Calcified Tissue International

, Volume 58, Issue 5, pp 320–325

Dietary protein intake and bone mass in women

  • C. Cooper
  • E. J. Atkinson
  • D. D. Hensrud
  • H. W. Wahner
  • W. M. O'Fallon
  • B. L. Riggs
  • L. J. MeltonIII
Clinical Investigations

Abstract

Population-based strategies to combat osteoporosis are urgently needed. The role of nutrition in such strategies has been particularly contentious. We examined the relationship among six key nutrients that are thought to affect bone metabolism and bone mineral density in the axial and appendicular skeleton using data from a population-based study in the northern United States. Data on the dietary intake of calcium, phosphorus, vitamin D, protein, fat, and total energy were obtained from a 7-day dietary record. Bone density measurements were made by dual photon absorptiometry in the lumbar spine and proximal femur, and by single photon absorptiometry in the distal and midradius. Among the 72 premenopausal women studied, there was a statistically significant positive association between protein intake and bone mineral in the distal radius and proximal femur, which was not altered by adjustment for age, weight, and physical activity. Among 218 postmenoprusal women, no such relationship was found between protein intake and bone mineral, and the only significant findings in this group were negative associations between fat consumption and bone density in the lumbar spine and radius. Our results suggest that dietary protein intake may be a determinant of the peak bone mass attained by premenopausal white women. The relevance of this finding for the design of population strategies to maximize skeletal growth requires further investigation.

