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Calcium and protein in bone health*

Published online by Cambridge University Press:  05 March 2007

Bess Dawson-Hughes*
Affiliation:
Calcium and Bone Metabolism Laboratory, The Jean Mayer USD A Human Nutrition Research Center on Aging, Tufts University, 711 Washington St, Boston, MA, 02111, USA
*
Corresponding author: Dr Bess Dawson-Hughes, fax +1 617 556 3305, Bess.Dawson-Hughes@Tufts.edu
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Abstract

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Dietary protein has several opposing effects on Ca balance and its net effect on bone is not well established. It has long been recognized that increasing protein intake increases urinary Ca excretion. More recently, it has been observed that increasing dietary protein raises the circulating level of insulin-like growth factor-1, a growth factor that promotes osteoblast formation and bone growth. Other effects of protein on the Ca economy have been suggested in some studies, but they are less well established. Several studies have examined associations between protein intake and bone loss and fracture rates. In the original Framingham cohort subjects with lower total and animal protein intakes had greater rates of bone loss from the femoral neck and spine than subjects consuming more protein. In another study higher total (and animal) protein intakes were associated with a reduced incidence of hip fractures in post-menopausal women. In contrast, a high animahplant protein intake has been associated with greater bone loss from the femoral neck and a greater risk of hip fracture in older women. Higher total and higher animal protein intakes have also been associated with increased risk of forearm fracture in younger post-menopausal women. In a recent study it was found that increasing dietary protein was associated with a favourable (positive) change in bone mineral density of the femoral neck and total body in subjects taking supplemental calcium citrate malate with vitamin D, but not in those taking placebo. The possibility that Ca intake may influence the impact of dietary protein on the skeleton warrants further investigation.

Type
Macronutrient Group Symposium on ‘Protein intake and chronic disease’
Copyright
Copyright © The Nutrition Society 2003

Footnotes

*

This material is based on work supported by agrant (AG10353) from the National Institutes of Health and by the US Department of Agriculture, under agreement no. 58-1950-9001. Any opinions, findings, conclusions or recommendations expressed in this publication are those of the author, and do not necessarily reflect the view of the US Department of Agriculture

References

Bushinsky, DA, Parker, WR, Alexander, KM & Krieger, NS (2001) Metabolic, but not respiratory, acidosis increases bone PGE(2) levels and calcium release. American Journal of Physiology 281, F1058F1066.Google Scholar
Cadogan, J, Eastell, R, Jones, N & Barker, ME (1997) Milk intake and bone mineral acquisition in adolescent girls: randomised, controlled intervention trial. British Medical Journal 315, 12551260.Google Scholar
Dawson-Hughes, B & Harris, SS (2002) Calcium intake influences the association of protein intake with rates of bone loss in elderly men and women. American Journal of Clinical Nutrition 75, 773779.Google Scholar
Dawson-Hughes, B, Harris, SS, Krall, EA & Dallal, GE (1997) Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. New England Journal of Medicine 337, 670676.Google Scholar
Delmi, M, Rapin, CH, Bengoa, JM, Delmas, PD, Vasey, H & Bonjour, JP (1990) Dietary supplementation in elderly patients with fractured neck of the femur. Lancet 335, 10131016.Google Scholar
Feskanich, D, Willett, WC, Stampfer, MJ & Colditz, GA (1996) Protein consumption and bone fractures in women. American Journal of Epidemiology 143, 472479.Google Scholar
Hannan, MT, Tucker, KL, Dawson-Hughes, B, Cupples, LA, Felson, DT & Kiel, DP (2000) Effect of dietary protein on bone loss in elderly men and women: the Framingham Osteoporosis Study. Journal of Bone and Mineral Research 15, 25042512.Google Scholar
Heaney, RP, McCarron, DA, Dawson-Hughes, B, Oparil, S, Berga, SL, Stern, JS, Barr, SI & Rosen, CJ (1999) Dietary changes favorably affect bone remodeling in older adults. Journal of the American Dietetic Association 99, 12281233.Google Scholar
Hegsted, M & Linkswiler, HM (1981) Long-term effects of level of protein intake on calcium metabolism in young adult women. Journal of Nutrition 111, 244251.Google Scholar
Higashi, Y, Takenaka, A, Takahashi, S & Noguchi, T (1996) Effect of protein restriction on the messenger RNA contents of bone-matrix proteins, insulin-like growth factors and insulin-like growth factor binding proteins in femur of ovariectomized rats. British Journal of Nutrition 75, 811823.Google Scholar
Kerstetter, JE, Looker, AC & Insogna, KL (2000) Low dietary protein and low bone density. Calcified Tissue International 66 313.Google Scholar
Kerstetter, JE, O'Brien, KO & Insogna, KL (1998) Dietary protein affects intestinal calcium absorption. American Journal of Clinical Nutrition 68, 859865.Google Scholar
Kraut, JA, Mishler, DR, Singer, FR & Goodman, WG (1986) The effects of metabolic acidosis on bone formation and bone resorption in the rat. Kidney International 30, 694700.Google Scholar
Meyer, HE, Pedersen, JI, Loken, EB & Tverdal, A (1997) Dietary factors and the incidence of hip fracture in middle-aged Norwegians. A prospective study. American Journal of Epidemiology 145, 117123.Google Scholar
Munger, RG, Cerhan, JR & Chiu, BC (1999) Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. American Journal of Clinical Nutrition 69, 147152.Google Scholar
Oxlund, H, Mosekilde, L & Ortoft, G (1996) Reduced concentration of collagen reducible cross links in human trabecular bone with respect to age and osteoporosis. Bone 19, 479484.Google Scholar
Promislow, JHE, Godoman-Gruen, D, Slymen, DJ, Barrett-Connor, E (2002) Protein consumption and bone mineral density in the elderly. American Journal of Epidemiology 155, 636644.Google Scholar
Schürch, MA, Rizzoli, R, Slosman, D, Vadas, L, Vergnaud, P & Bonjour, JP (1998) Protein supplements increase serum insulin-like growth factor-I levels and attenuate proximal femur bone loss in patients with recent hip fracture. A randomized, double-blind, placebo-controlled trial. Annals of Internal Medicine 128, 801809.Google Scholar
Sellmeyer, DE, Stone, KL, Sebastian, A & Cummings, SR (2001) A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. Study of Osteoporotic Fractures Research Group. American Journal of Clinical Nutrition 73, 118122.Google Scholar
Sutton, RA, Wong, NL & Dirks, JH (1979) Effects of metabolic acidosis and alkalosis on sodium and calcium transport in the dog kidney. Kidney International 15, 520533.Google Scholar