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

Authors

  • Floor Neelemaat MSc, RD,

    Corresponding author
    1. Department of Internal Medicine, VU University Medical Center
    2. EMGO Institute for Health and Care Research, Amsterdam, the Netherlands
    • Department of Nutrition and Dietetics
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  • Paul Lips MD, PhD,

    1. Section of Endocrinology
    2. EMGO Institute for Health and Care Research, Amsterdam, the Netherlands
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  • Judith E. Bosmans PhD,

    1. Department of Health Sciences, Faculty of Earth and Life Sciences, VU University
    2. EMGO Institute for Health and Care Research, Amsterdam, the Netherlands
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  • Abel Thijs MD, PhD,

    1. Department of Internal Medicine, VU University Medical Center
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  • Jaap C. Seidell PhD,

    1. Department of Health Sciences, Faculty of Earth and Life Sciences, VU University
    2. EMGO Institute for Health and Care Research, Amsterdam, the Netherlands
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  • Marian A. E. van Bokhorst-de van der Schueren PhD, RD

    1. Department of Nutrition and Dietetics
    2. Department of Internal Medicine, VU University Medical Center
    3. EMGO Institute for Health and Care Research, Amsterdam, the Netherlands
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  • This trial was registered on http://www.trialregister.nl (candidate number 1660, NTR number NTR476, ISRCTN29617677, date ISRCTN created 27-jan-2006).
  • Oral and poster presentation at the ESPEN 2011 congres (Göteborg – Sweden).

Address correspondence to F. Neelemaat, Department of Nutrition and Dietetics, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands. E-mail: F.Neelemaat@vumc.nl

Abstract

Objectives

To evaluate the effects of a short-term nutritional intervention with protein and vitamin D on falls in malnourished older adults.

Design

Randomized controlled trial.

Setting

From hospital admission until 3 months after discharge.

Participants

Malnourished older adults (≥60) newly admitted to an acute hospital (n = 210).

Intervention

Participants were randomized to receive nutritional intervention (energy- and protein-enriched diet, oral nutritional supplements, calcium-vitamin D supplement, telephone counseling by a dietitian) for 3 months after discharge or usual care.

Measurements

Number of participants who fell, fall incidents, serum 25-hydroxyvitamin D, and dietary intake. Measurements were performed on admission to hospital and 3 months after discharge.

Results

Three months after discharge, 10 participants (10%) in the intervention group had fallen at least once, compared with 24 (23%) in the control group (hazard ratio = 0.41, 95% confidence interval (CI) = 0.19–0.86). There were 57 fall incidents (16 in the intervention group; 41 in the control group). A significantly higher intake of energy (280 kcal, 95% CI = 37–524 kcal) and protein (11 g, 95% CI = 1–25 g) and significantly higher serum 25-hydroxyvitamin D levels (10.9 nmol/L, 95% CI = 2.9–18.9 nmol/L) were found in participants in the intervention group than in controls.

Conclusion

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.

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