High dairy protein intake is associated with greater bone strength parameters at the distal radius and tibia in older men: a cross-sectional study
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Dairy protein but not plant protein was associated with bone strength of the radius and tibia in older men. These results are consistent with previous results in women and support similar findings related to fracture outcomes. Bone strength differences were largely due to thickness and area of the bone cortex.
Our objective was to determine the association of protein intake by source (dairy, non-dairy animal, plant) with bone strength and bone microarchitecture among older men.
We used data from 1016 men (mean 84.3 years) who attended the Year 14 exam of the Osteoporotic Fractures in Men (MrOS) study, completed a food frequency questionnaire (500–5000 kcal/day), were not taking androgen or androgen agonists, and had high-resolution peripheral quantitative computed tomography (HR-pQCT) scans of the distal radius and distal or diaphyseal tibia. Protein was expressed as percentage of total energy intake (TEI); mean ± SD for TEI = 1548 ± 607 kcal/day and for total protein = 16.2 ± 2.9%TEI. We used linear regression with standardized HR-pQCT parameters as dependent variables and adjusted for age, limb length, center, education, race/ethnicity, marital status, smoking, alcohol intake, physical activity level, corticosteroids use, supplement use (calcium and vitamin D), and osteoporosis medications.
Higher dairy protein intake was associated with higher estimated failure load at the distal radius and distal tibia [radius effect size = 0.17 (95% CI 0.07, 0.27), tibia effect size = 0.13 (95% CI 0.03, 0.23)], while higher non-dairy animal protein was associated with higher failure load at only the distal radius. Plant protein intake was not associated with failure load at any site.
The association between protein intake and bone strength varied by source of protein. These results support a link between dairy protein intake and skeletal health, but an intervention study is needed to evaluate causality.
KeywordsBone microarchitecture Bone strength Older men Protein intake
Compliance with ethical standards
Conflicts of interest
None. This manuscript is the result of work supported with resources and use of facilities of the Minneapolis VA Health Care System. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.
- 1.Gaffney-Stomberg E, Cao JJ, Lin GG, Wulff CR, Murphy NE, Young AJ, McClung JP, Pasiakos SM (2014) Dietary protein level and source differentially affect bone metabolism, strength, and intestinal calcium transporter expression during ad libitum and food-restricted conditions in male rats. J Nutr 144:821–829CrossRefPubMedGoogle Scholar
- 4.Orwoll E, Blank JB, Barrett-Connor E, Cauley J, Cummings S, Ensrud K, Lewis C, Cawthon PM, Marcus R, Marshall LM, McGowan J, Phipps K, Sherman S, Stefanick ML, Stone K (2005) Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study—a large observational study of the determinants of fracture in older men. Contemp Clin Trials 26:569–585CrossRefPubMedGoogle Scholar
- 5.Burghardt AJ, Pialat JB, Kazakia GJ, Boutroy S, Engelke K, Patsch JM, Valentinitsch A, Liu D, Szabo E, Bogado CE, Zanchetta MB, McKay HA, Shane E, Boyd SK, Bouxsein ML, Chapurlat R, Khosla S, Majumdar S (2013) Multicenter precision of cortical and trabecular bone quality measures assessed by high-resolution peripheral quantitative computed tomography. J Bone Miner Res 28:524–536CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Langsetmo L, Barr SI, Berger C, Kreiger N, Rahme E, Adachi JD, Papaioannou A, Kaiser SM, Prior JC, Hanley DA, Kovacs CS, Josse RG, Goltzman D (2015) Associations of protein intake and protein source with bone mineral density and fracture risk: a population-based cohort study. J Nutr Health Aging 19:861–868CrossRefPubMedPubMedCentralGoogle Scholar
- 19.Burt LA, Hanley DA, Boyd SK (2017) Cross-sectional versus longitudinal change in a prospective HR-pQCT study. J Bone Miner ResGoogle Scholar
- 20.Pasiakos SM, Agarwal S, Lieberman HR, Fulgoni VL, III. Sources and amounts of animal, dairy, and plant protein intake of US adults in 2007–2010. Nutrients 2015; 7: 7058–7069Google Scholar
- 23.Kerstetter JE, Bihuniak JD, Brindisi J, Sullivan RR, Mangano KM, Larocque S, Kotler BM, Simpson CA, Cusano AM, Gaffney-Stomberg E, Kleppinger A, Reynolds J, Dziura J, Kenny AM, Insogna KL (2015) The effect of a whey protein supplement on bone mass in older Caucasian adults. J Clin Endocrinol Metab 100:2214–2222CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Zhu K, Meng X, Kerr DA, Devine A, Solah V, Binns CW, Prince RL (2011) The effects of a two-year randomized, controlled trial of whey protein supplementation on bone structure, IGF-1, and urinary calcium excretion in older postmenopausal women. J Bone Miner Res 26:2298–2306CrossRefPubMedGoogle Scholar