A new study finds that vitamin D3 supplements (2000 IU/day) did not reduce total, nonvertebral, or hip fractures, and no effect was seen on major osteoporotic fractures, wrist fractures, or pelvic fractures.
Vitamin D supplements are widely prescribed and used to benefit bone health. However, definitive data on whether these supplements actually reduce bone fractures in the general population have been inconsistent.
To improve scientific understanding of this issue, a team of scientists at Brigham and Women’s Hospital conducted an ancillary study in the VITamin D and OmegA-3 TriaL (VITAL), a clinical trial of more than 25,000 adults, also led by researchers at Brigham. . A total of 1,991 incident fractures were confirmed in 1,551 participants during a mean follow-up of 5.3 years.
“Overall, the results of this large clinical trial do not support the use of vitamin D supplements to reduce fractures in generally healthy US men and women.” – Meryl LeBoff, MD
According to the results, supplemental vitamin D3 (2000 IU/day) did not reduce total, nonvertebral, or hip fractures compared with placebo. In addition, there were no effects of supplemental vitamin D3 on major osteoporotic fractures, wrist fractures, or pelvic fractures. In the analysis, the effects were not modified by baseline age, sex, race, body mass index, baseline blood vitamin D levels, and personal use of calcium supplements and/or vitamin D
“Overall, the results of this large clinical trial do not support the use of vitamin D supplements to reduce fractures in generally healthy US men and women,” said lead author Meryl LeBoff, MD , head of the Calcium and Bone Section of the Endocrine Division. at the Brigham.
“These findings do not apply to adults with vitamin D deficiency or low bone mass or osteoporosis. Most of the trial participants were not deficient and may have already reached the level of vitamin D needed for bone health. Our ongoing studies are focusing on whether free vitamin D levels or genetic variation in vitamin D absorption, metabolism, or receptor function will provide insight into individuals who may benefit from vitamin supplementation D in musculoskeletal health”.
“Although VITAL was originally designed to look at cardiovascular and cancer outcomes, this is a wonderful example of how it has shed light on health outcomes far beyond its original goals,” said co-author JoAnn Manson, MD and chief of the Division of Preventive Medicine at the Brigham.
Reference: “Supplemental Vitamin D and Incident Fractures in Midlife and Older Adults” by Meryl S. LeBoff, MD, Sharon H. Chou, MD, Kristin A. Ratliff, BA, Nancy R. Cook, Sc.D., Bharti Khurana, MD, Eunjung Kim, MS, Peggy M. Cawthon, Ph.D., MPH, Douglas C. Bauer, MD, Dennis Black, Ph.D., J. Chris Gallagher, MD, I-Min Lee, MB, BS, Sc.D., Julie E. Buring, Sc.D. and JoAnn E. Manson, MD, Dr.PH, July 28, 2022, New England Journal of Medicine.DOI: 10.1056/NEJMoa2202106
Funding: NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases