Optimizing Bone Health in Older Adults: The Importance of Dietary Protein
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Age-related bone loss is progressive and can lead to osteoporosis. While it is accepted that both dietary calcium and vitamin D are important and beneficial for skeletal health, the impact of dietary protein on calcium metabolism and bone balance remains controversial. Contrary to the hypothesis that increasing dietary protein contributes to bone loss, research supports the notion that protein may play a pivotal role in maintenance of bone health by several mechanisms; for example, increasing dietary protein increases IGF-1, calcium absorption, muscle strength and mass, all of which could potentially benefit the skeleton. A moderate increase in dietary protein recommendations for the aging population (above the recommended dietary allowance of 0.8 g/kg) may be beneficial to bone health, while still falling within the safe and acceptable range for protein intake (as defined by the dietary reference intakes).
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Reviews of research studies reveal little or no evidence that high-protein diets cause kidney damage in healthy individuals, including older persons.
“However, reviews of research studies reveal little or no evidence that high-protein diets cause kidney damage in healthy individuals, including those who are older.6,54,55”
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 [54]
The “Potential safety concerns of a high-protein diet” section says that increased filtration in people with normal kidney function has not been linked to declining renal function. For older adults, however, it says only that a moderate increase to 1–1.5 g/kg appears safe and calls for more research on higher protein intakes; it does not establish the broader claim about high-protein diets in older people. (LLM, conf=0.85)
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Cites
Effect of Dietary Protein on Bone Loss in Elderly Men and Women: The Framingham Osteoporosis Study
Hannan, M. T., Tucker, K. L., Dawson-Hughes, B., Cupples, L. A., Felson, D. T., & Kiel, D. P. (2000) · Journal of Bone and Mineral Research · doi:10.1359/jbmr.2000.15.12.2504 · Cited by 536 · see citing works
Fulgoni, V. L. (2008) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/87.5.1554s · Cited by 369 · see citing works
Dietary Guidelines should reflect new understandings about adult protein needs
Layman, D. K. (2009) · Nutrition & Metabolism · doi:10.1186/1743-7075-6-12 · Cited by 146 · see citing works
Meng, X., Zhu, K., Devine, A., Kerr, D. A., Binns, C. W., & Prince, R. L. (2009) · Journal of Bone and Mineral Research · doi:10.1359/jbmr.090513 · Cited by 123 · see citing works
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Research works printed but not linked: 62
- [1]Abrahamsen B van Staa T Ariely R Olson M Cooper C Excess mortality following hip fracture: a systematic epidemiological review Osteoporos Int 20 10 1633 1650 2009 19421703
- Institute of Medicine, Food and Nutrition Board Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride National Academy Press Washington, DC, USA 1999 Dietary reference intakes for energy: provides a detailed explanation of the of current dietary guidelines for subsets of the US population and for the population as a whole 23115811
- Bonjour JP Dietary protein: an essential nutrient for bone health J Am Coll Nutr 24 6 Suppl 526S 536S 2005 Important critical review of the evidence that dietary protein negatively impacts bone health 16373952
