Is protein intake associated with bone mineral density in young women?

Beasley, Jeannette M.; Ichikawa, Laura; Ange, Brett A.; Spangler, Leslie; LaCroix, Andrea Z.; Ott, Susan M.; Scholes, Delia

doi:10.3945/ajcn.2009.28728

Cited by 39 publications

(39 citation statements)

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“…They conclude that dietary proteins, if not significantly favorable, are at least not detrimental to bone density. In addition, a recent longitudinal study including 540 premenopausal women found no adverse effect of increased protein intakes (from 5 to 25% of the energy intake) on BMD (Beasley et al, 2010). Studies frequently cited to support the deleterious effect of HP diet on bone health are retrospective analyses of hip fracture incidence in postmenopausal women of different countries (Abelow et al, 1992;Frassetto et al, 2000), which found that the highest rate of hip fractures occurred in industrialized Western countries, which have the highest animal protein intake.…”

Section: Protein Intake and Bone Healthmentioning

confidence: 99%

Protein intake, calcium balance and health consequences

et al. 2011

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High-protein (HP) diets exert a hypercalciuric effect at constant levels of calcium intake, even though the effect may depend on the nature of the dietary protein. Lower urinary pH is also consistently observed for subjects consuming HP diets. The combination of these two effects was suspected to be associated with a dietary environment favorable for demineralization of the skeleton. However, increased calcium excretion due to HP diet does not seem to be linked to impaired calcium balance. In contrast, some data indicate that HP intakes induce an increase of intestinal calcium absorption. Moreover, no clinical data support the hypothesis of a detrimental effect of HP diet on bone health, except in a context of inadequate calcium supply. In addition, HP intake promotes bone growth and retards bone loss and low-protein diet is associated with higher risk of hip fractures. The increase of acid and calcium excretion due to HP diet is also accused of constituting a favorable environment for kidney stones and renal diseases. However, in healthy subjects, no damaging effect of HP diets on kidney has been found in either observational or interventional studies and it seems that HP diets might be deleterious only in patients with preexisting metabolic renal dysfunction. Thus, HP diet does not seem to lead to calcium bone loss, and the role of protein seems to be complex and probably dependent on other dietary factors and the presence of other nutrients in the diet.

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Section: Protein Intake and Bone Healthmentioning

confidence: 99%

Protein intake, calcium balance and health consequences

et al. 2011

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“…Data indicate that protein source (animal or vegetable) may influence the relationship between protein intake and bone health because protein from animal sources is high in acidic amino acids such as cysteine and methionine,3 although these acidic amino acids are also found in plant‐based sources such as nuts. Three recent studies have shown that vegetable protein, but not animal protein, is associated with increased BMD in women 10, 11, 12. Conversely, in a study of 562 women, increased intake of 15 g animal protein per day was associated with increased BMD at the hip (0.016 g/cm 2 ) and femoral neck (0.012 g/cm 2 ), and a 15 g/day increase in vegetable protein intake was associated with lower BMD at the hip (–0.013 g/cm 2 ) and femoral neck (–0.010 g/cm 2 ),13 and in a study of post‐menopausal women the relative risk of hip fracture was found to decrease significantly across increasing quartiles of animal protein intake (1.00 [reference]; 0.59 [95% CI, 0.3 to 1.3]; 0.63 [95% CI, 0.3 to 1.4]; and 0.31 [95% CI, 0.1 to 0.9]) 14…”

Section: Introductionmentioning

confidence: 99%

Amino Acid Intakes Are Associated With Bone Mineral Density and Prevalence of Low Bone Mass in Women: Evidence From Discordant Monozygotic Twins

Jennings

Macgregor

Spector

et al. 2015

Journal of Bone and Mineral Research

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Although a higher protein intake, particularly from vegetable sources, has been shown to be associated with higher bone mineral density (BMD) the relative impact of specific amino acids on BMD and risk of osteoporosis remains to be determined. Mechanistic research suggests that a number of specific amino acids, including five nonessential amino acids—alanine, arginine, glutamic acid, glycine, and proline—may play a role in bone health, principally through improved production of insulin and insulin‐like growth factor 1 and the synthesis of collagen and muscle protein. However to date, no previous studies have examined the associations between habitual intake of amino acids and direct measures of BMD and prevalence of osteoporosis or osteopenia, and no studies have examined this relationship in discordant identical twin‐pairs. In these analyses of female monozygotic twin‐pairs discordant for amino acid intake (n = 135), twins with higher intakes of alanine and glycine had significantly higher BMD at the spine than their co‐twins with within‐pair differences in spine‐BMD of 0.012 g/cm2 (SE 0.01; p = 0.039) and 0.014 g/cm2 (SE 0.01; p = 0.026), respectively. Furthermore, in cross‐sectional multivariable analyses of 3160 females aged 18 to 79 years, a higher intake of total protein was significantly associated with higher DXA‐measured BMD at the spine (quartile Q4 to quartile Q1: 0.017 g/cm2, SE 0.01, p = 0.035) and forearm (Q4 to Q1: 0.010 g/cm2, SE 0.003, p = 0.002). Intake of six amino acids (alanine, arginine, glutamic acid, leucine, lysine, and proline) were associated with higher BMD at the spine and forearm with the strongest association observed for leucine (Q4 to Q1: 0.024 g/cm2, SE 0.01, p = 0.007). When intakes were stratified by protein source, vegetable or animal, prevalence of osteoporosis or osteopenia was 13% to 19% lower comparing extreme quartiles of vegetable intake for five amino acids (not glutamic acid or proline). These data provide evidence to suggest that intake of protein and several amino acids, including alanine and glycine, may be beneficial for bone health, independent of genetic background. © 2015 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.

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“…BMD was positively associated with animal protein intake and negatively to vegetable intake in one study (Promislow et al, 2002) but the opposite association was found when considering bone ultrasound attenuation (Weikert et al, 2005). Low levels of both protein types have been associated with deleterious effects on bone: low animal protein is related to bone loss (Hannan et al, 2000) and low vegetable protein is related to low BMD (Beasley et al, 2010). These results suggest that a minimum intake of both proteins is required regardless of the source.…”

Section: Animal Vs Vegetable Proteinmentioning

confidence: 68%

“…On the other hand, two studies on premenopausal women concluded that protein intake had no relation with BMD (Beasley et al, 2010;Mazess & Barden, 1991). One study reported a negative association with BMC (Metz et al, 1993).…”

Section: Protein and Bone Parameters 41 Bone Mineral Densitymentioning

confidence: 99%