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Associations of Protein Intake and Protein Source with Bone Mineral Density and Fracture Risk: A Population-Based Cohort Study

Alexandra Papaioannou, Stephanie M Kaiser, A Papaioannou, Susan I Barr, Christopher S Kovacs, Claudie Berger, David A Hanley, David Goltzman, Jonathan D Adachi, Lisa Langsetmo, Jerilynn C Prior, E Rahme, Robert G Josse, S M Kaiser, CaMos Research Group, Nancy Kreiger

  • McMaster University, Hamilton, ON, Canada ROR
  • Dalhousie University ROR
  • Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
  • Vancouver Hospital and Health Sciences Centre ROR
  • Memorial University of Newfoundland, St John’s, NL, Canada ROR
  • McGill University ROR
  • Royal Victoria Regional Health Centre ROR
  • University of Toronto ROR

The Journal of Nutrition, Health & Aging, 19(8), 861-868

DOI 10.1007/s12603-015-0544-6 PMID 26412291

Abstract

High dietary protein has been hypothesized to cause lower bone mineral density (BMD) and greater fracture risk. Previous results are conflicting and few studies have assessed potential differences related to differing protein sources.

Objective

To determine associations between total protein intake, and protein intake by source (dairy, non-dairy animal, plant) with BMD, BMD change, and incident osteoporotic fracture. DESIGN/

Setting

Prospective cohort study (Canadian Multicentre Osteoporosis Study). Participants/

Measures

Protein intake was assessed as percent of total energy intake (TEI) at Year 2 (1997-99) using a food frequency questionnaire (N=6510). Participants were contacted annually to ascertain incident fracture. Total hip and lumbar spine BMD was measured at baseline and Year 5. Analyses were stratified by group (men 25-49 y, men 50+ y, premenopausal women 25-49 y, and postmenopausal women 50+ y) and adjusted for major confounders. Fracture analyses were limited to those 50+ y.

Results

Intakes of dairy protein (with adjustment for BMI) were positively associated with total hip BMD among men and women aged 50+ y, and in men aged 25-49. Among adults aged 50+ y, those with protein intakes of <12% TEI (women) and <11% TEI (men) had increased fracture risk compared to those with intakes of 15% TEI. Fracture risk did not significantly change as intake increased above 15% TEI, and was not significantly associated with protein source.

Conclusions

In contrast to hypothesized risk of high protein, we found that for adults 50+ y, low protein intake (below 15% TEI) may lead to increased fracture risk. Source of protein was a determinant of BMD, but not fracture risk.

Topics

Bone Health
dietary protein bone mineral density, protein source bone health outcomes, dairy protein BMD association, plant protein bone fracture risk, animal protein osteoporosis risk, Canadian Multicentre Osteoporosis Study protein, high protein diet bone loss, protein intake fracture risk cohort, dietary protein BMD change, protein source skeletal health
PMID 26412291 26412291 DOI 10.1007/s12603-015-0544-6 10.1007/s12603-015-0544-6

Cite this article

Langsetmo, L., Barr, S. I., Berger, C., Kreiger, N., Rahme, E., Adachi, J. D., Papaioannou, A., Kaiser, S. M., Prior, J. C., Hanley, D. A., Kovacs, C. S., Josse, R. G., Goltzman, D., & CaMos Research Group (2015). Associations of Protein Intake and Protein Source with Bone Mineral Density and Fracture Risk: A Population-Based Cohort Study. *The journal of nutrition, health & aging*, *19*(8), 861-868. https://doi.org/10.1007/s12603-015-0544-6

Keywords

Dietary Proteins

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