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Osteoporos Int. 2018 May 8. doi: 10.1007/s00198-018-4534-5. [Epub ahead of print]

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.

Author information

1
Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, 1211, Geneva 14, Switzerland. rene.rizzoli@unige.ch.
2
Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, 1211, Geneva 14, Switzerland.
3
INRA, Unité de Nutrition Humaine, CRNH Auvergne, Université Clermont Auvergne, F-63000, Clermont-Ferrand, France.
4
McGill University Health Center, Montreal, Canada.
5
University of Sheffield, Sheffield, UK.
6
Institute for Health and Ageing, Catholic University of Australia, Melbourne, Australia.
7
College of Nursing, Creighton University, Creighton, NE, USA.
8
Aarhus University Hospital, Aarhus, Denmark.
9
Hebrew SeniorLife and Harvard Medical School, Institute for Aging Research, Boston, MA, USA.
10
Women's Global Health Institute, Department of Nutrition Science, Purdue University, Purdue, West Lafayette, IN, USA.
11
School of Human Nutrition, McGill University, Montreal, QC, Canada.
12
Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.

Abstract

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.

KEYWORDS:

Acid-base homeostasis; Bone mineral density; Bone turnover; Dairy products; Fracture; Osteoporosis

PMID:
29740667
DOI:
10.1007/s00198-018-4534-5

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