Short‐Term Oral Nutritional Intervention with Protein and Vitamin D Decreases Falls in Malnourished Older Adults

MSc, RD Floor Neelemaat; Lips, Paul; Bosmans, Judith E.; Thijs, Abel; Seidell, Jacob C.; Schueren, Marian A.E. de van der

doi:10.1111/j.1532-5415.2011.03888.x

Cited by 99 publications

(76 citation statements)

References 34 publications

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“…The trial designs included parallel group, [22-27,29,30,35,37,38] cluster [20,28,33] and factorial [31,32,36] design RCTs. The studies were undertaken in Australia, [20,22,25,32,33] the Netherlands, [24,26,38] New Zealand, [31] Switzerland, [35,36] Germany, [37] Sweden, [29] Taiwan [27,28] and the USA [23,30]. A total of 5034 participants were included, with sample sizes ranging from 24 [35] to 1,107 [32].…”

Section: Resultsmentioning

confidence: 99%

“…The mean age of participants in the included studies ranged from 69 to 86.4 years and the proportion of females ranged from 38% to 100%. Twelve studies [7,24-26,29-31,33,35-38] recruited only participants known to be at high risk of falling. Six studies targeted people with specific characteristics including visual impairment, [31] osteoporosis/osteopenia, [35] acute hip fracture, [36] stroke, [29] malnourishment [38] and foot problems [25].…”

Section: Resultsmentioning

confidence: 99%

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Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis

et al. 2014

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BackgroundLimited attention has been paid in the literature to multiple component fall prevention interventions that comprise two or more fixed combinations of fall prevention interventions that are not individually tailored following a risk assessment. The study objective was to determine the effect of multiple component interventions on fall rates, number of fallers and fall-related injuries among older people and to establish effect sizes of particular intervention combinations.MethodsMedline, EMBASE, CINAHL, PsychInfo, Cochrane, AMED, UK Clinical Research Network Study Portfolio, Current Controlled Trials register and Australian and New Zealand Clinical Trials register were systematically searched to August 2013 for randomised controlled trials targeting those aged 60 years and older with any medical condition or in any setting that compared multiple component interventions with no intervention, placebo or usual clinical care on the outcomes reported falls, number that fall or fall-related injuries. Included studies were appraised using the Cochrane risk of bias tool. Estimates of fall rate ratio and risk ratio were pooled across studies using random effects meta-analysis. Data synthesis took place in 2013.ResultsEighteen papers reporting 17 trials were included (5034 participants). There was a reduction in the number of people that fell (pooled risk ratio = 0.85, 95% confidence interval (95% CI) 0.80 to 0.91) and the fall rate (pooled rate ratio = 0.80, 95% CI 0.72 to 0.89) in favour of multiple component interventions when compared with controls. There was a small amount of statistical heterogeneity (I2 = 20%) across studies for fall rate and no heterogeneity across studies examining number of people that fell.ConclusionsThis systematic review and meta-analysis of randomised controlled trials found evidence that multiple component interventions that are not tailored to individually assessed risk factors are effective at reducing both the number of people that fall and the fall rate. This approach should be considered as a service delivery option.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis

et al. 2014

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“…Results from these investigations suggest that nutritional supplementation after hospitalization can lower the incidence of falls [64], reduce inflammation (during concomitant rehabilitation) [66], and increase handgrip strength [63, 65]. However, these previous studies have not observed benefits of protein supplementation on measures of physical function or muscle size.…”

Section: Discussionmentioning

confidence: 99%

Identifying effective and feasible interventions to accelerate functional recovery from hospitalization in older adults: A randomized controlled pilot trial

