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

R. Rizzoli, E. Biver, J. P. Bonjour, V. Coxam, D. Goltzman, J. A. Kanis, Joan M. Lappe, L. Rejnmark, S. Sahni, C. Weaver, H. Weiler, J. Y. Reginster

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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.

LanguageEnglish (US)
Pages1-16
Number of pages16
JournalOsteoporosis International
DOIs
StateAccepted/In press - May 8 2018

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Musculoskeletal Diseases
Dietary Proteins
Osteoarthritis
Osteoporosis
Safety
Bone and Bones
Health
Meta-Analysis
Hip Fractures
Dietary Calcium
Proteins
Bone Remodeling
Bone Development
Bone Fractures
Dietary Supplements
Insulin-Like Growth Factor I
Reference Values
Randomized Controlled Trials
Body Weight
Maintenance

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

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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. / Rizzoli, R.; Biver, E.; Bonjour, J. P.; Coxam, V.; Goltzman, D.; Kanis, J. A.; Lappe, Joan M.; Rejnmark, L.; Sahni, S.; Weaver, C.; Weiler, H.; Reginster, J. Y.

In: Osteoporosis International, 08.05.2018, p. 1-16.

Research output: Contribution to journalArticle

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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.",
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