This three-year double-blind RCT tested whether daily calcium plus vitamin D reduces bone loss and fractures in men and women 65 and older living at home. Subjects received either 500 mg calcium plus 700 IU vitamin D3 or placebo. Outcomes were bone mineral density, bone turnover markers, and nonvertebral fractures.
For a community-dwelling patient over 65, daily calcium (500 mg) plus vitamin D3 (700 IU) is a low-cost intervention that nearly halves nonvertebral fracture risk. The mechanism is worth understanding: the density gains were modest and concentrated in year 1, yet fractures kept dropping across all three years.
The authors attribute this to reduced bone turnover lowering trabecular perforation and cortical porosity, meaning better bone quality rather than more mineral. This reframes how you think about supplementation. It is not just about adding density on a DEXA report.
Note the limits: the fracture numbers were small (37 events total), and this remains a supplement trial, not a substitute for bisphosphonates in established osteoporosis. Still, it established that men and both sexes living at home benefit, extending evidence beyond the earlier retirement-home and postmenopausal-women studies.
This three-year double-blind RCT tested whether daily calcium plus vitamin D reduces bone loss and fractures in men and women 65 and older living at home. Subjects received either 500 mg calcium plus 700 IU vitamin D3 or placebo. Outcomes were bone mineral density, bone turnover markers, and nonvertebral fractures.
For a community-dwelling patient over 65, daily calcium (500 mg) plus vitamin D3 (700 IU) is a low-cost intervention that nearly halves nonvertebral fracture risk. The mechanism is worth understanding: the density gains were modest and concentrated in year 1, yet fractures kept dropping across all three years.
The authors attribute this to reduced bone turnover lowering trabecular perforation and cortical porosity, meaning better bone quality rather than more mineral. This reframes how you think about supplementation. It is not just about adding density on a DEXA report.
Note the limits: the fracture numbers were small (37 events total), and this remains a supplement trial, not a substitute for bisphosphonates in established osteoporosis. Still, it established that men and both sexes living at home benefit, extending evidence beyond the earlier retirement-home and postmenopausal-women studies.