Increased calcium and protein intake through dairy products like milk, yogurt, and cheese was associated with a significant reduction in the risk of falls and hip fractures in older adults living in residential care facilities, according to the findings of a study published in the BMJ.
The randomized controlled study included 7195 permanent residents (mean age, 86.0 years; 68% female) from 60 residential aged care facilities in Australia. Half of the facilities provided residents with additional cheese (20 g), milk (250 mL), and yogurt (100 g) that contained 562 mg/day calcium and 12 g/day protein. This helped residents achieve a total calcium intake of 1142 (353) mg/day and a total protein intake of 69 g/day protein (1.1 g/kg body weight). Foods were provided based on residents’ preferences.
Control facilities did not provide additional dairy products to their residents, who consumed <2 servings of dairy products per day. They consumed 700 mg calcium per day and 58 g/day of protein (0.9 g/kg body weight).
Over the mean follow-up of 12.6 months, a total of 324 fractures occurred, including 121 in the intervention group and 203 in the control group. Based on these numbers, the investigators concluded that increased dairy consumption led to a 33% reduction in fracture risk (hazard ratio, 0.67; 95% CI, 0.48-0.93; P =.02). The intervention and control groups recorded 42 and 93 hip fractures, corresponding to a 46% risk reduction (HR, 0.54; 0.35-0.83; P =.005).
There were 4302 falls during the study period, including 1879 in the intervention group and 2423 in the control group, representing an 11% risk reduction for falls with increased dairy consumption (HR, 0.89; 95% CI, 0.78-0.98; P =.04). The investigators noted that the risk reduction for both hip fractures and falls achieved statistical significance at 5 months (P =.02) and 3 months (P =.004), respectively.
During follow-up, there were 1974 deaths recorded in the entire study group population, with 900 in the intervention group and 1074 in the control group. There was no statistically significant difference in mortality between these 2 groups (HR, 1.01; 0.43-3.08; P =.91).
Measures of dietary intake and causes of secondary osteoporosis were obtained from only 716 residents, and dietary protocols were monitored in only 10 percent of the residents, factors which were considered limitations of the study.
Investigators concluded that “nutritional intervention has widespread implications as a public health measure for fracture prevention in the aged care setting and potentially in the wider community.”
Disclosure: Multiple authors declared affiliations with the pharmaceutical industry. Please refer to the original article for a full list of disclosures.
Iuliano S, Poon S, Robbins J, et al. Effect of dietary sources of calcium and protein on hip fractures and falls in older adults in residential care: cluster randomised controlled trial. BMJ. Published online October 20, 2021. doi:10.1136/bmj.n2364