A high dose of oral vitamin D supplementation may reduce the risk of hip and nonvertebral fracture in the enderly.

The purpose of a study, led by Heike A. Bischoff-Ferrari at Harvard School of Public Health, Boston, has been to evaluate the effectiveness of vitamin D supplementation in preventing hip and nonvertebral fractures in older persons.

A systematic review of articles was carried out.
Only double-blind RCTs ( randomized controlled trials ) of oral vitamin D supplementation ( Cholecalciferol, Ergocalciferol) with or without calcium supplementation vs calcium supplementation or placebo in older persons ( 60 years ) that examined hip or nonvertebral fractures were included.

Five RCTs for hip fracture ( n = 9294 ) and 7 RCTs for nonvertebral fracture risk ( n = 9820 ) met inclusion criteria.
All trials used Cholecalciferol.

Trial were divided in two groups: low-dose ( 400 IU/d ) and higher-dose vitamin D ( 700-800 IU/d ).

A vitamin D dose of 700 to 800 IU/d reduced the relative risk of hip fracture by 26% ( 3 RCTs with 5572 persons ) and any nonvertebral fracture by 23% ( 5 RCTs with 6098 persons ) versus calcium or placebo.

No significant benefit was observed for RCTs with 400 IU/d vitamin D ( 2 RCTs with 3722 persons ).

According to meta-analysis of controlled studies, oral vitamin D supplementation between 700 to 800 IU/d appears to reduce the risk of hip and any nonvertebral fractures in ambulatory or institutionalized elderly persons.
An oral vitamin D dose of 400 IU/d is not sufficient for fracture prevention.

Source: Journal of American Medical Association, 2005

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