- [4]Institute of Medicine, Food and Nutrition Board Dietary Reference Intakes for Energy, Carbohydrates, Fiber, Fat, Protein and Amino Acids (Macronutrients) National Academy Press Washington, DC, USA 2002
- [5]Wolfe RR Miller SL Miller KB Optimal protein intake in the elderly Clin Nutr 27 5 675 684 2008 18819733
- [6]Wolfe RR Protein Summit: consensus areas and future research Am J Clin Nutr 87 5 1582S 1583S 2008 18469292
- [9]WHO Protein and amino acid requirements in human nutrition World Health Organ Tech Rep Ser 935 1 265 2008 18330140
- Darling AL Millward DJ Torgerson DJ Hewitt CE Lanham-New SL Dietary protein and bone health: a systematic review and meta-analysis Am J Clin Nutr 90 6 1674 1692 2009 First paper to provide a systematic review and meta-analysis of the relationship between dietary protein and bone parameters 19889822
- [13]Munger RG Cerhan JR Chiu BC Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women Am J Clin Nutr 69 1 147 152 1999 9925137
- [14]Kerstetter JE Allen LH Protein intake and calcium homeostasis Adv Nutr Res 9 167 181 1994 7747665
- [15]Wapnir R Wapnir RA Calcium, magnesium and phosphorus absorption, nutritional status and effect of proteins Protein Nutrition and Mineral Absorption CRC Press FL, USA 77 97 1990
- [16]Kerstetter JE O’Brien KO Insogna KL Dietary protein, calcium metabolism, and skeletal homeostasis revisited Am J Clin Nutr 78 3 Suppl 584S 592S 2003 12936953
- [17]Arnett T Regulation of bone cell function by acid-base balance Proc Nutr Soc 62 2 511 520 2003 14506899
- [18]Sebastian A Harris ST Ottaway JH Todd KM Morris RC Jr Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate N Engl J Med 330 25 1776 1781 1994 8190153
- [19]Jehle S Zanetti A Muser J Hulter HN Krapf R Partial neutralization of the acidogenic Western diet with potassium citrate increases bone mass in postmenopausal women with osteopenia J Am Soc Nephrol 17 11 3213 3222 2006 17035614
- [20]Barzel US Massey LK Excess dietary protein can adversely affect bone J Nutr 128 6 1051 1053 1998 9614169
- [21]Fenton TR Lyon AW Eliasziw M Tough SC Hanley DA Meta-analysis of the effect of the acid-ash hypothesis of osteoporosis on calcium balance J Bone Miner Res 24 11 1835 1840 2009 19419322
- [22]Roughead ZK Johnson LK Lykken GI Hunt JR Controlled high meat diets do not affect calcium retention or indices of bone status in healthy postmenopausal women J Nutr 133 4 1020 1026 2003 12672913
- [23]Hunt JR Johnson LK Fariba Roughead ZK Dietary protein and calcium interact to influence calcium retention: a controlled feeding study Am J Clin Nutr 89 5 1357 1365 2009 19279077
- [24]Kerstetter JE O’Brien KO Caseria DM Wall DE Insogna KL The impact of dietary protein on calcium absorption and kinetic measures of bone turnover in women J Clin Endocrinol Metab 90 1 26 31 2005 15546911
- [25]Heaney RP Dietary protein and phosphorus do not affect calcium absorption Am J Clin Nutr 72 3 758 761 2000 10966895
- [26]Ceglia L Harris SS Abrams SA Rasmussen HM Dallal GE Dawson-Hughes B Potassium bicarbonate attenuates the urinary nitrogen excretion that accompanies an increase in dietary protein and may promote calcium absorption J Clin Endocrinol Metab 94 2 645 653 2009 19050051 PMC2730228
- [27]Kerstetter JE O’Brien KO Insogna KL Dietary protein affects intestinal calcium absorption Am J Clin Nutr 68 859 865 1998 9771863
- [28]Zemel MB Calcium utilization: effect of varying level and source of dietary protein Am J Clin Nutr 48 3 Suppl 880 883 1988 3414594
- [29]Heaney RP Recker RR Determinants of endogenous fecal calcium in healthy women J Bone Miner Res 9 10 1621 1627 1994 7817809
- [30]Davies KM Rafferty K Heaney RP Determinants of endogenous calcium entry into the gut Am J Clin Nutr 80 4 919 923 2004 15447899
