Joel A. Simon, MD, MPH
Does vitamin D, calcium, or a combination of both improve health outcomes?
Included studies evaluated oral vitamin D and calcium supplements with known doses, used alone or together, in generally healthy people. Exclusion criteria included studies of older adults (mean age ≥ 65 y) who had a disease other than hypertension at baseline and those of younger adults that included > 20% of people with diseases at baseline. Additional selection criteria were used for each outcome and for systematic reviews. This abstract focuses on a subset of evaluated outcomes in randomized controlled trials (RCTs): mortality, cardiovascular (CV) disease, and cancer.
MEDLINE and Cochrane CENTRAL (to Apr 2009), Cochrane Database of Systematic Reviews and Health Technology Assessments (to Dec 2008), and reference lists were searched for English-language RCTs; prospective, nonrandomized, comparative studies; prospective longitudinal or nested case–control studies; and systematic reviews. 165 studies, including 60 RCTs, and 11 systematic reviews met the selection criteria.
The Table shows selected results.
Evidence for the effectiveness of vitamin D, calcium, or a combination of both for improving health outcomes is limited.
Vitamin D, calcium, or a combination of both vs placebo or no treatment*
*CV = cardiovascular; HR = hazard ratio; OR = odds ratio; RCT = randomized controlled trial; RR = relative risk; other abbreviations defined in Glossary. Individual studies were all graded B on a 3-category (A to C) quality scale.
†Values < 1 favor treatment.
‡Calcium was included in both treatment groups in some trials.
§Composite of myocardial infarction, coronary heart disease mortality, coronary artery bypass graft, or percutaneous coronary intervention.
Simon JA. Review: Evidence for the effectiveness of vitamin D and calcium for reducing CV outcomes, cancer, and death is limited. Ann Intern Med. 2009;151:JC5–5. doi: 10.7326/0003-4819-151-10-200911170-02005
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Published: Ann Intern Med. 2009;151(10):JC5-5.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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