Antifracture efficacy with supplemental vitamin D has been questioned by recent trials. Methods: We performed a meta-analysis on the efficacy of oral supplemental vitamin D in preventing nonvertebral and hip fractures among older individuals (Ն65 years). We included 12 double-blind randomized controlled trials (RCTs) for nonvertebral fractures (n=42 279) and 8 RCTs for hip fractures (n=40 886) comparing oral vitamin D, with or without calcium, with calcium or placebo. To incorporate adherence

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... treatment, we multiplied the dose by the percentage of adherence to estimate the mean received dose (doseϫadherence) for each trial. Results: The pooled relative risk (RR) was 0.86 (95% confidence interval [CI], 0.77-0.96) for prevention of nonvertebral fractures and 0.91 (95% CI, 0.78-1.05) for the prevention of hip fractures, but with significant heterogeneity for both end points. Including all trials, antifrac-