Calcium and Vitamin D, and Vitamin K2

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Commissioned by Food Supplements Europe, this Frost & Sullivan study examines the potential health and economic benefits of supplementation with calcium and vitamin D, and vitamin K2 in form of menaquinone-7 (MK-7).

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The study quantifies the potential economic value of reducing osteoporotic fractures across the 27 EU Member States and the United Kingdom over the period 2025 to 2035. It focuses on adults estimated to have osteoporosis: those aged 50 and over for calcium and vitamin D, and those aged 55 and over for vitamin K2.

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Combining published scientific evidence with economic modelling, the analysis estimates the potential reductions in fractures and associated direct hospital costs. It then deducts supplementation costs to calculate the net economic benefits. The main analysis excludes wider costs associated with long-term disability, productivity losses, and informal care.

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Key Findings

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A growing burden of osteoporotic fractures: Across the EU27 and UK, an estimated 34.6 million adults aged 50 and over have osteoporosis in 2025, with approximately 4.6 million new fragility fractures annually. Even with hospital costs per fracture held constant, the study projects that annual direct hospital costs will rise from €59.9 billion in 2025 to €68.9 billion by 2035, driven by demographic ageing.

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Potential economic value from targeted supplementation: For every €1 spent on supplementation, the model estimates a net economic benefit of €2.37 for calcium and vitamin D, and €1.11 for vitamin K2 (MK-7), after deducting supplementation costs.

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The headline results use a scenario assuming 100% uptake among eligible individuals. They represent potential benefits rather than observed savings or additional savings over current supplementation practices. The interventions are modelled separately, and their benefits should not be added together to estimate the effects of taking both.

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Policy Implications

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The European Commission's Healthier Together initiative supports EU Member States in reducing the burden of non-communicable diseases through a coordinated approach to prevention and care. This broader policy focus provides a relevant context for considering how to address the growing burden of osteoporotic fractures. 

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This study provides an economic basis for assessing how appropriate supplementation could complement adequate nutrition, physical activity, falls prevention, and medical care. The findings could also inform discussions on improving access to professional nutritional advice and making appropriate supplementation more affordable for people with osteoporosis, taking account of individual needs and national circumstances.

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To take this evidence forward, FSE encourages policymakers at EU and national levels to:

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• Consider bone health within public health and ageing policies: Assess the potential contribution of evidence-based supplementation to broader strategies for reducing osteoporotic fractures.

• Improve access to nutritional assessment and professional advice: Support people with osteoporosis, and those at risk of developing it, in identifying their nutritional needs and understanding whether supplementation may be appropriate. 

• Explore measures to improve affordability and access: Assess whether targeted financial support or fiscal measures could make appropriate supplementation more accessible, informed by individual needs, and scientific evidence.