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Bagheri R, Karimi Z, Mousavi Z, Ziaee Bashirzad M, Camera DM, Sadeghi R, Dabbagh VR, Kargarfard M, Dutheil F. High-Protein Diets during either Resistance or Concurrent Training Have No Detrimental Effect on Bone Parameters in Resistance-Trained Males. Nutrients 2024; 16:325. [PMID: 38276563 PMCID: PMC10819948 DOI: 10.3390/nu16020325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The effects of combining resistance training (RT) and concurrent training (CT; resistance + endurance training) with varied protein doses on bone measures remain poorly understood. Hence, we conducted a comparison of the impacts of two high-protein diets (1.6 or 3.2 g kg-1 d-1) over 16 weeks in resistance-trained males, either with CT or RT alone. METHODS A total of forty-eight males, all of whom were resistance-trained, had the following demographics: 26.6 ± 6 years, body mass index: 25.6 ± 2.9 kg m-2 administered either 3.2 g kg-1 d-1 protein (CT2; n = 12; RT2; n = 12) or 1.6 g kg-1 d-1 protein (CT1; n = 12; RT1; n = 12) during 16 weeks (four sessions·w-1). Bone parameters were assessed pre- and post-intervention. RESULTS There was no significant interaction between the intervention group and time for the legs, arms, ribs, or pelvis area BMC and BMD (p > 0.05). For the BMD of the pelvis and the BMC of the right ribs, however, there were significant time effects noted (p < 0.05). Furthermore, there was a significant interaction between the intervention group and time in the lumbar and thoracic spines, with a particular time effect noted for the thoracic spine region (p < 0.05). The regional differences in skeletal responses to the intervention are highlighted by these data. CONCLUSION Our findings show that the intake of two high-protein diets combined with RT and CT during 16 weeks had no adverse effects on bone tissue parameters. While these findings indicate that protein intake between 2 and 3 times the current RDI does not promote bone demineralization when consumed in conjunction with exercise, future studies investigating the long-term effects of chronic high protein intake on bone tissue health are warranted.
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Affiliation(s)
- Reza Bagheri
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan 8174673441, Iran;
| | - Zohreh Karimi
- Department of Physical Education and Sport Sciences, Science and Research Branch, Islamic Azad University, Tehran 1477893855, Iran;
| | - Zeynabalsadat Mousavi
- Nutrition and Food Service, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran 1416634793, Iran;
| | - Mahdi Ziaee Bashirzad
- Department of Sport Science, Islamic Azad University, Bojnourd Branch, Bojnourd 9417697796, Iran;
| | - Donny M. Camera
- Department of Health and Biostatistics, Swinburne University, Melbourne, VIC 3122, Australia;
| | - Ramin Sadeghi
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad 9177949025, Iran; (R.S.); (V.R.D.)
| | - Vahid Reza Dabbagh
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad 9177949025, Iran; (R.S.); (V.R.D.)
| | - Mehdi Kargarfard
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan 8174673441, Iran;
| | - Frederic Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, F-63000 Clermont-Ferrand, France;
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Smith N, Shirazi S, Cakouros D, Gronthos S. Impact of Environmental and Epigenetic Changes on Mesenchymal Stem Cells during Aging. Int J Mol Sci 2023; 24:ijms24076499. [PMID: 37047469 PMCID: PMC10095074 DOI: 10.3390/ijms24076499] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/22/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
Abstract
Many crucial epigenetic changes occur during early skeletal development and throughout life due to aging, disease and are heavily influenced by an individual’s lifestyle. Epigenetics is the study of heritable changes in gene expression as the result of changes in the environment without any mutation in the underlying DNA sequence. The epigenetic profiles of cells are dynamic and mediated by different mechanisms, including histone modifications, non-coding RNA-associated gene silencing and DNA methylation. Given the underlining role of dysfunctional mesenchymal tissues in common age-related skeletal diseases such as osteoporosis and osteoarthritis, investigations into skeletal stem cells or mesenchymal stem cells (MSC) and their functional deregulation during aging has been of great interest and how this is mediated by an evolving epigenetic landscape. The present review describes the recent findings in epigenetic changes of MSCs that effect growth and cell fate determination in the context of aging, diet, exercise and bone-related diseases.
