Evidence map›Paper›PMID 34670754›Full record

Trial reportBMJ (Clinical research ed.)2021

Effect of dietary sources of calcium and protein on hip fractures and falls in older adults in residential care: cluster randomised controlled trial.

S Iuliano, S Poon, J Robbins, M Bui, X Wang, L De Groot, M Van Loan, A Ghasem Zadeh, T Nguyen, E Seeman

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
71citing papers in PubMed, 9 pooled it
10.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

71 citing papers in PubMed, 9 syntheses or guidelines pooled it, 118 citations in OpenAlex.

  1. Pooled it
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  4. Interventions for preventing falls in older people in care facilities.The Cochrane database of systematic reviews · 2025
    Pooled it
  5. Guideline
  6. Guideline
  7. Pooled it
  8. [Exercise therapy and basic treatment for osteoporosis].Orthopadie (Heidelberg, Germany) · 2023
    Guideline
  9. Pooled it
  10. Trial
  11. Trial
  12. Trial
  13. Article
  14. Management of glucocorticoid-induced osteoporosis in rheumatic diseases.Best practice & research. Clinical rheumatology · 2026
    Review
  15. Review
  16. Review
  17. Article
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  19. Article
  20. Comparison of vitamin D, parathyroid hormone (PTH), and bone metabolism markers in hip fracture patients by fracture type and control group.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026
    Article

11 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 3 countries.

S IulianoDepartments of Medicine and Endocrinology, Austin Health, University of Melbourne, Melbourne, Australia.ORCID 0000-0003-3900-2030
S PoonDepartments of Medicine and Endocrinology, Austin Health, University of Melbourne, Melbourne, Australia.
J RobbinsDepartments of Medicine and Endocrinology, Austin Health, University of Melbourne, Melbourne, Australia.
M BuiSchool of Population and Global Health, University of Melbourne, Melbourne, Australia.
X WangDepartments of Medicine and Endocrinology, Austin Health, University of Melbourne, Melbourne, Australia.
L De GrootDivision of Human Nutrition, Wageningen University, Wageningen, Netherlands.
M Van LoanUS Department of Agriculture-ARS, University of California, Davis, CA, USA.
A Ghasem ZadehDepartments of Medicine and Endocrinology, Austin Health, University of Melbourne, Melbourne, Australia.
T NguyenGarvan Institute of Medical Research, Sydney, Australia.
E SeemanDepartments of Medicine and Endocrinology, Austin Health, University of Melbourne, Melbourne, Australia.
The University of Melbourne · AUUniversity of California, Davis · USUniversity of Technology Sydney · AUWageningen University & Research · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the antifracture efficacy and safety of a nutritional intervention in institutionalised older adults replete in vitamin D but with mean intakes of 600 mg/day calcium and <1 g/kg body weight protein/day.

designTwo year cluster randomised controlled trial.

setting60 accredited residential aged care facilities in Australia housing predominantly ambulant residents.

participants7195 permanent residents (4920 (68%) female; mean age 86.0 (SD 8.2) years).

interventionFacilities were stratified by location and organisation, with 30 facilities randomised to provide residents with additional milk, yoghurt, and cheese that contained 562 (166) mg/day calcium and 12 (6) g/day protein achieving a total intake of 1142 (353) mg calcium/day and 69 (15) g/day protein (1.1 g/kg body weight). The 30 control facilities maintained their usual menus, with residents consuming 700 (247) mg/day calcium and 58 (14) g/day protein (0.9 g/kg body weight).

main outcome measuresGroup differences in incidence of fractures, falls, and all cause mortality.

resultsData from 27 intervention facilities and 29 control facilities were analysed. A total of 324 fractures (135 hip fractures), 4302 falls, and 1974 deaths were observed. The intervention was associated with risk reductions of 33% for all fractures (121

conclusionsImproving calcium and protein intakes by using dairy foods is a readily accessible intervention that reduces the risk of falls and fractures commonly occurring in aged care residents.

trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12613000228785.

Indexed as

Accidental FallsAgedAged, 80 and overAustraliaCalcium, DietaryDietary ProteinsDouble-Blind MethodFemaleFollow-Up StudiesHip FracturesHomes for the AgedHumansIncidenceKaplan-Meier EstimateMaleOsteoporosisCalcium, DietaryDietary Proteins

Identifiers

PMID34670754
PMCPMC8527562
OpenAlexW3207968445

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.