Using diet to reduce fractures in residential aged care homes in Australia

Dr. Sandra Iuliano is a senior research fellow in the department of medicine, University of Melbourne who undertakes research on nutrition and exercise across the lifespan specifically to improve musculoskeletal health. Dr. Iuliano presented at the FFN Congress on her recent work which involved over 7000 older adults from 60 residential aged-care homes in Australia. Research shows that in Australia 6 % of people are in care homes however these account for 30% of all the hip fractures. This is a result of the 5 times greater risk of falling than older adults in the community with 1 in 10 residents hospitalised annual due to a fall-related injury half of which are fractures. She notes that many individuals may not necessarily receive secondary prevention and rehabilitation following their fracture which can result in greater likelihood of mortality.

Dr. Iuliano’s work increased the intake of milk, yoghurt, and cheese provided to residents in care home, achieving 3.5 servings daily in older adults increasing calcium intake to over 1100mg per day and protein to 1.1g per kg body weight. The research team worked with the food service staff to increase the amount of these foods on their menus in a way that considered the preferences of the residents.

After 2 years the results found:

• Relative risk reduction of
  • 33% for all fractures
  • 46% for hip fractures
  • 11% for falls
• Slowing of bone loss
• Increase in IGF-1
• Maintenance of nutritional status
• Maintenance of weight

Dr. Iuliano noted that some consider the decline in nutritional status to be a normal result of aging, however this is not accurate. Changing the nutritional intake for individuals in care home for 2 years, including enhancing the intake of calcium and protein helps prevent falls and fractures, and reduces the risk of malnutrition.