According to the panel of independent experts, while the essential nutrients are important for overall health, there is inadequate evidence of net benefit for these endpoints, and supplementation could be accompanied by a small risk of kidney stones.
The recommendation applies to post-menopausal women and men over the age 60 but excludes community-dwelling adults who may be more susceptible to falls or fractures or those with medical conditions associated with vitamin D deficiency or a diagnosis of osteoporosis.
When finalized, it will update a 2018 final recommendation against daily supplementation with 400 IU or less of vitamin D and 100 mg or less of calcium for the primary prevention of fractures that applied only to community-dwelling, postmenopausal women.
At the time, evidence was insufficient to assess the balance of the benefits and harms of vitamin D and calcium supplementation, alone or in combination, for the primary prevention of fractures in men and premenopausal women, or at doses greater than 400 IU of vitamin D and greater than 1,000 mg of calcium in community-dwelling, postmenopausal women.
The updated recommendation, which removes reference to specific doses, is accompanied by a 210-page evidence review prepared for the Agency for Healthcare Research and Quality at the U.S. Department of Health and Human Services.
‘Don’t Discard Your Vitamin D Just Yet’
In a statement titled “Not So Fast. Don’t Discard Your Vitamin D Just Yet” issued Wednesday, the Council for Responsible Nutrition (CRN) cautioned that because recommendations are limited to a small segment of the population, they should not be misinterpreted as broadly advising against supplementation with essential nutrients. The trade association also highlighted that a science review must consider baseline vitamin D levels to reach proper conclusions.
“Americans continue to fall short on key nutrients like calcium and vitamin D,” said Dr. Andrea Wong, senior vice president of scientific and regulatory affairs at CRN. “Dismissing supplementation as unnecessary for the general population undermines its value for those who need it most. It’s time for guidance that reflects the full scope of science and prioritizes public health equity.”
She added that older adults with limited sun exposure, restricted diets or darker skin tones often face a higher risk of deficiency, making targeted supplementation critical for their health.
Task force member Dr. Goutham Rao, chair of the Department of Family Medicine and Community Health and chief clinician experience officer for the University Hospitals Health System in Cleveland, noted that the USPSTF recommendation recognizes the importance of maintaining vitamin levels.
“One of the key messages we need to get out there is, nobody is suggesting that you not take vitamin D and calcium, because the National Academy of Medicine has specific recommendations for how much vitamin D and calcium you should have in your diet or through supplements on a daily basis, and it’s very important for bone health, for brain health, for all sorts of things,” he told CNN. “It’s just with respect to fractures and falls that we didn’t see the benefit.”
Recommended levels and cost savings
The National Academy of Medicine recommends a dietary intake of 600 IU of vitamin D and 1,000 mg of calcium for adults ages 19 to 50 years and males ages 51 to 70 years, 600 IU of vitamin D and 1,200 mg of calcium for females ages 51 to 70 years, and 800 IU of vitamin D and 1,200 mg of calcium for adults 70 years and older, for overall health.
Vitamin D has been associated with a range of health benefits from helping the body absorb calcium for normal bone mineralization and preventing rickets to regulating immunity, brain development, muscle function and cell growth. Calcium is the most abundant mineral in the body and is stored mostly in bones and teeth.
In its statement, CRN also highlighted findings from its Supplements to Savings report, which showed that consistent vitamin D and calcium supplementation among at-risk populations could help prevent significant numbers of fractures annually, translating into substantial healthcare cost savings.
“Investing in preventive nutrition is not only beneficial for individual health but also makes economic sense,” Dr. Wong said.
The USPSTF draft recommendation is available for public comment through Jan. 21.
