No evidence vitamin D supplements improve bone health, major analysis finds
Contrary to current medical guidelines, a meta-analysis suggests that vitamin D supplements do not significantly improve bone health.
Vitamin D supplements for adults do not prevent fractures, falls or improve bone mineral density, according to authors of the biggest review of evidence to date who urged a change to current clinical guidelines as a result.
, published in The Lancet Diabetes and Endocrinology (online, 4 October 2018), also found no differences in the effects of higher versus lower doses of vitamin D.
The authors concluded that there was little justification to use vitamin D supplements to maintain or improve musculoskeletal health. The exception was to prevent rare conditions such as rickets and osteomalacia in high-risk groups, which can occur owing to vitamin D deficiency after a prolonged lack of exposure to sunshine.
Vitamin D supplements have traditionally been recommended for older people to treat or prevent osteoporosis, after early evidence suggested benefits for bone health. The Department of Health and Social Care currently recommends that everyone should consider taking a vitamin D supplement during the winter months, based on given in 2016.
The authors said clinical guidelines that continue to recommend vitamin D supplementation for bone health should be changed to reflect the best available evidence.
Lead author Mark J Bolland from the University of Auckland, New Zealand, said that since the last major review of evidence in 2014, more than 30 randomised controlled trials on vitamin D and bone health had been published, “nearly doubling the evidence base available”.
In the study, the authors pooled data from 81 randomised controlled trials and found there was reliable evidence that vitamin D does not reduce total fractures, hip fractures or falls by 15% — a clinically meaningful threshold.
“Our meta-analysis finds that vitamin D does not prevent fractures, falls or improve bone mineral density, whether at high or low dose. Clinical guidelines should be changed to reflect these findings,” said Bolland.
“On the strength of existing evidence, we believe there is little justification for more trials of vitamin D supplements looking at musculoskeletal outcomes.”
Citation: The Salvadore DOI: 10.1211/PJ.2018.20205553
Recommended from Pharmaceutical Press
Pharmacy Registration Assessment Questions 2 features more than 400 entirely new, closed book and calculation questions. It can be used in conjunction with the previous volume or on its own. All questions are in line with current GPhC guidance, enabling you to prepare for the pharmaceutical pre-registration exam with confidence.£35.00
An introduction to economic evaluation specific to healthcare, for those with little or no knowledge of economics. Covers cost effectiveness, cost utility and cost benefit analysis.£33.00
Explains drug testing regulatory frameworks and all aspects of drug analysis. Case studies of successful programmes are included.£81.00
An introduction to the basics of accounting and financial management. Applies these principles to pharmacy practice.£38.00
All the drugs and poisons that you are most likely to encounter in forensic toxicology. Focuses on collection, extraction and analysis.£65.00