Benefits and safety of dietary protein for bone health-an expert consensus paper endorsed by the European Society for Clinical and Economical Aspects of Osteopororosis, Osteoarthritis, and Musculoskeletal Diseases and by the International Osteoporosis Foundation.
Study Goal
The researchers aimed to summarize and synthesize systematic reviews and meta-analyses on the benefits and risks of dietary protein intakes (including dairy) for bone health in adults, particularly focusing on bone mineral density (BMD) and fracture risk.
Results Summary
Higher protein intake (≥ 0.8 g/kg body weight/day) was associated with higher BMD, slower bone loss, and reduced hip fracture risk in older adults with osteoporosis, provided calcium intakes were adequate. Dietary protein supplements attenuated age-related BMD decrease and improved bone turnover markers, with no evidence of harm from diet-derived acid load.
Population
Adults, particularly older individuals with osteoporosis.
Effective Dosage
≥ 0.8 g/kg body weight/day (above the current RDA).
Duration
Not specified.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
dietary protein intakes even above the current RDA | decrease | bone loss and hip fracture risk | adults | - | may be beneficial in reducing | #1 |
adequate supplies of dietary protein | increase | bone growth and maintenance of healthy bone | - | - | are required for optimal | #2 |
variation in protein intakes within the 'normal' range | neutral | BMD variance | adults | 2-4% | accounts for | #3 |
higher protein intake (≥ 0.8-g/kg body weight/day, i.e., above the current RDA) | increase | BMD | older people with osteoporosis | - | is associated with higher | #4 |
higher protein intake (≥ 0.8-g/kg body weight/day, i.e., above the current RDA) | decrease | bone loss | older people with osteoporosis | - | is associated with a slower rate of | #5 |
higher protein intake (≥ 0.8-g/kg body weight/day, i.e., above the current RDA) | decrease | hip fracture | older people with osteoporosis | - | is associated with reduced risk of | #6 |
intervention with dietary protein supplements | decrease | age-related BMD decrease | - | - | attenuate | #7 |
intervention with dietary protein supplements | decrease | bone turnover marker levels | - | - | reduce | #8 |
intervention with dietary protein supplements | increase | IGF-I | - | - | an increase in | #9 |
intervention with dietary protein supplements | decrease | PTH | - | - | a decrease in | #10 |
diet-derived acid load | decrease | bone health | - | no evidence | is deleterious for | #11 |
A summary of systematic reviews and meta-analyses addressing the benefits and risks of dietary protein intakes for bone health in adults suggests that dietary protein levels even above the current RDA may be beneficial in reducing bone loss and hip fracture risk, provided calcium intakes are adequate. Several systematic reviews and meta-analyses have addressed the benefits and risks of dietary protein intakes for bone health in adults. This narrative review of the literature summarizes and synthesizes recent systematic reviews and meta-analyses and highlights key messages. Adequate supplies of dietary protein are required for optimal bone growth and maintenance of healthy bone. Variation in protein intakes within the "normal" range accounts for 2-4% of BMD variance in adults. In older people with osteoporosis, higher protein intake (≥ 0.8-g/kg body weight/day, i.e., above the current RDA) is associated with higher BMD, a slower rate of bone loss, and reduced risk of hip fracture, provided that dietary calcium intakes are adequate. Intervention with dietary protein supplements attenuate age-related BMD decrease and reduce bone turnover marker levels, together with an increase in IGF-I and a decrease in PTH. There is no evidence that diet-derived acid load is deleterious for bone health. Thus, insufficient dietary protein intakes may be a more severe problem than protein excess in the elderly. Long-term, well-controlled randomized trials are required to further assess the influence of dietary protein intakes on fracture risk.