Supplemental Vitamin D and Incident Fractures in Midlife and Older Adults

Design

• Study: ancillary fracture analysis nested in VITAL — factorial RCT of vitamin D₃ (2000 IU/day) and marine omega-3 vs placebo for cancer/CVD parent trial
• Population: 25,871 US men (≥50 y) and women (≥55 y) not recruited for vitamin D deficiency, low bone mass, or osteoporosis
• Endpoints: participant-reported fractures with central adjudication; primary statistical endpoints total, nonvertebral, and hip fractures

Results (intention-to-treat; abstract)

• Total fractures: HR 0.98 (95% CI 0.89–1.08; P = 0.70)
• Nonvertebral fractures: HR 0.97 (95% CI 0.87–1.07; P = 0.50)
• Hip fractures: HR 1.01 (95% CI 0.70–1.47; P = 0.96)
• Subgroup note: abstract reports no meaningful effect modification by baseline 25(OH)D, age, sex, race/ethnicity, or BMI

Evidence hygiene

• General-population supplement test — not a replacement for osteoporosis treatment trials or repletion studies in documented deficiency.
• Pair with dietary / cutaneous vitamin D physiology reviews (Holick 2007) and sun-exposure association literature (Kirsch et al. 2021) without merging distinct question frames.

Publication

LeBoff MS, Chou SH, Murata EM, et al. N Engl J Med. 2022 Jul 28;387(4):299-309. doi: 10.1056/NEJMoa2202106. PMID 35939577. ClinicalTrials.gov NCT01704859.