Deer

Dickinson

Fisher

et al. 2016

Contemporary Clinical Trials

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Hospitalization induces functional decline in older adults. Many geriatric patients fail to fully recover physical function after hospitalization, which increases the risk of frailty, disability, dependence, re-hospitalization, and mortality. There is a lack of evidence-based therapies that can be implemented following hospitalization to accelerate functional improvements. The aims of this Phase I clinical trial are to determine 1) the effect size and variability of targeted interventions in accelerating functional recovery from hospitalization and 2) the feasibility of implementing such interventions in community-dwelling older adults. Older patients (≥65 yr, n=100) will be recruited from a single site during hospitalization for an acute medical condition. Subjects will be randomized to one of five interventions initiated immediately upon discharge: 1. protein supplementation, 2. in-home rehabilitation plus placebo supplementation, 3. in-home rehabilitation plus protein supplementation, 4. single testosterone injection, or 5. isocaloric placebo supplementation. Testing will occur during hospitalization (baseline) and at 1 and 4 weeks post discharge. Each testing session will include measures of muscle strength, physical function/performance, body composition, and psychological function. Physical activity levels will be continuously monitored throughout study participation. Feasibility will be determined through collection of the number of eligible, contacted, and enrolled patients; intervention adherence and compliance; and reasons for declining enrollment and study withdrawal. This research will determine the feasibility of post-hospitalization strategies to improve physical function in older adults. These results will also provide a foundation for performing larger, multi-site clinical trials to improve physical function and reduce readmissions in geriatric patents.

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“…The current literature is not in agreement concerning the effects of protein supplements on total energy intake, especially with a wide variety of supplementing methods. The findings suggest that energy intake can be increased (Cawood et al, 2011;Kuipers et al, 1993;Neelemaat et al, 2012;Raynaud-Simon, 2005;Wilson et al, 2002), decreased (Jeor et al, 2001 or unchanged (Rumpler et al, 2006) when supplementing with protein. It was concluded that the amount of protein (34 g) supplemented by Rumpler et al (2006) was insufficient to induce a change in energy intake, which could explain why in this study there was no difference in energy intake between baseline and HP.…”

Section: Table 3 Effect Of High Protein (Hp) and Mixed Macronutrient mentioning

confidence: 91%

Protein Supplements: Do They Alter Dietary Intakes?

Mallard¹,

McLay-Cooke²,

Rehrer³

2014

International Journal of Sport Nutrition and Exercise Metabolism

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Effects of protein versus mixed macronutrient supplementation on total energy intake (TEI) and protein intake during an ad libitum diet were examined. Trained males undertook two, 2-week dietary interventions which were randomized, double blinded, and separated by 2 weeks. These were high-protein supplementation (HP: 1034.5 kJ energy, 29.6 g protein, 8.7 g fat and 12.3 g CHO) and standard meal supplementation (SM: 1039 kJ energy, 9.9 g protein, 9.5 g fat, and 29.4 g CHO) consumed daily following a week of baseline measures. Eighteen participants finished both interventions and one only completed HP. TEI (mean ± SD) was not different between baseline (11148 ± 3347 kJ) and HP (10705 ± 3143 kJ) nor between baseline and SM (12381 ± 3877 kJ), however, TEI was greater with SM than HP (923 ± 4015 kJ p = .043). Protein intake (%TEI) was greater with HP (22.4 ± 6.2%) than baseline (19.4 ± 5.4%; p = .008) but not SM (20.0 ± 5.0%). No differences in absolute daily protein intake were found. Absolute CHO intake was greater with SM than HP (52.0 ± 89.5 g, p = .006). No differences in fat intake were found. Body mass did not change between baseline (82.7 ± 11.2 kg) and either HP (83.1 ± 11.7 kg) or SM (82.9 ± 11.0 kg). Protein supplementation increases the relative proportion of protein in the diet, but doesn't increase the absolute amount of total protein or energy consumed. Thus some compensation by a reduction in other foods occurs. This is in contrast to a mixed nutrient supplement, which does not alter the proportion of protein consumed but does increase TEI.

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Short‐Term Oral Nutritional Intervention with Protein and Vitamin D Decreases Falls in Malnourished Older Adults

Abstract: A short-term nutritional intervention consisting of oral nutritional supplements and calcium and vitamin D supplementation and supported by dietetic counseling in malnourished older adults decreases the number of patients who fall and fall incidents.

Cited by 99 publications

References 34 publications

Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis

Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis

Identifying effective and feasible interventions to accelerate functional recovery from hospitalization in older adults: A randomized controlled pilot trial

Protein Supplements: Do They Alter Dietary Intakes?

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