Nutritional treatment of bone fracture.
OBJECTIVE
Osteoporosis and sarcopenia are nutrition-related risk factors for bone fracture and delayed recuperation from fracture. The purpose of this review was to summarize recent studies that evaluated the effect of the nutritional or anabolic treatment of patients with osteoeporotic, e.g. hip, fractures.


RESULTS
Four short-term supplementation trials reported trends for improved nutritional and functional status. A high dropout rate and low compliance contributed to negative deductions. The latest Cochrane update on hip fracture aftercare sticks to its previous conclusion that multinutrient feeds reduce the incidence of unfavourable outcomes, i.e. mortality and complications combined. Nandrolone in combination with liquid supplementation improved lean body mass, activities of daily living function and quality of life, effects reported to be partly similar for growth hormone treatment. Bone resorption decreased on 12 months' liquid supplementation in community dwelling osteoporotic individuals. A high protein intake was associated with a lower risk of hip fracture. Calcium and vitamin D supplementation remain the basic prevention for osteoporotic fractures.


CONCLUSIONS
Recent supplementation studies appeared to be underpowered or suffered logistic problems, but previous recommendations for multinutrient feeding in hip fracture aftercare remain. Supplementation trials of higher scientific quality are needed, and enteral feeding, anabolic treatment and multimodal approaches need to be evaluated further.
Cederholm
Tommy
T
Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden. tommy.cederholm@neurotec.ki.se
Hedström
Margareta
M
D045930:Anabolic Agents / Q000627:therapeutic use; D015519:Bone Density; D019587:Dietary Supplements; D017102:Fracture Healing / Q000502:physiology*; D006620:Hip Fractures / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D018529:Nutritional Support; D010024:Osteoporosis / Q000150:complications / Q000517:prevention & control; D016896:Treatment Outcome
D045930:Anabolic Agents