Vitamin D Did Not Alter Risk of Falls Interview with:
Dr Mark Bolland, PhD
Bone and Joint Research Group, Department of Medicine
University of Auckland, Auckland, New Zealand What are the main findings of the study?

Prof. Bolland: In a meta-analysis of 20 randomized clinical trials, there was no effect of vitamin D with or without calcium on falls.  In a trial sequential analysis of these trials, the effect estimate for vitamin D with or without calcium on falls lay within the futility boundary, providing reliable evidence that vitamin D supplementation does not alter the relative risk of falls by ≥15% and suggesting that future trials that are similar in design to current trials are unlikely to change that conclusion. Were any of the findings unexpected?

Prof. Bolland: Previously meta-analyses have reported conflicting results on the effect of vitamin D on falls, but a number of large, fairly recent randomised clinical trials have reported either harm or no effect of vitamin D on falls. The most recent meta-analyses that include these trials, generally report similar findings to ours. The results are in broad agreement with a number of recent meta-analyses and systematic reviews that report no effect of vitamin D supplements in community dwelling individuals on a very broad range of health outcomes including fracture, bone density, cancer, and cardiovascular events. What should clinicians and patients take away from your report?

Prof. Bolland: There is little justification currently for prescribing vitamin D to prevent falls. People who are at risk of osteomalacia because of very low vitamin D levels (frail elderly people living in residential care, people who actively avoid the sun, and people with deeply pigmented skin) should consider taking vitamin D supplements. For others, vitamin D supplements are not necessary. What recommendations do you have for future research as a result of this study?

Prof. Bolland: Research should focus on better defining what vitamin D level is adequate for health, rather than carrying out more trials of vitamin D supplements that are similar to the existing ones.

The effect of vitamin D supplementation on skeletal, vascular, or cancer outcomes: a trial sequential meta-analysis
Dr Mark J Bolland PhD,Andrew Grey MD,Greg D Gamble MSc,Prof Ian R Reid MD
The Lancet Diabetes & Endocrinology – 1 April 2014 ( Vol. 2, Issue 4, Pages 307-320 )
DOI: 10.1016/S2213-8587(13)70212-2

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