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Affiliation(s)
- Nicholas Smith
- Mesenchymal Stem Cell Laboratory, School of Biomedicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5001, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia
| | - Suzanna Shirazi
- Mesenchymal Stem Cell Laboratory, School of Biomedicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5001, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia
| | - Dimitrios Cakouros
- Mesenchymal Stem Cell Laboratory, School of Biomedicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5001, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia
- Correspondence: (D.C.); (S.G.); Tel.: +61-8-8128-4395 (S.G.)
| | - Stan Gronthos
- Mesenchymal Stem Cell Laboratory, School of Biomedicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5001, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia
- Correspondence: (D.C.); (S.G.); Tel.: +61-8-8128-4395 (S.G.)
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Riquelme-Gallego B, García-Molina L, Cano-Ibáñez N, Andújar-Vera F, González-Salvatierra S, García-Fontana C, Bueno-Cavanillas A, Muñoz-Torres M, García-Fontana B. Undercarboxylated Osteocalcin: A Promising Target for Early Diagnosis of Cardiovascular and Glycemic Disorders in Patients with Metabolic Syndrome: A Pilot Study. Nutrients 2022; 14:nu14142991. [PMID: 35889946 PMCID: PMC9321347 DOI: 10.3390/nu14142991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/13/2022] [Accepted: 07/16/2022] [Indexed: 12/04/2022] Open
Abstract
Lifestyle changes are causing an exponential increase in the prevalence of obesity and metabolic syndrome (MetS) worldwide. The most frequent complications of these are the development of diabetes (T2D) and cardiovascular disease (CVD). Accurate tools are needed to classify the cardiovascular risk (CVR) in the MetS population. In recent years, numerous biomarkers of bone metabolism have been associated with CVR. The aim of this study was to determine the levels of undercarboxylated osteocalcin (ucOC) in a cohort of patients with MetS and to analyse its association with MetS parameters and CVR as well as with T2D prevalence. A longitudinal study was conducted in which a MetS population was followed for one year. Weight change, adherence to the Mediterranean diet (MedDiet), ucOC levels, MetS parameters and CVR were analysed and CVR was calculated using different scores. Our results showed a decrease of CVR associated with a better adherence to the MetDiet resulting in higher HDL-C and ucOC levels though the improvement of MetS risk factors. This bone protein appeared as a potential biomarker to classify CVR in the MetS population, especially for MetS patients without prevalent T2D. Furthermore, ucOC serum levels could be good predictors of T2D prevalence.
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Affiliation(s)
- Blanca Riquelme-Gallego
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (B.R.-G.); (L.G.-M.); (N.C.-I.); (A.B.-C.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain;
| | - Laura García-Molina
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (B.R.-G.); (L.G.-M.); (N.C.-I.); (A.B.-C.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain;
| | - Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (B.R.-G.); (L.G.-M.); (N.C.-I.); (A.B.-C.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Francisco Andújar-Vera
- Department of Computer Science and Artificial Intelligence, University of Granada, 18071 Granada, Spain;
- Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI Institute), 18014 Granada, Spain
| | - Sheila González-Salvatierra
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain;
- Department of Medicine, University of Granada, 18016 Granada, Spain
| | - Cristina García-Fontana
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain;
- CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, 18016 Granada, Spain
- Correspondence: (C.G.-F.); (M.M.-T.); (B.G.-F.); Tel.: +34-958023460 (C.G.-F.); +34-958246124 (M.M.-T.); +34-958023460 (B.G.-F.)
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain; (B.R.-G.); (L.G.-M.); (N.C.-I.); (A.B.-C.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Manuel Muñoz-Torres
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain;
- Department of Medicine, University of Granada, 18016 Granada, Spain
- CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, 18016 Granada, Spain
- Correspondence: (C.G.-F.); (M.M.-T.); (B.G.-F.); Tel.: +34-958023460 (C.G.-F.); +34-958246124 (M.M.-T.); +34-958023460 (B.G.-F.)
| | - Beatriz García-Fontana
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain;
- CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, 18016 Granada, Spain
- Correspondence: (C.G.-F.); (M.M.-T.); (B.G.-F.); Tel.: +34-958023460 (C.G.-F.); +34-958246124 (M.M.-T.); +34-958023460 (B.G.-F.)
