Dietary protein and bone health: a systematic review and meta-analysis
Open accessAbstract
Background There has been a resurgence of interest in the controversial relation between dietary protein and bone health. Objective This article reports on the first systematic review and meta-analysis of the relation between protein and bone health in healthy human adults. Design The MEDLINE (January 1966 to September 2007) and EMBASE (1974 to July 2008) databases were electronically searched for all relevant studies of healthy adults; studies of calcium excretion or calcium balance were excluded. Results In cross-sectional surveys, all pooled r values for the relation between protein intake and bone mineral density (BMD) or bone mineral content at the main clinically relevant sites were significant and positive; protein intake explained 1-2% of BMD. A meta-analysis of randomized placebo-controlled trials indicated a significant positive influence of all protein supplementation on lumbar spine BMD but showed no association with relative risk of hip fractures. No significant effects were identified for soy protein or milk basic protein on lumbar spine BMD. Conclusions A small positive effect of protein supplementation on lumbar spine BMD in randomized placebo-controlled trials supports the positive association between protein intake and bone health found in cross-sectional surveys. However, these results were not supported by cohort study findings for hip fracture risk. Any effects found were small and had 95% CIs that were close to zero. Therefore, there is a small benefit of protein on bone health, but the benefit may not necessarily translate into reduced fracture risk in the long term.
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In older people with osteoporosis, a systematic review, prospective cohort studies, and a randomized controlled trial found higher bone mineral density when protein intake was higher than 0.8 g/kg body weight per day or was 24% of total energy intake.
“In older people with osteoporosis, findings from a systematic review, 88 several prospective cohort studies, 89,90 and a randomized, controlled trial 91 (RCT) all found higher bone mineral density when protein intake was at levels higher than 0.8 g/kg BW/d or was 24% of total energy intake (Table 4).”
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 [88]
A systematic review indicated a small positive effect of protein supplementation on lumbar spine BMD.
“Darling 2009 88 Not specified A systematic review indicating a small positive effect of protein supplementation on lumbar spine BMD”
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 Darling 2009
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- Authors
- Darling, A. L., Millward, D. J., Torgerson, D. J., Hewitt, C. E., & Lanham-New, S. A.
- Affiliations
- University of Surrey (GB)
- Corresponding author
- Darling, Andrea L
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2009-12
- Volume
- 90
- Issue
- 6
- Pages
- 1674-1692
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2167366583
- Cited by
- 310
- References
- 5
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 12 · 2023: 9 · 2022: 14 · 2021: 12 · 2020: 12 · 2019: 16 · 2018: 26 · 2017: 20 · 2016: 23 · 2015: 20 · 2014: 40 · 2013: 23 · 2012: 19
- FWCI
- 4.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Open Research (University of Surrey) (submittedVersion)
- Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- dietary protein, bone health, bone mineral density, protein supplementation, hip fracture risk, lumbar spine, soy protein, milk protein, healthy adults
- MeSH terms
- Cross-Sectional Studies, Dietary Proteins, Humans, Risk, Bone Density, Fractures, Bone
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