More Results from VITAL: Does Vitamin D Supplementation Reduce the Risk of Fractures in Midlife Adults?
BACKGROUND AND PURPOSE:
Vitamin D supplementation is often recommended as a method of preventing bone fracture, but evidence on its efficacy is conflicting
LeBoff et al. (NEJM, 2022) investigated whether supplemental vitamin D3 would result in a lower risk of incident fractures among generally healthy US adults
Ancillary study of the Vitamin D and Omega-3 Trial (VITAL)
RCT to study the effects of supplemental vitamin D3, n−3 fatty acids or both on the primary prevention of cancer and CVD
Men ≥50 years | Women ≥55 years
Supplemental vitamin D3: 2000 IU per day
Incident fractures were reported by participants on annual questionnaires
Reviewed by centralized medical-record review
Proportional-hazards models were used to estimate treatment effect
Incident total, nonvertebral, and hip fractures
50.6% women | 20.2% Black
Incident fractures: 1991
Median follow-up 5.3 years
Supplemental vitamin D3 did not have a significant effect on any fractures
Total fractures: HR 0.98 (95% CI, 0.89 to 1.08); P=0.70
Nonvertebral fractures: HR 0.97 (95% CI, 0.87 to 1.07); P=0.50
Hip fractures: HR 1.01 (95% CI, 0.70 to 1.47); P=0.96
Treatment effect was not altered by baseline characteristics, including
Age | Sex | Race or ethnic group | BMI | Serum 25-hydroxyvitamin D levels
Adverse events did not differ between groups
Vitamin D3 supplementation did not reduce the risk of fractures vs placebo among healthy individuals
The authors state
In this randomized, controlled trial, supplemental vitamin D3 did not result in a lower risk of incident total, nonvertebral, or hip fractures than placebo among generally healthy midlife and older adults who were not selected for vitamin D deficiency, low bone mass, or osteoporosis
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