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Association of protein intake with bone mineral density and bone mineral content among elderly women: The OSTPRE fracture prevention study

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The journal of nutrition, health & aging

Abstract

Abstract

It has been hypothesized that high protein intakes are associated with lower bone mineral content (BMC). Previous studies yield conflicting results and thus far no studies have undertaken the interaction of body mass index (BMI) and physical activity with protein intakes in relation to BMC and bone mineral density (BMD).

Objective

To evaluate the associations of dietary total protein (TP), animal protein (AP) and plant protein (PP) intakes with BMC and BMD and their changes. We tested also the interactions of protein intake with, obesity (BMI ≤30 vs. >30 kg/m2) and physical activity level (passive vs. active).

Design/ Setting

Prospective cohort study (Osteoporosis Risk-Factor and Fracture-Prevention Study).

Participants/measures

At the baseline, 554 women aged 65-72 years filled out a 3-day food record and a questionnaire covering data on lifestyle, physical activity, diseases, and medications. Intervention group received calcium 1000 mg/d and cholecalciferol 800 IU for 3 years. Control group received neither supplementation nor placebo. Bone density was measured at baseline and year 3, using dual energy x-ray absorptiometry. Multivariable regression analyses were conducted to examine the associations between protein intake and BMD and BMC.

Results

In cross-sectional analyses energy-adjusted TP (P≤0·029) and AP (P≤0·045) but not PP (g/d) were negatively associated with femoral neck (FN) BMD and BMC. Women with TP≥1·2 g/kg/body weight (BW) (Ptrend≤0·009) had lower FN, lumbar spine (LS) and total BMD and BMC. In follow-up analysis, TP (g/kg/BW) was inversely associated with LS BMD and LS BMC. The detrimental associations were stronger in women with BMI<30 kg/m2. In active women, TP (g/kg/BW) was positively associated with LS BMD and FN BMC changes.

Conclusions

This study suggests detrimental associations between protein intake and bone health. However, these negative associations maybe counteracted by BMI>30 kg/m2 and physical activity.

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Authors and Affiliations

  1. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1C, P.O. Box 1627, FI70211, Kuopio, Finland

    Masoud Isanejad, J. Mursu & A. T. Erkkilä

  2. Department of Orthopaedics and Traumatology, Kuopio University Hospital, Kuopio, Finland

    J. Sirola & H. Kröger

  3. Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland

    Masoud Isanejad, J. Sirola & H. Kröger

  4. Department of Obstetrics and Gynaegology, Kuopio University Hospital, Kuopio, Finland

    M. Tuppurainen

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  1. Masoud Isanejad
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  2. J. Sirola
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  3. J. Mursu
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Correspondence to Masoud Isanejad.

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Isanejad, M., Sirola, J., Mursu, J. et al. Association of protein intake with bone mineral density and bone mineral content among elderly women: The OSTPRE fracture prevention study. J Nutr Health Aging 21, 622–630 (2017). https://doi.org/10.1007/s12603-016-0800-4

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  • DOI: https://doi.org/10.1007/s12603-016-0800-4

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