Der Einfluss von Protein auf die Prävention von Fragilitätsfrakturen bei älteren Erwachsenen
Abstract
Zusammenfassung. Mit diesem Übersichtsartikel soll die Proteinzufuhr bei älteren Menschen mit einem Risiko für Fragilitätsfrakturen als ein modifizierbarer Faktor zur Frakturprävention diskutiert werden. Proteine sind Bausteine der Knochenmatrix und der Muskulatur. Diese Doppelfunktion passt zum Konzept der Prävention von Fragilitätsfrakturen bei älteren Menschen, die sowohl auf eine Reduktion des Knochenabbaus als auch auf die Sturzprävention abzielt. Bei älteren Menschen könnte eine proteinreiche Ernährung, neben den etablierten Empfehlungen zur ausreichenden Vitamin-D- und Kalzium-Zufuhr, eine weitere einfache und effiziente Massnahme zur Förderung der Knochen- und Muskelgesundheit darstellen.
Abstract. The aim of this review article is to discuss protein intake in senior adults at risk for fragility fractures as a modifiable factor for fracture prevention. Proteins are building blocks of the bone matrix and the muscles. This dual function fits in with the concept of prevention of fragility fractures in senior adults aimed at reducing both bone loss and falls. In older adults, a protein-rich diet could be another simple and effective way to promote bone and muscle health, in addition to the established recommendations for adequate vitamin D and calcium intake.
Résumé. Le but de cet article de revue est de discuter de la consommation de protéines chez les adultes âgés à risque de fractures de fragilité en tant que facteur modifiable pour la prévention des fractures. Les protéines sont des blocs de construction de la matrice osseuse et des muscles. Cette double fonction s’inscrit dans le concept de prévention des fractures de fragilité chez les adultes âgés visant à réduire à la fois la perte osseuse et les chutes. Chez les personnes âgées, un régime riche en protéines pourrait être un autre moyen simple et efficace de promouvoir la santé des os et des muscles, en plus des recommandations établies pour un apport adéquat en vitamine D et en calcium.
Bibliografie
: Development of a nomogram for individualizing hip fracture risk in men and women. Osteoporos Int 2007; 18: 1109–1117.
: The role of falls in fracture prediction. Curr Osteoporos Rep 2011; 9: 116–121.
: Vitamin D Summary Report. BAG 2012. Verfügbar unter: https://www.blv.admin.ch/dam/blv/de/dokumente/lebensmittel-und-ernaehrung/ernaehrung/empfehlungen-vitamin-d.pdf.download.pdf/empfehlungen-vitamin-d.pdf; letzter Zugriff 11.06.2018.
: Three steps to unbreakable bones: the 2011 World Osteoporosis Day Report 2011. Verfügbar unter https://www.iofbonehealth.org/news/three-steps-unbreakable-bones-world-osteoporosis-day; letzter Zugriff 16.05.2018.
, : Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc 2013; 14: 542–559.
: Effects of bone matrix proteins on fracture and fragility in osteoporosis. Curr Osteoporos Rep 2012; 10: 141–150.
: Residual Lifetime Risk of Fractures in Women and Men. J Bone Miner Res 2007; 12: 12.
, : Recovery from hip fracture in eight areas of function. J Gerontol A Biol Sci Med Sci 2000; 55: 498–507.
: Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med, 1997; 337: 1279–1284.
: Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev 1985; 7: 178–208.
: Hip fracture. Clin Geriatr Med 1994; 10 (4): 589–609.
: Fragility fractures: the future epidemic and its challenges. Skeletal Radiol 2013; 42: 161–163.
: Risk factors for falls among elderly persons living in the community. N Engl J Med 1988; 319: 1701–1707.
: Falls in old age: a study of frequency and related clinical factors. Age Ageing 1981; 10: 264–270.
: Stalking sarcopenia. Ann Intern Med 1995; 123: 727–728.
: Considerations concerning the definition of sarcopenia. Osteoporos Int 2016; 27: 3139–3144.
, : Sarcopenia: European consensus on definition and diagnosis, report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010; 39: 412–423.
: Welcome to the ICD-10 code for sarcopenia. J Cachexia Sarcopenia Muscle 2016; 7: 512–514.
, : Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older. Osteoporos Int 2015; 26: 2793–7802.
: What is the cause of the ageing atrophy? Total number, size and proportion of different fiber types studied in whole vastus lateralis muscle from 15- to 83-year-old men. J Neurol Sci 1988; 84: 275–294.
: The underappreciated role of muscle in health and disease. Am J Clin Nutr 2006; 84: 475–482.
: Satellite cell content is specifically reduced in type II skeletal muscle fibers in the elderly. Am J Physiol Endocrinol Metab 2007; 292: E151–157.
, : Dietary protein intake and bone mass in women. Calcif Tissue Int 1996; 58: 320–325.
: The interaction between dietary protein and bone health. J Bone Miner Metab 2011; 29: 1–14.
: Protein supplements increase serum insulin-like growth factor-I levels and attenuate proximal femur bone loss in patients with recent hip fracture. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1998; 128: 801–809.
, : Dietary protein intake is associated with lean mass change in older, community-dwelling adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr 2008; 87: 150–155.
: Dietary protein is associated with musculoskeletal health independently of dietary pattern: the Framingham Third Generation Study. Am J Clin Nutr 2017; 105: 714–722.
