The British Medical Journal publishes a randomized clinical trial where adequate intake of dairy products-milk, yogurt and cheese-is shown to reduce the risks of falls and bone fractures in the elderly. (1)
Thus, the value of dairy products as health ingredients is reconfirmed in a perspective that is by no means taken for granted. In the context, of course, of a varied but healthy and balanced diet.
Elderly people, vulnerability and risk of bone fractures
Life expectancy and elderly population shares are increasing, partly due to population decline. In Europe and Italy especially, as we have seen. Thus, vulnerabilities increase, leading, among other things, to greater exposure to the risks of falls and bone fractures.
Hip fractures are the most problematic as they drastically affect the autonomy of older people (daily activities, mobility and personal care). And it is difficult to recover functionality prior to the injury, even following surgery. Therefore, it is necessary to take appropriate preventive measures. (2)
Osteoporosis is one of the first causes of fragility that is associated with the risk of bone fractures. In addition to advancing age and nutritional deficiencies that often recur, as noted. Particularly with regard to vitamin D, protein, and calcium. (3)
Vitamin D, protein, and calcium. The study
Australian researchers aimed to test the possibility of stimulating an improvement in the overall health status (‘Health-related Quality of Life‘) of the elderly by supplementing their diet. Having regard to the correlations between muscular and skeletal fragility, on the one hand, and psychological problems that negatively affect the quality of life of these people. (4)
Milk, yogurt and cheese were therefore included in the diets of a group of over-85 residents of 30 dedicated inpatient facilities to ensure an intake of 1,300 mg/day of calcium and 1.1 g of protein per kg of body weight. In fact, the average baseline values showed insufficient intakes of calcium (600 mg/day) and protein (0.9 g per kg of weight), while finding no deficit of the equally essential vitamin D, in which dairy products are also rich.
More dairy, fewer falls and even fewer fractures
A significant reduction in bone fractures in general (-33%) — hip fractures especially (-46%) — and falls (-11%) was observed in the group of over-85-year-olds undergoing the specific nutrition program, compared with the control group. As early as 3-5 months after starting dairy supplementation. Within a cohort of about 7,200 elderly people. Conversely, no changes were found on mortality rates.
The results of the trial are mainly attributed to slowing down osteoporosis and increasing IGF-1(Insulin-like Growth Factor-1), a hormone involved in bone and muscle formation and maintenance. Demonstrating a minimum requirement of 1-1.5 g of protein per kg of body weight, in this age group. (5)
Interim conclusions
Increased life expectancy also increases the number of elderly individuals who require care and hospitalization due to their increasing frailty. Nutrition appropriate to their needs seems to be of great help in maintaining their health status.
A high intake of protein and calcium, combined with optimal vitamin D dosage, has been shown to slow progressive bone fragility and thus reduce the incidence of falls and bone fractures in the elderly. More attention should therefore be paid to supplementing the diet of elderly people with milk, yogurt and cheese.
Dario Dongo and Andrea Adelmo Della Penna
Notes
(1) Iuliano et al. (2021). Effect of dietary sources of calcium and protein on hip fractures and falls in older adults in residential care: cluster randomized controlled trial. BMJ 375 :n2364 , http://doi.org/10.1136/bmj.n2364
(2) Amarilla-Donoso et al. (2020). Quality of life in elderly people after a hip fracture: a prospective study. Health Qual. Life Outcomes 18:71, https://doi.org/10.1186/s12955-020-01314-2
(3) Inderjeeth et al. (2021). Osteoporosis in older people. Journal of Pharmacy Practice and Research 51(3):265-274, https://doi.org/10.1002/jppr.1743
(4) Pollansky Silva and Farias et al. (2020). Physical and psychological states interfere with health-related quality of life of institutionalized elderly: a cross-sectional study. BMC Geriatrics 20:386, https://doi.org/10.1186/s12877-020-01791-6
(5) The increased presence of C-terminal telopeptide (formed by the breakdown of type I collagen, which makes up much of the bone structure) and a reduction in bone mineral density were indeed observed in the control group alone, which was not subjected to dietary supplementation with dairy products
Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.
Graduated in Food Technologies and Biotechnologies, qualified food technologist, he follows the research and development area. With particular regard to European research projects (in Horizon 2020, PRIMA) where the FARE division of WIISE Srl, a benefit company, participates.