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Habibi M, Shili CN, Sutton J, Goodarzi P, Pezeshki A. Dietary branched-chain amino acids modulate the dynamics of calcium absorption and reabsorption in protein-restricted pigs. J Anim Sci Biotechnol 2022; 13:15. [PMID: 35139926 PMCID: PMC8830008 DOI: 10.1186/s40104-021-00669-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 12/14/2021] [Indexed: 01/25/2023] Open
Abstract
Background Very low-protein (VLP) diets negatively impact calcium (Ca) metabolism and absorption. The objective of this study was to investigate the effect of supplemental branched-chain amino acids (BCAA) and limiting amino acids (LAA) on Ca digestibility, absorption and reabsorption in pigs fed with VLP diets. Forty-eight piglets were assigned to six treatments: positive control (PC), negative control (NC), and NC containing LAA 25%, LAA 50%, LAA + BCAA 25% (LB25) and LAA + BCAA 50% (LB50) more than recommendations. Results Relative to PC or NC, LB25 and LB50 had higher digestibility of Ca and plasma Ca and phosphorus (P), but lower plasma vitamin D3. LB50 tended to increase vitamin D receptor transcript and protein in the gut, but decreased mRNA or protein abundance of parathyroid hormone 1 receptor (PTH1R), calbindin 1 (CALB1), cytochrome P450 family 27 subfamily B member 1 and occludin in small intestine. LB50 increased the transcript of cytochrome P450 family 24 subfamily A member 1 and PTH1R but decreased the transcript of transient receptor potential cation channel subfamily V member 5, CALB1 and solute carrier family 17 member 4 in kidney. Conclusion Overall, BCAA increased Ca digestibility through regulating the transcellular and paracellular Ca absorption in the gut and reabsorption in kidney during protein restriction.
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Affiliation(s)
- Mohammad Habibi
- Department of Animal and Food Sciences, Oklahoma State University, 206C Animal Science Building, Stillwater, OK, 74078, USA
| | - Cedrick N Shili
- Department of Animal and Food Sciences, Oklahoma State University, 206C Animal Science Building, Stillwater, OK, 74078, USA
| | - Julia Sutton
- Department of Animal and Food Sciences, Oklahoma State University, 206C Animal Science Building, Stillwater, OK, 74078, USA
| | - Parniyan Goodarzi
- Department of Animal and Food Sciences, Oklahoma State University, 206C Animal Science Building, Stillwater, OK, 74078, USA
| | - Adel Pezeshki
- Department of Animal and Food Sciences, Oklahoma State University, 206C Animal Science Building, Stillwater, OK, 74078, USA.
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Koutsofta I, Mamais I, Chrysostomou S. The effect of protein diets in postmenopausal women with osteoporosis: Systematic review of randomized controlled trials. J Women Aging 2018; 31:117-139. [DOI: 10.1080/08952841.2018.1418822] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Ioanna Koutsofta
- Department of Life Sciences, European University Cyprus, Nicosia, Cyprus
| | - Ioannis Mamais
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavri Chrysostomou
- Department of Life Sciences, School of Science, European University Cyprus, Nicosia, Cyprus
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6
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Wang F, Wang X, Wang K, Han L, Wang J, Xue C. Phosphorylated peptides from Antarctic Krill (Euphausia superba
) improve fracture healing in mice with ovariectomy induced osteoporosis. J Food Biochem 2017. [DOI: 10.1111/jfbc.12408] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Fei Wang
- College of Food Science and Engineering; Ocean University of China; Qingdao Shandong Province 266003 China
| | - Xiaohong Wang
- College of Food Science and Engineering; Ocean University of China; Qingdao Shandong Province 266003 China
| | - Kai Wang
- College of Food Science and Engineering; Ocean University of China; Qingdao Shandong Province 266003 China
| | - Lihua Han
- College of Food Science and Engineering; Ocean University of China; Qingdao Shandong Province 266003 China
| | - Jingfeng Wang
- College of Food Science and Engineering; Ocean University of China; Qingdao Shandong Province 266003 China
| | - Changhu Xue
- College of Food Science and Engineering; Ocean University of China; Qingdao Shandong Province 266003 China
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Carnauba RA, Baptistella AB, Paschoal V, Hübscher GH. Diet-Induced Low-Grade Metabolic Acidosis and Clinical Outcomes: A Review. Nutrients 2017; 9:E538. [PMID: 28587067 PMCID: PMC5490517 DOI: 10.3390/nu9060538] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/05/2017] [Accepted: 05/17/2017] [Indexed: 01/04/2023] Open
Abstract
Low-grade metabolic acidosis is a condition characterized by a slight decrease in blood pH, within the range considered normal, and feeding is one of the main factors that may influence the occurrence of such a condition. The excessive consumption of acid precursor foods (sources of phosphorus and proteins), to the detriment of those precursors of bases (sources of potassium, calcium, and magnesium), leads to acid-base balance volubility. If this condition occurs in a prolonged, chronic way, low-grade metabolic acidosis can become significant and predispose to metabolic imbalances such as kidney stone formation, increased bone resorption, reduced bone mineral density, and the loss of muscle mass, as well as the increased risk of chronic diseases such as type 2 diabetes mellitus, hypertension, and non-alcoholic hepatic steatosis. Considering the increase in the number of studies investigating the influence of diet-induced metabolic acidosis on clinical outcomes, this review gathers the available evidence evaluating the association of this disturbance and metabolic imbalances, as well as related mechanisms. It is necessary to look at the western dietary pattern of most countries and the increasing incidence of non-comunicable diseases for the balance between fruit and vegetable intake and the appropriate supply of protein, mainly from animal sources, so that it does not exceed the daily recommendations.
