A pooled analysis of vitamin D dose requirements for fracture prevention.

@article{BischoffFerrari2012APA,
  title={A pooled analysis of vitamin D dose requirements for fracture prevention.},
  author={Heike Annette Bischoff-Ferrari and Walter C. Willett and Endel John Orav and Paul Lips and Pierre Jean Meunier and Ronan A. Lyons and Leon Flicker and John Dennis Wark and Rebecca D. Jackson and Jane A. Cauley and Haakon Eduard Meyer and Michael Pfeifer and Kerrie M. Sanders and Hannes B. St{\"a}helin and Robert Theiler and Bess Dawson-Hughes},
  journal={The New England journal of medicine},
  year={2012},
  volume={367 1},
  pages={
          40-9
        }
}
BACKGROUND The results of meta-analyses examining the relationship between vitamin D supplementation and fracture reduction have been inconsistent. METHODS We pooled participant-level data from 11 double-blind, randomized, controlled trials of oral vitamin D supplementation (daily, weekly, or every 4 months), with or without calcium, as compared with placebo or calcium alone in persons 65 years of age or older. Primary end points were the incidence of hip and any nonvertebral fractures… 
Comparison of fracture risk using different supplemental doses of vitamin D, calcium or their combination: a network meta-analysis of randomised controlled trials
TLDR
The use of supplements that included calcium, vitamin D or both was not found to be better than placebo or no treatment in terms of risk of fractures among community-dwelling older adults, which means the routine use of these supplements in community-Dwelling elderly people should be treated more carefully.
Effects of vitamin D supplements on bone mineral density: a systematic review and meta-analysis
TLDR
Continuing widespread use of vitamin D for osteoporosis prevention in community-dwelling adults without specific risk factors for vitamin D deficiency seems to be inappropriate.
A Meta-Analysis of High Dose, Intermittent Vitamin D Supplementation among Older Adults
TLDR
High dose, intermittent vitamin D therapy did not decrease all-cause mortality among older adults and Supplementation of intermittent, high dose vitamin D may not be effective in preventing overall mortality, fractures, or falls among Older adults.
Randomized controlled trial of vitamin D supplementation in older people to optimize bone health
TLDR
There was no difference in change in BMD over 12 mo between the 3 doses of vitamin D, suggesting no effect of the intervention or a similar attenuation of the anticipated decrease in B MD over 12Mo.
Vitamin D and Calcium for the Prevention of Fracture
TLDR
In this study, neither intermittent nor daily dosing with standard doses of vitamin D alone was associated with reduced risk of fracture, but daily treatment with both vitamin D and calcium was a more promising strategy.
Should vitamin D administration for fracture prevention be continued?
TLDR
Vitamin D supplementation might not be effective in primary prevention among adults age 50 years and older without vitamin D deficiency and osteoporosis; however, clinical trials on primary prevention are limited.
Vitamin D supplements with or without calcium to prevent fractures.
TLDR
A vitamin D supplement of 800 IU per day in combination with calcium may decrease the incidence of non-vertebral fractures, especially in persons in the older age groups having low-baseline vitamin D status and low calcium intake and showing good compliance.
Influence of vitamin D on fracture reduction among older adults: a discussion of recent meta-analysis findings
TLDR
It is still reasonable to take 800 to 1000 IU vitamin D per day, following current recommendations, and reducing the risk of fractures among vulnerable older adults age 65 and older, at risk of vitamin D deficiency and fractures, remains a major public health target.
Association Between Calcium or Vitamin D Supplementation and Fracture Incidence in Community-Dwelling Older Adults: A Systematic Review and Meta-analysis
TLDR
Findings do not support the routine use of these supplements in community-dwelling older people, and the use of supplements that included calcium, vitamin D, or both compared with placebo or no treatment was not associated with a lower risk of fractures.
Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation
TLDR
This meta-analysis of RCTs supports the use of calcium plus vitamin D supplements as an intervention for fracture risk reduction in both community-dwelling and institutionalized middle-aged to older adults.
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TLDR
Among healthy postmenopausal women, calcium with vitamin D supplementation resulted in a small but significant improvement in hip bone density, did not significantly reduce hip fracture, and increased the risk of kidney stones.
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Nonvertebral fracture prevention with vitamin D is dose dependent, and a higher dose should reduce fractures by at least 20% for individuals aged 65 years or older.
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TLDR
An annual i.m. injection of 300,000 IU vitamin D2 is not effective in preventing non-vertebral fractures among elderly men and women resident in the general population.
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