To the Editor In a meta-analysis of randomized clinical trials (RCTs), Dr Zhao and colleagues1 showed that the use of calcium or vitamin D supplements or both was not associated with a lower risk of fractures in community-dwelling older adults compared with placebo or no treatment. We have a number of concerns.
First, the duration of most studies was 1 to 2 years, which is short to show antifracture efficacy. Second, the participants in all studies were at a relatively low risk of fracture, which reduces the likelihood of further risk reduction. In particular, the age range was 60 to 70 years in 8 studies and 77 to 80 years in 3 studies, and bone mineral density (BMD) was normal or in the osteopenic range.
Anagnostis P, Paschou SA, Goulis DG. Calcium and Vitamin D Supplements and Fractures in Community-Dwelling Adults. JAMA. 2018;319(19):2041. doi:10.1001/jama.2018.3935
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