Eat up, and build up to prevent falls

By Caroline Salisbury

It is estimated that approximately 30% of Australian over 65 years old who live in the community will have a fall. For those over 80 years old, the fall rate escalates to 1 in 2. Today Alex is joined by regular 666 dietitian Caroline Salisbury as well as Helen Palethrope from the YMCA, Canberra and Dr Rob Daly, Senior Research Fellow at the Centre for Physical Activity and Nutrition Research at Deakin University to discuss diet and exercise factors that affect falls.

There are numerous factors that can increase your risk of falling. Caroline highlights that poor nutritional status can increase risk. Age related loss of muscle mass is exacerbated by poor nutrition, which can affect gait, especially important given that tripping has been identified as one of the major causes of falls. A recent study by Sydney researchers have found that up to 80% of the elderly admitted to an acute aged care facility were malnourished or at risk of malnutrition. Low body weight and poor nutrient intake is also a risk factor for osteoporosis. The latest figures from the Australian institute of Health and Welfare, found that over 2000 Canberrans were hospitalised with falls in 2003 - 2004. You can find the link to the report below. Unfortunately once hospitalised with falls, the undernourished have longer hospital stays, increased risk of complications and higher rate of death. Australian studies have found indicators such as unintentional weight loss and taking more then 3 medications a day are important indicators of increased falls risk.


Eat up to build up

Aging is associated with loss of muscle mass known as sarcopenia. It starts in your 40s, and increase to 1-2% a year once you're in your 50s. Unlike wasting conditions associated with illness, sarcopenia occurs in people who are otherwise well. The loss of function and decreased mobility can contribute to increased disability and mortality. Dr Daly suggests that there is also increasing concern about the rise in sarcopenic obesity or the 'fat frail', where bodyweight may not change significantly, but the muscle mass decreases while fat mass increases. Obesity is also a risk factor for falls due to its impact on mobility.

Dr Daly also highlights the vital role of Vitamin D status and calcium in falls prevention and fracture risk. A significant number of Australians are deficient in Vitamin D, once thought to be impossible in sunny Australia. People at the highest risk include the elderly, especially those who are housebound or in residential care. As we age we also produce less Vitamin D. The working Group of the Australian and New Zealand Bone and Mineral Society recommends a supplement of 400 IU or 10 micrograms per day. Caroline suggests that dietary sources of vitamin D include fatty fish, liver, eggs and fortified foods such as margarine and some low fat milks. Unfortunately it is difficult to gain adequate Vitamin D from diet, and diet alone is insufficient to raise levels once levels are deficient. Serum or blood levels of Vitamin D also fall in winter.

Vitamin D and calcium work together to strengthen bones but they also work in less obvious ways to prevent falls. Several studies have found that Vitamin D also plays a role in muscular strength. There are highly specific vitamin D receptors in skeletal muscle. The binding of vitamin D to these receptors promotes protein synthesis and promotes cell growth. Increases in Vitamin D status may show increases after 3 months of treatment. When calcium and vitamin D are combined it has been shown to improve muscle function in nursing home residents with Vitamin D deficiency. Vitamin D supplementation has been found in several studies to reduce falls risk, with or without calcium. Check with your GP before commencing Vitamin D supplements.


Come to the YMCA for fitness

The YMCA Canberra Helen Palethorpe also joins Caroline and Alex to discuss the wonderful program of exercise classes for anyone over 50 years old. Classes include the Ever active program which focuses on balance, strength and stamina. You could join the 60s+ weights which uses resistance training to strengthen bones and muscles. If you like to move to music then join the 50s+ aerobic class. For those with special needs, the YMCA also provides instruction and support for individuals recovering from a stroke, or spinal or head injury.

Weight bearing exercise and resistance exercise such as weights work to maintain bone structure, as well as preventing falls through the maintenance of muscle size and strength. Helen stresses that the effect of supplementation with Vitamin D and adequate diet works best in conjunction with a range of exercises to maintain bone and muscle strength, as well as preventing decline in functional capacity. She has seen large numbers of people who are benefiting from aging actively by attending the wide number of classes available.

source:www.abc.net.au