Vitamin D and Reduced Fracture Risk

Research synthesisLow evidenceSmall effect6 studies · 3 beneficial · 3 neutral · 0 harmful

Across 6 studies, 3 reported beneficial small effects of vitamin D on fracture risk, while 3 found neutral effects. The predominant effect size was small. No clear dose range emerged, and the most studied population was postmenopausal women. Effect sizes were consistently small across both beneficial and neutral findings.

Studied populations: postmenopausal women, older adults

Caveats: Many of the included studies did not reach statistical significance (only 3 of 6 studies were significant) — effect may be smaller than the predominant direction suggests. Evidence base is small (only 6 studies) — conclusions should be considered preliminary. Limited by inconsistent reporting of doses and study durations.

Generated Jul 12, 2026

Doses used in studies

IU/day: 2,000–4,000 (median 3,000, IQR 2,000–4,000) — 1 study

Safety in these studies

fallIncreased risk
growing evidence suggesting an increased fall risk associated with high-dose bolus administration
from: Revisiting the Role of Vitamin D in Fracture Prevention in the Era of Mega-Trials.
Overall tolerabilityReported
Calcium and vitamin D co-supplementation robustly preserves bone mineral density and mitigates fracture risk.
from: Dietary interventions and nutritional strategies for menopausal health: a mini review.
Overall tolerabilityReported
High-certainty evidence supports vitamin D safety
from: Complementary therapies for management of menopausal symptoms: a systematic review to info
micronutrient deficienciesReported
Despite these advances, postmenopausal women remain disproportionately vulnerable to micronutrient deficiencies, underscoring the imperative for balanced, nutrient-dense intake.
from: Dietary interventions and nutritional strategies for menopausal health: a mini review.

6 of 6 papersPopulation:

The effects of combined calcium and vitamin D supplementation on bone mineral density and fracture risk in postmenopausal women with osteoporosis: a systematic review and meta-analysis of randomized controlled trials.
- 2025-10-08
- Meta-Analysis · n = 869
- BMC musculoskeletal disorders 26(1)
- - Bo Cong
  - Haiguang Zhang
- PubMed: 41063100
- DOI: 10.1186/s12891-025-09089-7
7 Insights on
- Reduced Fracture Risk
- High evidence
- Clinical
The overall fracture risk was not significantly reduced (RR = 0.98, 95% CI: 0.89–1.07, p = 0.68)
Effect
Neutral
Effect size
Small
Significant
No
Complementary therapies for management of menopausal symptoms: a systematic review to inform the update of the International Menopause Society recommendations on women's midlife health.
- 2026-01-07
- Systematic Review
- Climacteric : the journal of the International Menopause Society 29(2)
- - Alison Maunder
  - Amelia K Mardon
  - Vibhuti Rao
  - Sophia Torkel
  - Najwa-Joelle Metri
  - Jing Liu
  - Guoyan Yang
  - Nora Giese
  - Evangeline Mantzioris
  - Nur K Abdul Jafar
  - Geovanna E Rodrigues de Souza
  - Ieman Al-Kanini
  - Lorena Romero
  - Nick Panay
  - Hugo Pedder
  - Carolyn Ee
- PubMed: 41498229
- DOI: 10.1080/13697137.2025.2584061
2 Insights on
- Reduced Fracture Risk
- High evidence
- Clinical
moderate-certainty evidence supports vitamin D (fracture risk)
Effect
Beneficial
Effect size
Small
Significant
Yes
Effect of vitamin D-fortified foods on bone health and osteoporosis: a scoping review and future policies focusing on the United Arab Emirates.
- 2025-09-22
- Systematic Review · n = 14
- Archives of osteoporosis 20(1)
- - Sehar Iqbal
  - Maya Abuajlan
  - Amira Alktheri
  - Zoha Imtiaz Malik
  - Abdul Momin Rizwan Ahmad
  - Taima Qudah
  - Suhad Abumweis
- PubMed: 40982112
- DOI: 10.1007/s11657-025-01611-7
3 Insights on
- Reduced Fracture Risk
- High evidence
Evidence from most of the studies (n=9) indicates that regular consumption of vitamin D-fortified foods improves serum 25(OH)D levels, enhances bone mineral density, and lowers the risk of fractures.
Effect
Beneficial
Effect size
Small
Significant
Yes
Effectiveness of Vitamin D Supplements in Reducing the Risk of Falls among Older Adults: A Meta-Analysis of Randomized Controlled Trials.
- 2023-09-30
- Meta-Analysis
- Annals of geriatric medicine and research 27(3)
- - Tiara Octary
  - Made Satya Nugraha Gautama
  - Hai Duong
- PubMed: 37654099
- DOI: 10.4235/agmr.23.0047
2 Insights on
- Reduced Fracture Risk
- High evidence
- Elderly
Pooled subgroup analysis showed that neither low (<2,000 IU/day) nor high (≥2,000 and <4,000 IU/day) doses of vitamin D supplementation had any significant effect on the incidence of falls and fractures.
Effect
Neutral
Effect size
Small
Significant
No
Dose
≥2000 and <4000 IU/day
Revisiting the Role of Vitamin D in Fracture Prevention in the Era of Mega-Trials.
- 2026-04-30
- Review
- Endocrinology and metabolism (Seoul, Korea) 41(2)
- - Sung Hye Kong
- PubMed: 42114835
- DOI: 10.3803/enm.2026.2938
3 Insights on
- Reduced Fracture Risk
- Low evidence
recent large-scale randomized controlled trials have failed to replicate the broad benefits previously observed in epidemiological studies, particularly with respect to fracture and fall prevention in vitamin D-replete populations.
Effect
Neutral
Effect size
Small
Significant
No
Dose
high-dose bolus administration
Dietary interventions and nutritional strategies for menopausal health: a mini review.
- 2025-12-15
- Review
- Frontiers in nutrition 12
- - Yi-Chen Liu
  - Zhi-Qing Guo
- PubMed: 41473185
- DOI: 10.3389/fnut.2025.1702105
2 Insights on
- Reduced Fracture Risk
- Low evidence
- Clinical
Calcium and vitamin D co-supplementation robustly preserves bone mineral density and mitigates fracture risk.
Effect
Beneficial
Effect size
Moderate
Significant
Yes

Vitamin D and Reduced Fracture Risk

The effects of combined calcium and vitamin D supplementation on bone mineral density and fracture risk in postmenopausal women with osteoporosis: a systematic review and meta-analysis of randomized controlled trials.

Complementary therapies for management of menopausal symptoms: a systematic review to inform the update of the International Menopause Society recommendations on women's midlife health.

Effect of vitamin D-fortified foods on bone health and osteoporosis: a scoping review and future policies focusing on the United Arab Emirates.

Effectiveness of Vitamin D Supplements in Reducing the Risk of Falls among Older Adults: A Meta-Analysis of Randomized Controlled Trials.

Revisiting the Role of Vitamin D in Fracture Prevention in the Era of Mega-Trials.

Dietary interventions and nutritional strategies for menopausal health: a mini review.