Dietary protein intake and subsequent falls in older men and women: The Framingham study

Abstract

Background Poor nutritional status is often present among older adults who experience a fall. However, dietary intake and weight loss are often overlooked as potential factors. The objective of this study was to test the association between dietary protein intake and risk of subsequent falls in a population-based cohort of elderly men and women. Methods Dietary intake and clinic data from 807 men and women (ages 67–93 years) from the Framingham Original Cohort Study were analyzed. Protein intake (total, animal and plant) was assessed as a continuous variable and by tertile of intake. Falls were reported by participants using a validated questionnaire at two time points. Weight was ascertained at each examination to examine the effect of weight loss over follow-up. Results Higher dietary protein intakes were associated with a reduced odds of falling, although of borderline statistical significance (OR=0.80, 95% CI: 0.60–1.07) and were not associated with the rate of falls over follow-up (RR=0.93, 95%CI: 0.73–1.19). Tertile analyses tended towards a protective association, but most did not achieve statistical significance; there was no dose-response. For those who lost ≥ 5% of their baseline weight, higher intakes of total, animal and plant protein showed a significantly lower rate of subsequent falls. Conclusion This work highlights the importance of adequate protein intake as a potentially modifiable risk factor for fall prevention in older adults. Further exploration of the interaction of protein intake and weight loss as related to falls is needed.

Dietary protein is beneficial to bone health under conditions of adequate calcium intake

“…Data from the Framingham Osteoporosis study show that greater protein intake is associated with decreased odds of falling [16], which is an important risk factor for fractures. Results from the same cohort reported that higher protein intake was protective against the risk of hip fracture [14].…”

Dietary Protein and Vitamin D Intake and Risk of Falls: A Secondary Analysis of Postmenopausal Women from the Study of Osteoporotic Fractures

“…To our knowledge, there is only one study directly examined protein intake and fall incidence. In a prospective study with 807 male and female participants (mean age 75 years) in the Framingham Study, Zoltick and colleagues (11) studied how dietary protein adjusted for total energy intake dietary calcium, calcium supplement use, dietary vitamin D, and weight loss affected risk of falling. Occurrence of falls (yes/no) was assessed at baseline and one-year follow-up.…”

“…Two main differences between our study and Zoltick and colleagues' study are they stratified their analyses by weight loss versus no weight change and 37% of their cohort were men. The authors theorized that a weight loss of ≥ 5% body weight at follow-up would be a potential effect modifier since unintentional weight loss is associated with increased risk of falling (11). They found some benefit of moderate protein intake on falls over a one-year period.…”

“…Total and animal protein intakes were significantly protective of falling in subjects who lost weight versus those who did not lose ≥5% of their weight, although there was no mention if the authors performed a test for interaction to observe this difference between the subgroups. There also was no association between protein intake and falls with weight maintenance (11). …”

“…The possible association between dietary protein and falls has been overlooked. To date, only one known prospective cohort study looked at the association of protein intake and fall risk (11). Dietary protein may affect fall incidence through its ability to affect muscle mass and function.…”