Increasing calcium and protein intake through dairy foods could help to reduce the risk of falls and fractures in older care home residents, according to new research published in the British Medical Journal (BMJ).

It is well known that calcium and protein-rich foods, such as milk, yoghurt and cheese, help to prevent bone fragility. However, few studies have investigated whether increasing daily intake of these foods is an effective and safe way to reduce fracture and fall risk in older adults.

To address this gap in literature, researchers based in Australia, the Netherlands and the US examined whether achieving recommended daily intakes of calcium (1,300 mg) and protein (1g per kg of body weight) from food sources would reduce the risk of fragility fractures and falls among older adults.

Milk, yoghurt and cheese was used to reach target levels of calcium and protein intake

The randomised controlled trial took place over a two-year period and involved 7,195 older residents across 60 care facilities in Australia. The majority (72%) of the sample were women, with an average age of 86 years.

Half (30) of the facilities, assigned at random, provided residents with additional milk, yoghurt, and cheese, achieving intakes of 1,142 mg calcium/day and 1.1 g protein/kg body weight/day, while the remaining facilities continued with their usual menu which provided around 700mg of calcium per day and 0.9g protein per kg of body weight per day.

Data from 27 intervention facilities and 29 control facilities were analysed and a total of 324 fractures (135 hip fractures), 4,302 falls, and 1,974 deaths occurred during the study period.

The relative risk reduction for fractures was similar to that found in trials using potent drug therapy

Increased protein and calcium consumption were associated with a reduced risk of fractures by 33% (121 v 203), 46% for hip fractures (42 v 93), and 11% for falls (1,879 v 2,423). There was no group difference in all-cause mortality.

The relative risk reduction for fractures was similar to that found in trials using potent drug therapy to increase bone strength in people with osteoporosis.
Some limitations of the study were noted, including that loss of participants limited the researchers’ ability to examine the possible mechanisms that may contribute to fewer fractures and falls.

However, they conclude that improving calcium and protein intakes by using dairy foods “is a readily accessible intervention” that “has widespread implications as a public health measure for fracture prevention in the aged care setting and potentially in the wider community.”