MedicalResearch.com: What is the background for this study?
Response: Vitamin D supplements have long been recommended for older people to treat or prevent osteoporosis.
Early evidence suggested vitamin D supplements might have benefits for musculoskeletal health, but more recent systematic reviews have reported no effect of vitamin D supplementation on fractures, falls or bone mineral density. Some authors have suggested that inadequate vitamin D doses might explain these null results.
MedicalResearch.com: What are the main findings?
Response: In meta-analyses and trial sequential analyses of 81 randomised controlled trials, vitamin D supplementation did not have clinically relevant effects on fractures, falls, and bone mineral density, and this conclusion is unlikely to be altered by future trials with similar designs. Effects of higher doses of vitamin D were similar to effects of lower doses.
MedicalResearch.com: What should readers take away from your report?
Response: There is little justification for the use of vitamin D supplements to maintain or improve musculoskeletal health (except for the prevention or treatment of rickets and osteomalacia in high-risk groups), and clinical guidelines should reflect these findings.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Few trials have been carried out in cohorts with marked vitamin D deficiency (average baseline 25-hydroxyvitamin D <25 nmol/L). Trials in such cohorts (who are not at risk of osteomalacia) might produce different results, but require a strong scientific rationale before being undertaken, given the absence of effects of vitamin D seen in the existing trials.
MedicalResearch.com: Is there anything else you would like to add?
Response: I’ve co-authored many papers discussing vitamin D supplementation, but have no financial conflicts of interest to declare. I receive funding support from the Health Research Council of New Zealand (HRC), but the HRC had no role in any aspect of this study.
Effects of vitamin D supplementation on musculoskeletal health: a systematic review, meta-analysis, and trial sequential analysis
Mark J Bolland, PhD , Andrew Grey, MD, Alison Avenell, MD
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