- [31]Spencer H Kramer L DeBartolo M Norris C Osis D Further studies of the effect of a high protein diet as meat on calcium metabolism Am J Clin Nutr 37 6 924 929 1983 6846239
- [32]Kerstetter JE Caseria DM Mitnick ME Increased circulating concentrations of parathyroid hormone in healthy, young women consuming a protein-restricted diet Am J Clin Nutr 66 1188 1196 1997 9356538
- [33]Recker RR Calcium absorption and achlorhydria N Engl J Med 313 2 70 73 1985 4000241
- [34]O’Connell MB Madden DM Murray AM Heaney RP Kerzner LJ Effects of proton pump inhibitors on calcium carbonate absorption in women: a randomized crossover trial Am J Med 118 7 778 781 2005 15989913
- [35]Serfaty-Lacrosniere C Wood RJ Voytko D Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium or zinc from food in humans J Am Coll Nutr 14 4 364 368 1995 8568113
- [36]Dawson-Hughes B Harris SS Rasmussen H Song L Dallal GE Effect of dietary protein supplements on calcium excretion in healthy older men and women J Clin Endocrinol Metab 89 3 1169 1173 2004 15001604
- [37]Geusens PP Boonen S Osteoporosis and the growth hormone-insulin-like growth factor axis Horm Res 58 Suppl 3 49 55 2002 12435898
- [38]Bonjour JP Ammann P Chevalley T Rizzoli R Protein intake and bone growth Can J Appl Physiol 26 Suppl S153 S166 2001 11897891
- [39]Bonjour JP Schurch MA Chevalley T Ammann P Rizzoli R Protein intake, IGF-1 and osteoporosis Osteoporos Int 7 Suppl 3 S36 S42 1997 9536300
- [40]Wolfe RR The underappreciated role of muscle in health and disease Am J Clin Nut 84 3 475 482 2006 16960159
- [41]Paddon-Jones D Short KR Campbell WW Volpi E Wolfe RR Role of dietary protein in the sarcopenia of aging Am J Clin Nutr 87 5 1562S 1566S 2008 18469288
- [42]Houston DK Nicklas BJ Ding J Dietary protein intake is associated with lean mass change in older, community-dwelling adults: the Health, Aging, and Body Composition (Health ABC) Study Am J Clin Nutr 87 1 150 155 2008 18175749
- Paddon-Jones D Rasmussen BB Dietary protein recommendations and the prevention of sarcopenia Curr Opin Clin Nutr Metab Care 12 1 86 90 2009 Reviews recent research highlighting the importance of dietary protein for maintenance of skeletal muscle mass 19057193 PMC2760315
- [44]Heaney RP Layman DK Amount and type of protein influences bone health Am J Clin Nutr 87 5 1567S 1570S 2008 18469289
- [45]Friedman AN High-protein diets: potential effects on the kidney in renal health and disease Am J Kidney Dis 44 6 950 962 2004 15558517
- [46]Kopple JD National kidney foundation K/DOQI clinical practice guidelines for nutrition in chronic renal failure Am J Kidney Dis 37 1 Suppl 2 S66 S70 2001 11158865
- [47]Levey AS Coresh J Balk E National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification Ann Intern Med 139 2 137 147 2003 12859163
- [48]Knight EL Stampfer MJ Hankinson SE Spiegelman D Curhan GC The impact of protein intake on renal function decline in women with normal renal function or mild renal insufficiency Ann Intern Med 138 6 460 467 2003 12639078
- [49]Huang MC Chen ME Hung HC Inadequate energy and excess protein intakes may be associated with worsening renal function in chronic kidney disease J Ren Nutr 18 2 187 194 2008 18267211
- [50]Martin WF Armstrong LE Rodriguez NR Dietary protein intake and renal function Nutr Metab (Lond) 2 25 2005 16174292 PMC1262767
- [51]Walrand S Short KR Bigelow ML Sweatt AJ Hutson SM Nair KS Functional impact of high protein intake on healthy elderly people Am J Physiol Endocrinol Metab 295 4 E921 E928 2008 18697911 PMC2575899