, : Quality of life in sarcopenia and frailty. Calcif Tissue Int 2013; 93: 101–120.
: Dietary protein intake and subsequent falls in older men and women: the Framingham Study. J Nutr Health Aging 2011; 15: 147–152.
: Energy and nutrient intake of Swiss women aged 75–87 years. J Hum Nutr Diet 2006; 19: 431–435.
: The recommended dietary allowance for protein may not be adequate for older people to maintain skeletal muscle. J Gerontol A Biol Sci Med Sci 2001; 56: 373–380.
World Health Organization ,United Nations University : Protein and amino acid requirements in human nutrition. WHO, Editor. 2007.Schweizerische Gesellschaft für Ernährung : Merkblatt Ernährung für ältere Erwachsene 2011. Verfügbar unter http://www.sge-ssn.ch/merkblatt_ernaehrung_fuer_aeltere_erwachsene _2011-2/; letzter Zugriff 16.05.2018.Deutsche, Österreichische und Schweizerische Gesellschaften für Ernährung : D-A-CH-Referenzwerte für die Nährstoffzufuhr 2017. Verfügbar unter http://www.sge-ssn.ch/grundlagen /lebensmittel-und-naehrstoffe/naehrstoffempfehlungen/dachreferenzwerte/; letzter Zugriff 16.05.2018., : Does dietary protein reduce hip fracture risk in elders? The Framingham Osteoporosis Study. Osteoporos Int 2011; 22: 345–349.
, : The relationship between dietary protein consumption and risk of fracture: a subgroup and dose-response meta-analysis of prospective cohort studies. Sci Rep 2015; 5: 9151.
, : Dietary protein and bone health: a systematic review and meta-analysis from the National Osteoporosis Foundation. Am J Clin Nutr 2017; 105: 1528–1543.
: Dietary supplementation in elderly patients with fractured neck of the femur. Lancet 1990; 335: 1013–1016.
, : Benefits of oral protein supplementation in elderly patients with fracture of the proximal femur. J Am Coll Nutr 1992; 11: 519–525.
: Effects of leucine-rich protein supplements on anthropometric parameter and muscle strength in the elderly: a systematic review and meta-analysis. J Nutr Health Aging 2015; 19: 437–446.
, : Amount, distribution, and quality of protein intake are not associated with muscle mass, strength, and power in healthy older adults without functional limitations – an enable study. Nutrients 2017; 9: pii: E1358.
, : The impact of dietary protein or amino acid supplementation on muscle mass and strength in elderly people: individual participant data and meta-analysis of RCTs. J Nutr Health Aging 2017; 21: 994–1001.
, : Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc 2015; 16: 740–747.
: Randomized clinical trial of nutritional supplementation shows little effect on functional status among free-living frail elderly. J Nutr 1995; 125: 2965–2971.
: Short-term oral nutritional intervention with protein and vitamin D decreases falls in malnourished older adults. J Am Geriatr Soc 2012; 60: 691–699.
, : The effects of a two-year randomized, controlled trial of whey protein supplementation on bone structure, IGF-1, and urinary calcium excretion in older postmenopausal women. J Bone Miner Res 2011; 26: 2298–2306.
: Role of IGF-I on PTH effects on bone. J Endocrinol Invest 2010; 33 (Suppl 7): 22–26.
: Leucine: a nutrient ’trigger’ for muscle anabolism, but what more? J Physiol 2012; 590: 2065–2066.
: Maximizing muscle protein anabolism: the role of protein quality. Curr Opin Clin Nutr Metab Care 2009; 12: 66–71.
: Protein quality assessment: impact of expanding understanding of protein and amino acid needs for optimal health. Am J Clin Nutr 2008; 87: 1576–1581.
: The effectiveness of leucine on muscle protein synthesis, lean body mass and leg lean mass accretion in older people: a systematic review and meta-analysis. Br J Nutr 2015; 113: 25–34.
: Supplemental protein in support of muscle mass and health: advantage whey. J Food Sci 2015; 80 (Suppl 1): 8–15.
, : Resistance exercise enhances myofibrillar protein synthesis with graded intakes of whey protein in older men. Br J Nutr 2012; 108: 1780–1788.
, : Leucine co-ingestion improves post-prandial muscle protein accretion in elderly men. Clin Nutr 2013; 32: 412–419.
, : An even distribution of protein intake daily promotes protein adequacy but does not influence nutritional status in institutionalized elderly. J Am Med Dir Assoc 2018; 19: 33–39.
: Meta-analysis of the effect of the acid-ash hypothesis of osteoporosis on calcium balance. J Bone Miner Res 2009; 24: 1835–1840.
: Protein intake and bone health. Int J Vitam Nutr Res 2011; 81: 134–142.
, : Higher biomarker-calibrated protein intake is not associated with impaired renal function in postmenopausal women. J Nutr 2011; 141: 1502–1507.
: The impact of protein intake on renal function decline in women with normal renal function or mild renal insufficiency. Ann Intern Med 2003; 138: 460–467.
: Protein restriction and body composition in renal disease. J Ren Nutr 2008; 18: 167–186.
, : Efficacy and safety of a very-low-protein diet when postponing dialysis in the elderly: a prospective randomized multicenter controlled study. Am J Kidney Dis 2007; 49: 569–580.
, : Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 1998; 147: 755–763.
