IMPORTANCE OF DIETARY ADVICE, NUTRITIONAL SUPPLEMENTS AND COMPLIANCE FOR MAINTAINING BODY WEIGHT AND BODY FAT AFTER HIP FRACTURE

Objective: Poor nutritional status amongst elderly individuals with hip fractures is well documented. Studies have suggested that 30-50 % of patients admitted to orthopaedic departments suffer from protein-energy malnutrition (PEM). Design: An 6 month intervention study. Setting: The study was conducted in Sweden between February 2005 and October 2006. Participants: Elderly patients with hip fractures (n=32). Methods: Evaluation of compliance with individual nutritional support and whether body weight and body fat (BF) could be maintained after six months. Evaluation of possible effects of nutritional supplements and dietary advice after hip fracture on BMI, BF, and Mini Nutritional Assessment (MNA). Results: Overall compliance with supplement intake was 73%. After six months, BMI was unchanged. Women’s BF had decreased (P<0.01), although the mean calorie intake with nutritional support was 34 calories per kg body weight/day. Three groups could be identified: one group with increased body weight and BF, one with loss of body weight and BF, and one with increased body weight together with increased TBW and loss of BF. Participants who consumed 0-1 supplements daily lost more weight than those who consumed 2 supplements daily. There was a positive difference (p=<0.001) for women between MNA values at baseline and after six months. Conclusion: In the present study compliance was satisfactory at the group level, and the energy and protein intake increased significantly. BMI was unchanged during the 6 months period. However, the women lost BF during the study period of with some had increasing total body water (TBW). MNA values for women changed in a positive direction