Hip Fracture Patients in Geriatric Rehabilitation Show Poor Nutritional Status, Dietary Intake and Muscle Health.

The aim of this study was to gain insight into the nutritional status, dietary intake and muscle health of older Dutch hip fracture patients to prevent recurrent fractures and to underpin rehabilitation programs. This cross-sectional study enrolled 40 hip fracture patients (mean ± SD age 82 ± 8.0 years) from geriatric rehabilitation wards of two nursing homes in the Netherlands. Assessments included nutritional status (Mini Nutritional Assessment), dietary intake on three non-consecutive days which were compared with Dietary Reference Intake values, and handgrip strength. Muscle mass was measured using Bioelectrical Impedance Analysis and ultrasound scans of the rectus femoris. Malnutrition or risk of malnutrition was present in 73% of participants. Mean energy, protein, fibre and polyunsaturated fat intakes were significantly below the recommendations, while saturated fat was significantly above the UL. Protein intake was <0.8 in 46% and <1.2 g/(kg·day) in 92%. Regarding micronutrients, mean intakes of calcium, vitamin D, potassium, magnesium and selenium were significantly below the recommendations. The prevalence of low muscle mass, low handgrip strength and sarcopenia were 35%, 27% and 10%, respectively. In conclusion, a poor nutritional status, dietary intake and muscle health are common in older hip fracture patients in geriatric rehabilitation wards.

High Versus low Dietary Protein Intake and Bone Health in Older Adults: a Systematic Review and Meta-Analysis.

Protein may play a beneficial role in the prevention of bone loss and in slowing down osteoporosis. The effect of dietary protein may be different in older adults compared to younger adults, since this population has a greater need for protein. The aim of this systematic review and meta-analysis was to investigate the impact of a dietary protein intake above the Recommended Dietary Allowance (RDA) of 0.8 g/kg body weight/day from any source on Bone Mineral Density (BMD)/Bone Mineral Content (BMC), bone turnover markers, and fracture risk in older adults compared to a lower dietary protein intake. A systematic search was conducted through October 2018 in 3 databases: CENTRAL, MEDLINE, and EMBASE. We included all prospective cohort studies and Randomized Controlled Trials (RCTs) among adults aged ≥65 years that examined the relation between protein intake on bone health outcomes. Two investigators independently conducted abstract and full-text screenings, data extractions, and risk of bias assessments. Authors were contacted for missing data. After screening of 523 records, twelve cohort studies and one RCT were included. Qualitative evaluation showed a positive trend between higher protein intakes and higher femoral neck and total hip BMD. Meta-analysis of four cohort studies showed that higher protein intakes resulted in a significant decrease in hip fractures (pooled hazard ratio: 0.89; 95% confidence interval: 0.84, 0.94). This systematic review supports that a protein intake above the current RDA may reduce hip fracture risk and may play a beneficial role in BMD maintenance and loss in older adults.