- [52]Bossingham MJ Carnell NS Campbell WW Water balance, hydration status, and fat-free mass hydration in younger and older adults Am J Clin Nutr 81 6 1342 1350 2005 15941885 PMC2495085
- [53]Martin WF Cerundolo LH Pikosky MA Effects of dietary protein intake on indexes of hydration J Am Diet Assoc 106 4 587 589 2006 16567155
- [54]Fink HA Akornor JW Garimella PS Diet, fluid, or supplements for secondary prevention of nephrolithiasis: a systematic review and meta-analysis of randomized trials Eur Urol 56 1 72 80 2009 19321253 PMC2925677
- [55]Curhan GC Willett WC Rimm EB Stampfer MJ A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones N Engl J Med 328 12 833 838 1993 8441427
- [56]Dussol B Iovanna C Rotily M A randomized trial of low-animal-protein or high-fiber diets for secondary prevention of calcium nephrolithiasis Nephron Clin Pract 110 3 C185 C194 2008 18957869
- [57]Hess B Nutritional aspects of stone disease Endocrinol Metab Clin North Am 31 4 1017 1030 IX X 2002 12474643
- [58]Halton TL Hu FB The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review J Am Coll Nutr 23 5 373 385 2004 15466943
- [59]Bertenshaw EJ Lluch A Yeomans MR Dose-dependent effects of beverage protein content upon short-term intake Appetite 52 3 580 587 2009 19501753
- [60]Tome D Schwarz J Darcel N Fromentin G Protein, amino acids, vagus nerve signaling, and the brain Am J Clin Nutr 90 3 838S 843S 2009 19640948
- [61]Brownie S Why are elderly individuals at risk of nutritional deficiency? Int J Nurs Pract 12 2 110 118 2006 16529597
- [62]Smeets AJ Soenen S Luscombe-Marsh ND Ueland O Westerterp-Plantenga MS Energy expenditure, satiety, and plasma ghrelin, glucagon-like peptide 1, and peptide tyrosine-tyrosine concentrations following a single high-protein lunch J Nutr 138 4 698 702 2008 18356323
- [63]Leidy HJ Mattes RD Campbell WW Effects of acute and chronic protein intake on metabolism, appetite, and ghrelin during weight loss Obesity (Silver Spring) 15 5 1215 1225 2007 17495198
- [64]Fiatarone Singh MA Bernstein MA The effect of oral nutritional supplements on habitual dietary quality and quantity in frail elders J Nutr Health Aging 4 1 5 12 2000 10828934
- [65]Layman DK Clifton P Gannon MC Krauss RM Nuttall FQ Protein in optimal health: heart disease and Type 2 diabetes Am J Clin Nutr 87 5 1571S 1575S 2008 18469290
- [66]Gaffney-Stomberg E Insogna KL Rodriguez NR Kerstetter JE Increasing dietary protein requirements in elderly people for optimal muscle and bone health J Am Geriatr Soc 57 6 1073 1079 2009 19460090
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- Authors
- Surdykowski, A. K., Kenny, A. M., Insogna, K. L., & Kerstetter, J. E.
- Affiliations
- University of Connecticut (US)
- University of Connecticut Health Center, CT, USA
- Yale University (US)
- ORCID
- Insogna, Karl L
- Venue
- Aging Health
- Publisher
- Informa UK Limited
- Published
- 2010-06
- Volume
- 6
- Issue
- 3
- Pages
- 345-357
- ISSN
- 1745-509X (ISSN-L)
- 1745-5103
- PMC
- PMC2907525
- OpenAlex
- W2008532344
- Cited by
- 22
- References
- 4
- Citations by year
- 2024: 1 · 2023: 2 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 2 · 2016: 2 · 2014: 2 · 2013: 3
- FWCI
- 1.60
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Aging Health (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5RO1AR053701-04)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Keywords
- dietary protein, bone health, older adults, age-related bone loss, osteoporosis, calcium metabolism, insulin-like growth factor I, calcium absorption, muscle strength, protein intake recommendations, Dietary Reference Intakes
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