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Effect of Dietary Protein on Bone Loss in Elderly Men and Women: The Framingham Osteoporosis Study
Abstract
Few studies have evaluated protein intake and bone loss in elders. Excess protein may be associated with negative calcium balance, whereas low protein intake has been associated with fracture. We examined the relation between baseline dietary protein and subsequent 4-year change in bone mineral density (BMD) for 391 women and 224 men from the population-based Framingham Osteoporosis Study. BMD (g/cm2) was assessed in 1988-1989 and in 1992-1993 at the femur, spine, and radius. Usual dietary protein intake was determined using a semiquantitative food frequency questionnaire (FFQ) and expressed as percent of energy from protein intake. BMD loss over 4 years was regressed on percent protein intake, simultaneously adjusting for other baseline factors: age, weight, height, weight change, total energy intake, smoking, alcohol intake, caffeine, physical activity, calcium intake, and, for women, current estrogen use. Effects of animal protein on bone loss also were examined. Mean age at baseline (±SD) of 615 participants was 75 years (±4.4; range, 68-91 years). Mean protein intake was 68 g/day (±24.0; range, 14-175 g/day), and mean percent of energy from protein was 16% (±3.4; range, 7-30%). Proportional protein intakes were similar for men and women. Lower protein intake was significantly related to bone loss at femoral and spine sites (p ≤ 0.04) with effects similar to 10 lb of weight. Persons in the lowest quartile of protein intake showed the greatest bone loss. Similar to the overall protein effect, lower percent animal protein also was significantly related to bone loss at femoral and spine BMD sites (all p < 0.01) but not the radial shaft (p = 0.23). Even after controlling for known confounders including weight loss, women and men with relatively lower protein intake had increased bone loss, suggesting that protein intake is important in maintaining bone or minimizing bone loss in elderly persons. Further, higher intake of animal protein does not appear to affect the skeleton adversely in this elderly population.
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“Several epidemiological studies have found a positive correlation between higher dietary protein intake and higher bone mass density 39e41 ; slower rate of bone loss 42 ; and muscle mass and strength.43”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [42]
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Metadata
- Authors
- Hannan, M. T., Tucker, K. L., Dawson-Hughes, B., Cupples, L. A., Felson, D. T., & Kiel, D. P.
- Affiliations
- Boston University (US)
- Tufts University (US)
- Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, U.S.A.
- Harvard University (US)
- Corresponding author
- Hannan, Marian T.
- Venue
- Journal of Bone and Mineral Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2000-12-01
- Volume
- 15
- Issue
- 12
- Pages
- 2504-2512
- ISSN
- 0884-0431 (ISSN-L)
- 1523-4681
- OpenAlex
- W2087658867
- Cited by
- 536
- References
- 59
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 15 · 2023: 14 · 2022: 9 · 2021: 12 · 2020: 21 · 2019: 17 · 2018: 17 · 2017: 21 · 2016: 15 · 2015: 20 · 2014: 29 · 2013: 30 · 2012: 14
- FWCI
- 19.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Journal of Bone and Mineral Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Arthritis Foundation
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR-20613, R01 AR/AG 41398, P60AR020613)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- dietary protein, bone loss, bone mineral density, older adults, animal protein, calcium balance, osteoporosis, sex differences, femoral bone, radial bone
- MeSH terms
- Adult, Dietary Proteins, Female, Femur, Humans, Longitudinal Studies, Male, Middle Aged, Osteoporosis, Surveys and Questionnaires, Radius, Spine, Time Factors, Absorptiometry, Photon, Bone Density, Osteoporosis, Postmenopausal
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