Evidence map›Paper›PMID 26510847›Full record

SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2016

Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation.

C M Weaver, D D Alexander, C J Boushey, B Dawson-Hughes, J M Lappe, M S LeBoff, S Liu, A C Looker, T C Wallace, D D Wang

Erratum issuedOpen access · hybridAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 282 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
282citing papers in PubMed, 10 pooled it
28.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

282 citing papers in PubMed, 10 syntheses or guidelines pooled it, 592 citations in OpenAlex.

  1. Probiotic Supplementation and Bone Health Parameters in Adults: A Systematic Review and Meta-Analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
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  8. Dietary Inflammatory Index in relation to bone mineral density, osteoporosis risk and fracture risk: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021
    Pooled it
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  11. Effects of vitamin D3, omega-3s, and a simple home exercise program on incident vertebral fractures: the DO-HEALTH randomized controlled trial.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025
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  17. Regular Supplementation With Resveratrol Improves Bone Mineral Density in Postmenopausal Women: A Randomized, Placebo-Controlled Trial.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2020
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  20. Women's musculoskeletal health: insights from the 2024 National Academies of Sciences, Engineering, and Medicine report on chronic conditions.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026
    Review

222 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 1 country.

C M WeaverDepartment of Nutrition Science, Women's Global Health Institute, Purdue University, West Lafayette, IN, USA.
D D AlexanderEpidStat Institute, Evergreen, CO, USA.
C J BousheyCancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA.
B Dawson-HughesJean Mayer USDA Human Nutrition Research Center on Aging, Bone Metabolism Laboratory, Tufts University, Boston, MA, USA.
J M LappeSchool of Nursing, Creighton University, Omaha, NE, USA.
M S LeBoffSkeletal Health and Osteoporosis Center and Bone Density Unit, Calcium and Bone Section, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
S LiuGerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
A C LookerDivision of Health and Nutrition Examination Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA.
T C WallaceNational Osteoporosis Foundation, 1150 17th Street NW, Suite 850, Washington, DC, 20036, USA. taylor.wallace@nof.org.
D D WangDepartment of Public Health and Community Medicine, Tufts University, Boston, MA, USA.
Tufts University · USBone Health and Osteoporosis Foundation · USBrigham and Women's Hospital · USCancer Center of Hawaii · USCreighton University · USNational Center for Health Statistics · USPurdue University West Lafayette · US

Funding

VITamin D and OmegA-3 TriaL (VITAL): Interrelationship of Vitamin D and Vitamin K on BoneR01AR059775 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI LEBOFF, MERYL SUSAN · 2012 to 2022
$3.9M
NIAMS NIH HHS R01 AR059775
6 · The paper itself

Abstract

unlabelledThe aim was to meta-analyze randomized controlled trials of calcium plus vitamin D supplementation and fracture prevention. Meta-analysis showed a significant 15 % reduced risk of total fractures (summary relative risk estimate [SRRE], 0.85; 95 % confidence interval [CI], 0.73-0.98) and a 30 % reduced risk of hip fractures (SRRE, 0.70; 95 % CI, 0.56-0.87).

introductionCalcium plus vitamin D supplementation has been widely recommended to prevent osteoporosis and subsequent fractures; however, considerable controversy exists regarding the association of such supplementation and fracture risk. The aim was to conduct a meta-analysis of randomized controlled trials [RCTs] of calcium plus vitamin D supplementation and fracture prevention in adults.

methodsA PubMed literature search was conducted for the period from July 1, 2011 through July 31, 2015. RCTs reporting the effect of calcium plus vitamin D supplementation on fracture incidence were selected from English-language studies. Qualitative and quantitative information was extracted; random-effects meta-analyses were conducted to generate summary relative risk estimates (SRREs) for total and hip fractures. Statistical heterogeneity was assessed using Cochran's Q test and the I (2) statistic, and potential for publication bias was assessed.

resultsOf the citations retrieved, eight studies including 30,970 participants met criteria for inclusion in the primary analysis, reporting 195 hip fractures and 2231 total fractures. Meta-analysis of all studies showed that calcium plus vitamin D supplementation produced a statistically significant 15 % reduced risk of total fractures (SRRE, 0.85; 95 % confidence interval [CI], 0.73-0.98) and a 30 % reduced risk of hip fractures (SRRE, 0.70; 95 % CI, 0.56-0.87). Numerous sensitivity and subgroup analyses produced similar summary associations. A limitation is that this study utilized data from subgroup analysis of the Women's Health Initiative.

conclusionsThis meta-analysis of RCTs supports the use of calcium plus vitamin D supplements as an intervention for fracture risk reduction in both community-dwelling and institutionalized middle-aged to older adults.

Indexed as

Dietary SupplementsBone Density Conservation AgentsCalciumDrug Therapy, CombinationHumansOsteoporosis, PostmenopausalOsteoporotic FracturesRandomized Controlled Trials as TopicRisk AssessmentVitamin DBone Density Conservation AgentsCalciumVitamin DCalciumFractureSupplementVitamin D

Identifiers

PMID26510847
PMCPMC4715837
OpenAlexW2218738226

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.