A recent recommendation from the US Preventive Services Task Force (USPSTF) has raised concerns about the use of vitamin D and calcium supplements by older adults to prevent falls and fractures, the Washington Post reports.
The panel of independent health experts has advised against their use, citing insufficient evidence to support their effectiveness and highlighting potential risks associated with unsupervised supplementation.
While vitamin D and calcium are essential nutrients for bone health and muscle function, the task force’s guidance underscores the lack of substantial research supporting their ability to reduce the risk of falls or fractures in older adults. Additionally, the task force warned that supplementation could increase the likelihood of developing kidney stones, especially if not taken with proper medical guidance.
The recommendation, which applies to older adults living at home—including postmenopausal women and men aged 60 and older—reflects the panel’s conclusion that the benefits of these supplements do not outweigh the potential harms. People living in assisted living or nursing homes are excluded from this advice, as they may have higher health risks that require additional medical interventions.
The USPSTF has assigned a grade of “D” to this recommendation, indicating that there is moderate to high certainty that vitamin D and calcium supplements offer no net benefit for preventing falls or fractures. The grade also reflects the concern that these supplements may pose more harm than good, leading to an overall discouragement of their use for this purpose.
Falls remain a significant concern for older adults, as they are the leading cause of injury-related death among people aged 65 and older. The risk of falls has steadily increased from 2012 to 2021, with health care costs related to falls reaching $80 billion in 2020, according to the Centers for Disease Control and Prevention (CDC). Despite the widespread use of supplements, the task force’s review of the evidence found no meaningful difference in fall prevention between those who took vitamin D and calcium supplements and those who did not.
John M. Ruiz, a member of the task force and professor of clinical psychology at the University of Arizona, stated that extensive research found no significant benefits of vitamin D and calcium in preventing falls and fractures. He emphasized that the best studies conducted on this issue showed little to no difference between supplement users and non-users.
In response to the recommendations, Andrea Wong, senior vice president at the Council for Responsible Nutrition, a trade association for dietary supplements, expressed concerns. Wong argued that while it is challenging for individuals to obtain sufficient vitamin D through food alone, supplementation should not be the go-to solution without a proper diagnosis. Nutrient-dense foods, including fish (like trout, salmon, and tuna) and dairy products (such as milk, yogurt, and cheese), are natural sources of vitamin D and calcium.
The USPSTF’s stance aligns with findings from other studies, such as a 2020 randomized controlled trial involving nearly 26,000 participants aged 50 and older, which found no evidence that supplemental vitamin D improved bone health. Meryl Susan LeBoff, lead author of the study and chief of the Calcium and Bone Section at Brigham and Women’s Hospital in Boston, emphasized that the task force’s recommendations are consistent with her own research.
Excessive intake of vitamin D can also lead to harmful effects. Vitamin D is a fat-soluble vitamin, which means it can accumulate in the body and strain the kidneys, potentially causing damage. In contrast, water-soluble vitamins like vitamin C are more effectively filtered by the kidneys, lowering the risk of toxicity.
While vitamin D supplementation is one of the most commonly used supplements in the US, it is not regulated with the same rigor as prescription medications, which increases the risk of unsafe use. Research has also shown that overuse of supplements can lead to dangerous interactions with other medications. Nephrologist Francis P. Wilson, who has studied the effects of supplements on kidney health, advised against relying on supplements and recommended obtaining vitamin D through a diverse diet instead.
Experts, including Wilson, suggest that exercise, a balanced diet, and proper medical oversight are more effective strategies for reducing the risk of falls among older adults. While exercise may be more challenging than taking a daily supplement, it provides multiple health benefits that vitamin supplementation cannot match.
