No abstract

Dietary protein intake might be beneficial to physical function (PF) in the elderly. We examined the cross-sectional and prospective associations of protein intake of g/kg body weight (BW), fat mass (FM) and lean mass (LM) with PF in 554 women aged 65·3-71·6 years belonging to the Osteoporosis Risk Factor and Prevention Fracture Prevention Study. Participants filled a questionnaire on lifestyle factors and 3-d food record in 2002. Body composition was measured by dual-energy X-ray absorptiometry, and PF measures were performed at baseline and at 3-year follow-up. Sarcopaenia was defined using European Working Group on Sarcopenia in Older People criteria. At the baseline, women with higher protein intake (≥1·2 g/kg BW) had better performance in hand-grip strength/body mass (GS/BM) (P = 0·001), knee extension/BM (P = 0·003), one-leg stance (P = 0·047), chair rise (P = 0·043), squat (P = 0·019), squat to the ground (P = 0·001), faster walking speed for 10 m (P = 0·005) and higher short physical performance battery score (P = 0·004) compared with those with moderate and lower intakes (0·81-1·19 and ≤0·8 g/kg BW, respectively). In follow-up results, higher protein intake was associated with less decline in GS/BM, oneleg stance and tandem walk for 6 m over 3 years. Overall, results were no longer significant after controlling for FM. Associations were detected between protein intake and PF in non-sarcopaenic women but not in sarcopaenic women, except for change of GS (P = 0·037). Further, FM but not LM was negatively associated with PF measures (P < 0·050). This study suggests that higher protein intake and lower FM might be positively associated with PF in elderly women.

Antifracture efficacy of high-dose vitamin D (800 IU) and calcium (1000 mg) remains controversial. To determine whether daily 800 IU of vitamin D and 1000 mg of calcium supplementation prevents fractures, we randomized 3432 women of the population-based Osteoporosis Risk Factor and Prevention (OSTPRE) Study cohort (ages 65 to 71 years) living in the region of northern Savonia, Finland (latitude 628 to 648N) for 3 years to receive 800 IU of cholecalciferol and 1000 mg of calcium as calcium carbonate or to a control group that did not receive placebo. The main outcome measure was incident fractures. Fracture data were collected in telephone interviews and validated. Data on 3195 women, 1586 in the intervention group and 1609 in the control group, were available for analysis. In adjusted Cox proportional hazards models, the risk of any fracture decreased in the vitamin D and calcium group by 17% [adjusted hazard ratio (aHR) ¼ 0.83; 95% confidence interval (CI) 0.61-1.12], and the risk of any nonvertebral fracture decreased by 13% (aHR ¼ 0.87; 95% CI 0.63-1.19). The risk of distal forearm fractures decreased by 30% (aHR ¼ 0.70; 95% CI 0.41-1.20), and the risk of any upper extremity fractures decreased by 25% (aHR ¼ 0.75; 95% CI 0.49-1.16), whereas the risk of lower extremity fractures remained essentially equal (aHR ¼ 1.02; 95% CI 0.58-1.80). None of these effects reached statistical significance. In conclusion, this study did not produce statistically significant evidence that vitamin D and calcium supplementation prevents fractures in a 65-to 71-year-old general population of postmenopausal women. ß

Better diet quality as measured by higher adherence to BSD and MED might reduce the risk of sarcopenia in elderly women.