Population	Men or premenopausal women	Community-dwelling postmenopausal women at doses > 400 IU of vitamin D3 and > 1,000 mg of calcium	Community-dwelling postmenopausal women at doses ≤ 400 IU of vitamin D3 and ≤ 1,000 mg of calcium
Recommendation	No recommendation	No recommendation	Do not supplement
	Grade: I statement	Grade: I statement	Grade: D recommendation
Behavioral counseling interventions	Appropriate intake of vitamin D and calcium is essential to overall health. However, there is inadequate evidence to determine the effect of combined vitamin D and calcium supplementation on the incidence of fractures in men or premenopausal women.
	There is adequate evidence that daily supplementation with 400 IU of vitamin D3 and 1,000 mg of calcium has no effect on the incidence of fractures in postmenopausal women.
	There is inadequate evidence regarding the effect of higher doses of combined vitamin D and calcium supplementation on fracture incidence in community-dwelling postmenopausal women.
Balance of benefits and harms	Evidence is lacking regarding the benefit of daily vitamin D and calcium supplementation for the primary prevention of fractures, and the balance of benefits and harms cannot be determined.	Evidence is lacking regarding the benefit of daily supplementation with > 400 IU of vitamin D3 and > 1,000 mg of calcium for the primary prevention of fractures in postmenopausal women, and the balance of benefits and harms cannot be determined.	Daily supplementation with ≤ 400 IU of vitamin D3 and ≤ 1,000 mg of calcium has no net benefit for the primary prevention of fractures.
Other relevant USPSTF recommendations	The USPSTF has made recommendations on screening for osteoporosis and vitamin D supplementation to prevent falls in community-dwelling older adults. These recommendations are available at http://www.uspreventiveservicestaskforce.org.