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  • Nutrition

Skeletal muscle plays a crucial role within the body, helping to maintain physical movement and posture and influencing energy and protein metabolism. Loss of muscle mass, strength and function are strongly associated with poor health outcomes including increased falls and fractures1. Management strategies that help to maintain muscle mass can really make a difference to patients and should be encouraged from an early stage. Good nutrition, especially adequate intake of protein, energy, calcium and vitamin D, can help to maintain and restore muscle mass and function, even in frail elderly patients. Regular exercise that challenges and improves balance and builds strength can help to prevent falls and the combination of exercise plus appropriate nutrition is considered the gold standard for maintaining muscle strength and function.2,3

However, these interventions, particularly nutrition, are often overlooked in falls/ hip fracture pathways, resulting in patients who are too weak to exercise due to low energy and poor nutritional status.

A multidisciplinary group including specialist dietitians, physicians, nurses and physiotherapists came together in 2019 to discuss key issues and develop a best practice consensus on this area*. This resource has been designed to integrate with existing pathways (e.g. frailty and post fall/fracture pathways) and to provide practical guidance on screening, functional assessment, management strategies involving nutrition and exercise, monitoring and education.

Click here to download the guide.

*The consensus group was chaired by Ian Taylor, Head of Nutrition and Dietetics, UCLH, London. The other members of the consensus group were: Deborah Howland, Specialist Dietitian and Acute Team Leader, Torbay Hospital; Beverley Marwood, Senior Physiotherapist, Community Integrated Assessment Team, North Tees and Hartlepool NHS Foundation Trust; Dr Anuj Patel, GP, Wentworth Medical Practice, London; Lesley Roberts, Integrated Service Manager for End of Life and Admission Avoidance Services, Midlands Partnership NHS Foundation Trust; Dr Adrian Slee, Senior Teaching Fellow in Nutrition, University College London; Dr Sanjay Suman, Clinical Director Therapies and Older Persons Programme, Medway NHS Foundation Trust, Kent; Dr Julie Whitney, Physiotherapist and Academic, Academic Department of Physiotherapy, King’s College, London.


  1. Deutz NEP, et al. J Am Med Dir Assoc. 2019;20(1):22-27.
  2. Deutz NEP, et al. Clin Nutr. 2014;33(6):929-936.
  3. Sherrington C, et al. Br J Sports Med. 2017;51:1749-1757.

Date of preparation: December 2019

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