A landmark systematic review encompassing nearly 154,000 older adults has fundamentally challenged conventional wisdom surrounding calcium and vitamin D supplementation for fracture prevention. The comprehensive analysis of randomized controlled trials reveals that these supplements—among the most widely prescribed preventive interventions globally—provide minimal to no meaningful protection against fractures or falls in most older adults. This finding contradicts decades of clinical guidance that has made supplementation a standard recommendation across multiple healthcare systems. The review raises critical questions about current supplementation practices, their cost-effectiveness, and the universality of treatment approaches. Healthcare providers and policymakers must now reassess evidence-based strategies, potentially shifting emphasis toward alternative interventions such as targeted exercise programs, optimized protein intake, and comprehensive fall prevention strategies that may offer greater clinical benefit for aging populations.
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