A BMJ review of 69 trials with more than 150,000 people finds calcium and vitamin D pills do little to prevent fractures or falls.

Here's a study worth reading carefully, especially if there's a bottle of calcium or vitamin D on your kitchen counter. A systematic review and meta-analysis published in The BMJ pooled data from 69 trials involving more than 150,000 participants, ScienceAlert reports, and found that calcium, vitamin D, or the two combined had little to no effect on fractures or falls. The evidence was rated moderate-to-high certainty, and the results held largely consistent across subgroups by age, low vitamin D levels, an osteoporosis diagnosis, or a history of fractures or falls. Only the combination showed any effect on fractures, and the authors say the benefit was too small to be clinically meaningful. "These findings do not support routine supplementation with calcium, vitamin D, or combined supplementation to prevent fractures or falls," concluded the authors, led by clinical pharmacist Olivier Massé. An accompanying editorial by three independent researchers in Canada agreed that clear evidence of effectiveness is lacking. ScienceAlert notes calcium supplements can cause constipation, bloating, abdominal pain or cramps, and that a review of 34 health guidelines found 70 percent recommended or suggested vitamin D for fracture prevention or general health. Now the caveats. The review included very few trials of people with severe vitamin D deficiency, and it left out patients receiving drug treatment for osteoporosis, so it can't tell us whether supplements help them. This is about routine use to prevent fractures, not about treating a diagnosed deficiency. So don't toss anything your doctor prescribed. Bring your bottles to your next checkup and ask three questions: what is this doing for me, what's my actual fracture risk, and what else could lower it?