Key words

Epidemiology Osteoporosis Bone density Nutrition 

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References

  1. 1.
    Anonymous (1990) Osteoporosis. In: Berg RL, Cassells JS (eds) The second fifty years: promoting health and preventing disability. National Academy Press, Washington, DC, pp 76–100Google Scholar
  2. 2.
    Riggs BL, Melton LJ III (1986) Medical progress: involutional osteoporosis. N Engl J Med 314:1676–1686PubMedCrossRefGoogle Scholar
  3. 3.
    Hui SL, Slemenda CW, Johnston CC Jr (1990) The contribution of the bone loss to postmenopausal osteoporosis. Osteoporosis Int 1:30–34CrossRefGoogle Scholar
  4. 4.
    Cumming RG (1990) Calcium intake and bone mass: a quantitative review of the evidence. Calcif Tissue Int 47:194–201PubMedGoogle Scholar
  5. 5.
    Heaney RP (1992) Calcium in the prevention and treatment of osteoporosis. J Intern Med 231:169–180PubMedGoogle Scholar
  6. 6.
    Johnston CC Jr, Miller JZ, Slemenda CW, Reister TK, Hui S, Christian JC, Peacock M (1992) Calcium supplementation and increases in bone mineral density in children. N Engl J Med 327:82–87PubMedCrossRefGoogle Scholar
  7. 7.
    Dawson-Hughes B, Dallal GE, Krall EA, Sadowski L, Sahyoun N, Tannenbaum S (1990) A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. N Engl J Med 323:878–883PubMedCrossRefGoogle Scholar
  8. 8.
    Reid IR, Ames RW, Evans MC, Gamble GD, Sharpe SJ (1993) Effect of calcium supplementation on bone loss in postmenopausal women. N Engl J Med 328:460–464PubMedCrossRefGoogle Scholar
  9. 9.
    Prince R, Devine A, Dick I, Criddle A, Kerr D, Kent N, Price R, Randell A (1995) The effects of calcium supplementation (milk powder or tablets) and exercise on bone density in post-menopausal women. J Bone Miner Res 10:1068–1075PubMedCrossRefGoogle Scholar
  10. 10.
    Kanis JA, Passmore R (1989) Calcium supplementation of the diet—II: not justified by present evidence. Br Med J 298:205–208CrossRefGoogle Scholar
  11. 11.
    Nordin BEC, Heaney RP (1990) Calcium supplementation of the diet: justified by the present evidence. BMJ 300:1056–1060PubMedCrossRefGoogle Scholar
  12. 12.
    Wootton R, Brereton PJ, Clark MB, Hesp R, Hodkinson HM, Klenerman L, Reeve J, Slavin G, Tellez-Yudilevich M (1979) Fractured neck of femur in the elderly: an attempt to identify patients at risk. Clin Sci 57:93–101PubMedGoogle Scholar
  13. 13.
    Schaafsma G, van Beresteyn ECH, Raymakers JA, Duursma SA (1987) Nutritional aspects of osteoporosis. World Rev Nutr Diet 49:121–159PubMedGoogle Scholar
  14. 14.
    Heaney RP, Recker RR, Saville PD (1978) Menopausal changes in calcium balance performance. J Lab Clin Med 92:953–963PubMedGoogle Scholar
  15. 15.
    Kurland LT, Molgaard CA (1981) The patients record in epidemiology. Sci Am 245:54–63PubMedGoogle Scholar
  16. 16.
    Beard CM, Lane AW, O'Fallon WM, Riggs BL, Melton LJ III (1994) Comparison of respondents and nonrespondents in an osteoporosis study. Ann Epidemiol 4:398–403PubMedCrossRefGoogle Scholar
  17. 17.
    Beard CM, Melton LJ III, Cedel SL, Richelson LS, Riggs BL (1990) Ascertainment of risk factors for osteoporosis: comparison of interview data with medical record review. J Bone Miner Res 5:691–699PubMedGoogle Scholar
  18. 18.
    Consumer and Food Economics Institute (1979) United States Department of Agriculture. Agriculture Handbook 8Google Scholar
  19. 19.
    Riggs BL, Wahner HW, Seeman E, Offord KP, Dunn WL, Mazess RB, Johnson KA, Melton LJ III (1982) Changes in bone mineral density of the proximal femur and spine with aging: differences between the postmenopausal and senile osteoporosis syndromes. J Clin Invest 70:716–723PubMedGoogle Scholar
  20. 20.
    Arnaud CD, Tsao HS, Littledike T (1971) Radioimmunoassay of human parathyroid hormone in serum. J Clin Invest 50:21–34PubMedGoogle Scholar
  21. 21.
    Delmas PD, Stenner D, Wahner HW, Mann KG, Riggs BL (1983) Increase in serum bone γ-carboxyglutamic acid protein with aging in women: implications for the mechanism of agerelated bone loss. J Clin Invest 71:1316–1321PubMedCrossRefGoogle Scholar
  22. 22.
    Kivirikko KI, Laitinen O, Prockop DJ (1967) Modifications of a specific assay for hydroxyproline in urine. Anal Biochem 19:249–255PubMedCrossRefGoogle Scholar
  23. 23.
    Rosner W (1972) A simplified method for the quantitative determination of testosterone-estradiol-binding globulin activity in human plasma. J Clin Endocrinol Metab 34:983–988PubMedCrossRefGoogle Scholar
  24. 24.
    DeVane GW, Czekala NM, Judd HL, Yen SSC (1975) Circulating gonadotropins, estrogens, and androgens in polycystic ovarian disease. Am J Obstet Gynecol 121:496–500PubMedGoogle Scholar
  25. 25.
    Cooper C, Melton LJ III (1992) Epidemiology of osteoporosis. Trends Endocrinol Metab 3:224–229CrossRefPubMedGoogle Scholar
  26. 26.
    Yano K, Heilbrun HK, Wasnich RD, Hankin JH, Vogel JM (1985) The relationship between diet and bone mineral content of multiple skeletal sites in elderly Japanese-American men and women living in Hawaii. Am J Clin Nutr 42:877–888PubMedGoogle Scholar
  27. 27.
    Sowers MFR, Wallace RB, Lemke JH (1985) Correlates of mid-radius bone density among postmenopausal women: a community study. Am J Clin Nutr 1985; 41:1045–1053PubMedGoogle Scholar
  28. 28.
    Freudenheim JL, Johnson NE, Smith EL (1986) Relationships between usual nutrient intake and bone mineral content of women 35–65 years of age: longitudinal and cross-sectional analysis.Am J Clin Nutr 44:863–876PubMedGoogle Scholar
  29. 29.
    Angus RM, Sambrook PN, Pocock NA, Eisman JA (1988) Dietary intake and bone mineral density. Bone Miner 4:265–277PubMedGoogle Scholar
  30. 30.
    Bauer DC, Browner WS, Cauley JA, Orwoll ES, Scott JC, Black DM, Tao JL, Cummings SR for the study of Osteoporotic Fractures Research Group (1993) Factors associated with appendicular bone mass in older women. Ann Intern Med 118:657–665PubMedGoogle Scholar
  31. 31.
    Geinoz G, Rapin CH, Rizzoli R, Kraemer R, Buchs B, Slosman D, Michel JP, Bonjour JP (1993) Relationship between bone mineral density and dietary intakes in the elderly. Osteoporosis Int 3:242–248CrossRefGoogle Scholar
  32. 32.
    Metz JA, Anderson JJB, Gallagher PN Jr (1993) Intakes of calcium, phosphorus, and protein, and physical-activity level are related to radial bone mass in young adult women. Am J Clin Nutr 58:537–542PubMedGoogle Scholar
  33. 33.
    Mazess RB, Barden HS (1991) Bone density in premenopausal women: effects of age, dietary intake, physical activity, smoking, and birth-control pills. Am J Clin Nutr 53:132–142PubMedGoogle Scholar
  34. 34.
    Nieves JW, Golden AL, Siris E, Kelsey JL, Lindsay R (1995) Teenage and current calcium intake are related to bone mineral density of the hip and forearm in women aged 30–39 years. Am J Epidemiol 141:342–351PubMedGoogle Scholar
  35. 35.
    Henderson NK, Price RI, Cole JH, Gutteridge DH, Bhagat CI (1995) Bone density in young women is associated with body weight and muscle strength but not dietary intakes. J Bone Miner Res 10:384–393PubMedGoogle Scholar
  36. 36.
    Matković, V, Kostial K, Šimonović I, Buzina R, Brodarec A, Nordin BEC (1979) Bone status and fracture rates in two regions of Yugoslavia. Am J Clin Nutr 32:540–549PubMedGoogle Scholar
  37. 37.
    Sowers MF, Wallace RB, Lemke JH (1985) Correlates of forearm bone mass among women during maximal bone mineralization. Prev Med 14:585–596PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc 1996

Authors and Affiliations

  • C. Cooper
    • 1
  • E. J. Atkinson
    • 1
  • D. D. Hensrud
    • 2
  • H. W. Wahner
    • 3
  • W. M. O'Fallon
    • 1
  • B. L. Riggs
    • 4
  • L. J. MeltonIII
    • 1
  1. 1.Department of Health Sciences ResearchMayo Clinic and Mayo FoundationRochester
  2. 2.Division of Preventive MedicineMayo Clinic and Mayo FoundationRochester
  3. 3.Department of Diagnostic RadiologyMayo Clinic and Mayo FoundationRochester
  4. 4.Division of Endocrinology/MetabolismMayo Clinic and Mayo FoundationRochester
  5. 5.MRC Environmental Epidemiology UnitSouthampton General HospitalSouthamptonUK

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