Many older adults should avoid taking vitamin D and calcium supplements to prevent falls and fractures, and focus instead on exercises to improve balance and coordination, U.S. doctors recommend. The conclusion issued Tuesday by the U.S. Preventive Services Task Force (USPSTF) on fall and fracture prevention comes amid growing debate in the medical community over the role of vitamin D, which may help some people at lower doses but is linked to an increased risk of fractures, falls, kidney stones and certain cancers at higher doses. Vitamin D helps the boy use calcium to support bone health. The recommended daily intake of vitamin D for most adults is 600 international units, or 800 IU after age 70. Some people take vitamin D because it isn’t in many foods, though it can be found in beef liver, canned salmon or sardines, cheese and egg yolks as well as fortified milk and orange juice. Most milk sold in the U.S., for example, contains 100 IU of vitamin D per cup.

However, there isn’t enough evidence to determine the benefits and harms of taking vitamin D or calcium supplements to prevent fractures in men or women who haven’t gone through menopause, the Task Force concludes. After menopause, when decreased supplies of the hormone estrogen may increase the risk of osteoporosis, the Task Force recommends against lower doses of vitamin D and calcium to prevent fractures. Exercise can reduce the risk of falls and also lower the likelihood of falls causing serious injuries, said Dr. Janelle Guirguis-Blake, author of an evidence review published in JAMA and a researcher at the University of Washington in Seattle. “Our findings suggest that while vitamin D may possibly prevent people with known vitamin D deficiency from falling, the evidence to date does not support a benefit on fall prevention in the general population of older adults, and it appears that mega-high doses of vitamin D can actually cause harm,” Guirguis-Blake said by email.