clinical focus
Osteoporosis is sometimes referred to as the silent epidemic. It often goes unnoticed until a related fracture occurs. The condition develops when bones become weak, brittle and more susceptible to fractures and can indicate long-term deficits in calcium, vitamin D and protein, and lack of weight-bearing exercises. A balanced diet, exercise and sunshine play vital roles in maintaining bone strength and minimising the risk of falls.
Appetite goes before a fall
Reduce the risk of painful, damaging tumbles by ensuring proper nutrition and hydration.
By Samantha Ling
Falls are amongst some of the most serious and preventable injury-related causes of hospitalisation facing older Australians, with 1 in 5 people either breaking a bone or sustaining a serious injury due to a fall. Research indicates that poor nutrition is linked to many risk factors for falls and can play a key role in the severity of the injuries incurred from falling, as well as the time spent recovering.
Older Australians are at risk of undernourishment due to reduced energy needs influencing appetite, combined with a decreased ability to absorb nutrients. A staggering 30 per cent of people aged 60 years or older who live independently suffer from some degree of malnutrition. Sadly, almost 50 per cent of Australians living in aged-care facilities are malnourished.
Malnutrition is one of the many preventable risk factors that may increase a person’ s chances of having a fall. A suboptimal intake of food resulting in the unintentional loss of body weight( whether from reduced appetite or illness) often leads to frailty and weakness, loss of muscle mass and strength, limited mobility, impaired balance and therefore an increased risk of having a fall.
Similarly, a low body weight as a result of malnutrition affects not only muscle strength but also bone density, increasing the risk of fractures and broken bones as a result of a fall.
Reducing Risk Taking the following steps towards optimal nutrition in healthcare settings and in the community for older Australians is key to maximising nutritional health, preventing malnutrition and subsequently reducing the risk of falls.
Maintain a healthy weight. Weight loss is not a normal part of ageing and normally means you are losing muscle as well as fat stores. Rapid weight loss, particularly unintentional weight loss, indicates deficits in nutrients, increasing the risk of malnutrition. Carrying a little extra body fat can be protective against falls injuries. This is because body fat acts like a cushion as well as helping the body meet increased energy requirements sustained from an injury such as a fracture. An accredited practising dietitian can assist in determining if an individual’ s weight is healthy for their age, gender and level of physical activity.
The sunshine vitamin. Combined with calcium, vitamin D helps minimise bone loss and maintain strong, healthy bones. Vitamin D is also involved with maintaining muscle strength and healthy nerve function for everyday movement. Unfortunately, sourcing adequate vitamin D from the diet alone is not sufficient in maintaining healthy vitamin D levels. The main source of vitamin D for Australians is exposure of 15 per cent of the body to sunlight for about two hours a week; for example, exposing the face and arms. If regular sunlight exposure is not possible, vitamin D supplementation may be appropriate.
Provide 3 nutritious meals a day or smaller, regular meals. A nutrient-dense diet assists with providing adequate amounts of energy, protein and numerous vitamins and minerals that affect strength, mobility and visual and cognitive function. Fortified foods can help add extra nutrition without adding bulk to the meal. Smaller meals may be more appealing when appetite is low.
Try to include a source of protein with every meal. It is important to remember that muscle loss is a natural process that accompanies ageing. Recent research indicates that diets rich in protein, combined with resistance training can help minimise muscle wasting with ageing. Excellent sources of protein in the diet include meat, fish, poultry, dairy products, nuts, seeds, eggs and legumes such as baked beans. keep hydrated. Dehydration can lead to confusion, fluctuations in blood pressure and dizziness, increasing the risk of having a fall. Ideally, six to eight glasses of hydrating fluids should be consumed every day. This may include water, milk and non-dairy milk alternatives such as soy milk, smoothies, soup, fruit juices and cordial.
Provide 3 – 4 serves of calcium-rich foods every day. A diet rich in calcium can assist with maintaining strong bones and preventing fractures and osteoporosis. Calcium-rich foods, such as yoghurt, custard, cheese and flavoured milk can make tasty snacks. n
samantha Ling is an accredited practising clinical dietitian. To locate an accredited practising dietitian in your area, visit the‘ Find an APd’ section of the dAA website at daa. asn. au or call 1800 812 942.
30 agedcareinsite. com. au