MyNOURISH: Hydrolysed Collagen Supplementation in Older Adults With Fragility Fractures

Inclusion criteria

• Male or female participants aged 60 years and above.
• History of a fragility fracture (e.g., hip, wrist, or vertebral fracture) sustained within the past 12 months.
• Registered outpatient at Hospital Sultan Abdul Aziz Shah (HSAAS).
• Malaysian citizen.
• Able to communicate in Bahasa Malaysia or English.
• Able and willing to provide written informed consent.
• Cognitive function score >4 on the Elderly Cognitive Assessment Questionnaire (ECAQ).
• Currently undergoing a structured rehabilitation programme.
• May be receiving antiresorptive osteoporosis therapy or not receiving any osteoporosis pharmacological treatment at the time of recruitment.

Exclusion criteria

• Cognitive impairment, defined as ECAQ score ≤4
• Metabolic bone diseases other than osteoporosis (e.g., Paget's disease, osteomalacia).
• Severe endocrine or metabolic disorders affecting bone metabolism (e.g., primary hyperparathyroidism, Cushing's syndrome, hyperthyroidism, hypogonadism, acromegaly).
• Terminal illness or palliative care needs (e.g., advanced cancer, end-stage organ failure, late-stage neurodegenerative diseases).
• Known allergy to fish, seafood, or collagen supplements, or diagnosis of phenylketonuria.
• Kidney disease, including history of kidney stones or chronic kidney disease stage 4-5 (estimated glomerular filtration rate <44 mL/min/1.73 m²).
• Participation in another interventional study that may interfere with the study protocol.
• Use of nutritional supplements during the study period.
• Prior use of collagen or amino acid-based supplements within the past 6 months.
• Non-ambulatory status prior to the fracture.
• Unstable medical conditions (e.g., uncontrolled arrhythmias, recent myocardial infarction, unstable angina, uncontrolled hypertension, pulmonary embolism).
• Current use of anabolic osteoporosis therapy.
• Alcohol dependence or active alcoholism.