![]() Vitamin D may support skeletal health and improve bone mineralization by increasing intestinal calcium absorption, reducing secondary hyperparathyroidism, and decreasing bone turnover. 5 However, data on whether these supplements prevent fractures are conflicting. Between 19, use of vitamin D supplements increased from 5.1% to 19% among U.S. 2-4 Vitamin D supplements are widely recommended to the general population as a means to promote bone health. An estimated 53.6 million Americans have osteoporosis, low bone mass, or both, 1 and in the United States, 2 million osteoporotic fractures occur annually, a number projected to exceed 3 million fractures per year by 2040, with related costs of more than $95 billion per year. (Funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases VITAL number, NCT01704859.) Introductionįractures are major public health problems, especially among older adults. Vitamin D 3 supplementation did not result in a significantly lower risk of fractures than placebo among generally healthy midlife and older adults who were not selected for vitamin D deficiency, low bone mass, or osteoporosis. There were no substantial between-group differences in adverse events as assessed in the parent trial. There was no modification of the treatment effect according to baseline characteristics, including age, sex, race or ethnic group, body-mass index, or serum 25-hydroxyvitamin D levels. Supplemental vitamin D 3, as compared with placebo, did not have a significant effect on total fractures (which occurred in 769 of 12,927 participants in the vitamin D group and in 782 of 12,944 participants in the placebo group hazard ratio, 0.98 95% confidence interval, 0.89 to 1.08 P=0.70), nonvertebral fractures (hazard ratio, 0.97 95% CI, 0.87 to 1.07 P=0.50), or hip fractures (hazard ratio, 1.01 95% CI, 0.70 to 1.47 P=0.96). ResultsĪmong 25,871 participants (50.6% women and 20.2% Black ), we confirmed 1991 incident fractures in 1551 participants over a median follow-up of 5.3 years. Proportional-hazards models were used to estimate the treatment effect in intention-to-treat analyses. ![]() The primary end points were incident total, nonvertebral, and hip fractures. Incident fractures were reported by participants on annual questionnaires and adjudicated by centralized medical-record review. Participants were not recruited on the basis of vitamin D deficiency, low bone mass, or osteoporosis. VITAL was a two-by-two factorial, randomized, controlled trial that investigated whether supplemental vitamin D 3 (2000 IU per day), n−3 fatty acids (1 g per day), or both would prevent cancer and cardiovascular disease in men 50 years of age or older and women 55 years of age or older in the United States. In an ancillary study of the Vitamin D and Omega-3 Trial (VITAL), we tested whether supplemental vitamin D 3 would result in a lower risk of fractures than placebo. Vitamin D supplements are widely recommended for bone health in the general population, but data on whether they prevent fractures have been inconsistent. The most trusted, influential source of new medical knowledge and clinical best practices in the world. Information and tools for librarians about site license offerings. Valuable tools for building a rewarding career in health care. The authorized source of trusted medical research and education for the Chinese-language medical community. The most advanced way to teach, practice, and assess clinical reasoning skills. Information, resources, and support needed to approach rotations - and life as a resident. The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams. NEW! Peer-reviewed journal featuring in-depth articles to accelerate the transformation of health care delivery.Ĭoncise summaries and expert physician commentary that busy clinicians need to enhance patient care. NEW! A digital journal for innovative original research and fresh, bold ideas in clinical trial design and clinical decision-making.
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