Nutrition and fall prevention

The prevention of falls isn’t limited to exercise only. In fact, nutrition and hydration play an important role in fall prevention. While we know that around 20-30% of Canadian seniors fall each year, we also know that one third of seniors in Canada have an increased nutritional risk, which leads to weakness, frailty and falls.



Proteins and muscle mass


Older adults will need more proteins than younger adults to stay healthy, recover from illness, and maintain functionality. It is recommended to eat between 1.0 and 1.2 g of protein per kilogram of body weight per day (or 25 to 30 grams per meal). For older adults with acute or chronic diseases (except those with severe kidney disease), this number is a bit higher with 1.2 to 1.5 g per kg of body weight per day. Proteins can be found in eggs, meat, nuts, seeds, chicken and dairy products.


Aging is often linked with loss of appetite and changes in taste and smell. Moreover, it is often associated with reduced ability to swallow and mobility constraints which make it harder to shop for healthful foods and, therefore, lead to lower food choice and intake. Using community food resources like grocery delivery services, cooking with friends and family members, eating smaller meals more often are all good ways to improve nutrition and thus prevent falls! You should talk with your dentist or physician if you’re having trouble with your dentures or if you have difficulty swallowing.


It is normal to lose muscle mass with age. This process is known as sarcopenia. It is estimated that there is a 15% muscle loss per decade after the age of 70. This process may be faster with inactivity like bed rest and hospitalization even when eating proper amounts of proteins. Therefore, staying active is also important!



Vitamin D


Vitamin D is a common nutritional deficiency in adults. Over 80% of Canadians over the age of 71 don’t have adequate intakes of vitamin D and calcium. Vitamin D can be found in oily fish, red meat, egg yolks and fortified foods. In addition, spending enough time in the sun by doing activities outside is another solution. Examples include daily group walks and playing bingo outside (if the weather permits). If it’s hard to get good amounts of vitamin D from the diet and/or sunshine, supplements can be another option. For adults over 50, the recommended range of vitamin D supplements is 800-2000 mg per day.




Calcium


Calcium and Vitamin D work together! In fact, vitamin D helps your body absorb calcium. Lower vitamin D intakes does affect calcium absorption and might increase the risk of bone loss. Over 99% of total body calcium is found in teeth and bones. Calcium reduces fractures in older adults and may even influence the impact of protein on the skeleton. Adults over 50 need 1200mg of calcium per day.


Ask your physician about vitamin D and calcium supplementation!


Anemia


Anemia can make you weak and dizzy, which could lead to falls. This may be prevented by having adequate intakes of iron, folic acid and possibly vitamin B12.



Diabetes


People with diabetes should work with their doctor to manage their blood sugar levels as both high blood sugar (hyperglycemia) and low blood sugars (hypoglycemia) can cause falls.


Stay hydrated!


Dehydration and/or orthostatic hypotension (drop in the blood pressure when standing) increase the risk of falls. Thus, having adequate fluid levels in the body is important. It is recommended to drink at least 1.5 to 2 liters per day. This includes fluids like water, milk, soups, coffee and fruits or vegetables that have high water content like watermelon and cucumber.


Role of dieticians


A registered dietitian will help you develop meal plans that are specific to your dietary needs after a proper assessment. Dietitians also empower their patients to embrace, understand and to enjoy food!




References:


Injury Prevention Program, Winnipeg Regional Health Authority. (n.d). Falls are a significant health problem for older adults. Retrieved January 2, 2021, from https://preventfalls.ca/older-adults/


Dorner, B and ME Posthauer. (2012). Nutrition’s role in Sarcopenia Prevention. Today’s Dietitian Vol. 14 No 9 P.62


Bauer, J., Biolo, G., Cederholm, T., Cesari, M., Cruz-Jentoft, A. J., Morley, J. E., Phillips, S., Sieber, C., Stehle, P., Teta, D., Visvanathan, R., Volpi, E., & Boirie, Y. (2013). Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. Journal of the American Medical Directors Association, 14(8), 542–559. https://doi.org/10.1016/j.jamda.2013.05.021


HealthLinkBC. (2019, September). Quick Nutrition Check for Protein. Retrieved January 2, 2021, from https://www.healthlinkbc.ca/healthy-eating/Quick-Nutrition-Check-Protein


Institute of Medicine (US) Food Forum. Providing Healthy and Safe Foods As We Age: Workshop Summary. Washington (DC): National Academies Press (US); 2010. 5, Nutrition Concerns for Aging Populations. Available from: https://www.ncbi.nlm.nih.gov/books/NBK51837/


Boschung, K. (n.d). How to Prevent Falls with Good Nutrition. Retrieved January 2, 2021, from https://www.islandhealth.ca/sites/default/files/2018-09/Avoid-falls-good-nutrition.pdf


Osteoporosis Canada. (n.d). Calcium and vitamin D. Retrieved January 2, 2021, from https://osteoporosis.ca/bone-health-osteoporosis/calcium-and-vitamin-d/


Government of Canada. (2012, March 15). Do Canadian Adults Meet Their Nutrient Requirements Through Food Intake Alone? Retrieved January 2, 2021, from https://www.canada.ca/en/health-canada/services/food-nutrition/food-nutrition-surveillance/health-nutrition-surveys/canadian-community-health-survey-cchs/canadian-adults-meet-their-nutrient-requirements-through-food-intake-alone-health-canada-2012.html


United Kingdom National Health Service. (2020, August 03). Vitamin D – Vitamins and minerals. Retrieved January 2, 2021, from https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/


Eat Well Nutrition. (n.d). Falls prevention and nutrition. Retrieved January 2, 2021, from https://www.eatwellnutrition.com.au/preventing-malnutrition/falls-prevention-and-nutrition


Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington (DC): National Academies Press (US); 1997. 4, Calcium. Available from: https://www.ncbi.nlm.nih.gov/books/NBK109827/


Canadian Physiotherapy Association. (Spring 2015). Nutrition & Fall Prevention. Retrieved January 2, 2021, from https://physiotherapy.ca/nutrition-fall-prevention-spring-2015


Girelli, D., Marchi, G., & Camaschella, C. (2018). Anemia in the Elderly. HemaSphere, 2(3), e40. https://doi.org/10.1097/HS9.0000000000000040


Malabu, U. H., Vangaveti, V. N., & Kennedy, R. L. (2014). Disease burden evaluation of fall-related events in the elderly due to hypoglycemia and other diabetic complications: a clinical review. Clinical epidemiology, 6, 287–294. https://doi.org/10.2147/CLEP.S66821


Chidester, J. C., & Spangler, A. A. (1997). Fluid intake in the institutionalized elderly. Journal of the American Dietetic Association, 97(1), 23–30. https://doi.org/10.1016/S0002-8223(97)00011-4


Dietitians of Canada. (n.d). Learn About Dietitians. Retrieved January 2, 2021, from https://www.dietitians.ca/About/Learn-About-Dietitians


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