Osteoporosis International

, Volume 29, Issue 1, pp 69–77 | Cite as

High dairy protein intake is associated with greater bone strength parameters at the distal radius and tibia in older men: a cross-sectional study

  • L. LangsetmoEmail author
  • J. M. Shikany
  • A. J. Burghardt
  • P. M. Cawthon
  • E. S. Orwoll
  • J. A. Cauley
  • B. C. Taylor
  • J. T. Schousboe
  • D. C. Bauer
  • T. N. Vo
  • K. E. Ensrud
  • for the Osteoporotic Fractures in Men (MrOS) Study Research Group
Original Article



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.


Bone microarchitecture Bone strength Older men Protein intake 


Funding information

The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute on Aging (NIA), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Center for Advancing Translational Sciences (NCATS), and NIH Roadmap for Medical Research under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, UL1 TR000128, and R01 AR060700.

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.


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2017

Authors and Affiliations

  • L. Langsetmo
    • 1
    Email author
  • J. M. Shikany
    • 2
  • A. J. Burghardt
    • 3
  • P. M. Cawthon
    • 4
    • 5
  • E. S. Orwoll
    • 6
  • J. A. Cauley
    • 7
  • B. C. Taylor
    • 1
    • 8
    • 9
  • J. T. Schousboe
    • 10
    • 11
  • D. C. Bauer
    • 12
  • T. N. Vo
    • 1
  • K. E. Ensrud
    • 1
    • 8
    • 9
  • for the Osteoporotic Fractures in Men (MrOS) Study Research Group
  1. 1.Division of Epidemiology and Community HealthUniversity of MinnesotaMinneapolisUSA
  2. 2.Division of Preventive Medicine, School of MedicineUniversity of Alabama at BirminghamBirminghamUSA
  3. 3.Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoUSA
  4. 4.California Pacific Medical Center Research InstituteSan FranciscoUSA
  5. 5.Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoUSA
  6. 6.Bone and Mineral UnitOregon Health Sciences UniversityPortlandUSA
  7. 7.Department of Epidemiology, Graduate School of Public HealthUniversity of PittsburghPittsburghUSA
  8. 8.Department of MedicineUniversity of MinnesotaMinneapolisUSA
  9. 9.Center for Chronic Disease Outcomes ResearchMinneapolis VA Health Care SystemMinneapolisUSA
  10. 10.Park Nicollet Clinic and HealthPartners InstituteBloomingtonUSA
  11. 11.Division of Health Policy and ManagementUniversity of MinnesotaMinneapolisUSA
  12. 12.Departments of MedicineUniversity of California San FranciscoSan FranciscoUSA

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