Dietary approach to reducing falls and fractures

A large Australian study has found that increasing calcium and protein intake in older adults through dietary sources can reduce the incidence of falls and fractures, a major problem in this population.

The study involved more than 7000 residents from 60 residential aged care facilities in Victoria. Half of the centres were randomised to receive extra milk, yoghurt and cheese – increased from about two to 3.5 serves per day – and the other half to continue with their normal menus.

The research team reported that facilities providing residents with extra calcium and protein through their diet had a third less fractures overall, nearly half the number of hip fractures and an 11% reduction in falls compared to the control centres.


The seriousness of falls

Bone and muscle tissue naturally decline with aging, and can result in osteoporosis and sarcopenia, major risk factors for falls and fractures. Around a third of older adults experience falls, and more than half of those will suffer an injury that can have serious impacts on independence and quality of life.

About a third of older adults also suffer from malnutrition. This “silent killer” carries a high risk of bodily deterioration and mortality, making it a key target for addressing these issues.


Importance of prevention

It’s well established that protein is critical for maintaining muscle mass, especially with aging, and is important for bone health. Low calcium and vitamin D are also needed to maintain healthy bones.

Previous studies supplemented residents’ diets with vitamin D or calcium tables to reduce fracture risk. The research team from the current trial, led by Dr Sandra Iuliano from the University of Melbourne, set out to see if this could be achieved through diet.

Their study population had sufficient levels of vitamin D through routine supplementation, but less than adequate serves of foods containing calcium and protein.

The aim was to increase their intake to recommended levels of 1300 milligrams of calcium and 1g protein per kilogram of body weight per day. This was achieved by using milk powder to fortify milk used in recipes and drinks and offering dairy-based snacks and desserts in place of cakes and biscuits.

Reduced risk of falls and fractures was seen after just three and five months, and further subgroup analyses showed improved mineral bone density in the intervention centres. The authors say this offers an opportunity for improving health outcomes of aged-care residents.

“Our cluster randomised controlled trial showed muscles of the arms and legs [were] maintained and falls reduced in the residents given the additional dairy foods,” Iuliano told Hospital and Healthcare.

“This is an achievable goal in any aged-care setting as these foods are widely available, palatable, lost cost and can be incorporated into the daily menu.”




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