vitamin D supplementation and to refine future recommendations for bone health management.
The findings contribute to a growing body of scientific evidence supporting personalised healthcare strategies and reinforce the importance of balanced nutrition, healthy lifestyle choices and appropriate medical evaluation in maintaining strong bones throughout later life.