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Affiliation(s)
| | | | - Valéria Paschoal
- VP Research Institute, 287, Carlos Petit St, São Paulo 04110-000, Brazil.
| | - Gilberti Helena Hübscher
- Departament of Food Science and Technology, Federal University of Santa Maria, Rio Grande do Sul 97105-900, Brazil.
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Fujihara Y, Nawata H, Honda M, Kunitake T, Aida E, Nagai T, Kuramochi H, Ueno J, Yoshimoto S, Muta K. Comparative study of the correlation between atherosclerosis and osteoporosis in women in Japan and Mongolia. J Gen Fam Med 2017; 18:237-243. [PMID: 29264033 PMCID: PMC5689420 DOI: 10.1002/jgf2.56] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 09/20/2016] [Indexed: 11/17/2022] Open
Abstract
Objective Associations between vascular calcification and osteoporosis are well documented, yet effects of lifestyle on atherosclerosis and osteoporosis remain unclear. This study evaluated the relationship between atherosclerosis and osteoporosis of people with different lifestyles living on Uku Island in Japan (rice consumption and fishing lifestyle) and in Ulaanbaatar in Mongolia (meat consumption and nomadic lifestyle), and investigated the differences of lifestyles on atherosclerosis and osteoporosis. Methods Participants were women aged over 50 years who had undergone a previous medical examination for atherosclerosis and osteoporosis (Uku Island, 104, Ulaanbaatar, 71). Lifestyle habits were obtained by questionnaire. Bone mineral density of the right calcaneus was measured using quantitative ultrasound. Brachial‐ankle pulse wave velocity was measured as an index of atherosclerosis. Results There were no significant differences in bone mineral density and brachial‐ankle pulse wave velocity between the two groups, even though meat and dairy intake, number of meals skipped, and number of children were significantly greater in participants from Ulaanbaatar compared with Uku Island. Brachial‐ankle pulse wave velocity showed significant positive correlations with age, systolic and diastolic blood pressures, and body mass index and a significant negative correlation with bone mineral density for both groups. With step‐wise multiple regression analysis, brachial‐ankle pulse wave velocity significantly correlated with age and bone mineral density for both populations. Systolic blood pressure significantly correlated with brachial‐ankle pulse wave velocity for the Ulaanbaatar group. Conclusions Despite significant lifestyle differences, similar relationships between atherosclerosis and osteoporosis were observed in women from Uku Island and Ulaanbaatar. Hypertension was a significant contributing factor for atherosclerosis for the Ulaanbaatar group.
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Affiliation(s)
| | | | | | | | - Eiji Aida
- Medical Corp.Seiwakai Muta Hospital Fukuoka Japan
| | - Tetsu Nagai
- Medical Corp.Seiwakai Muta Hospital Fukuoka Japan
| | | | - Junichi Ueno
- Medical Corp.Seiwakai Muta Hospital Fukuoka Japan
| | | | - Kazuo Muta
- Medical Corp.Seiwakai Muta Hospital Fukuoka Japan
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Pounis G, Castelnuovo AD, Costanzo S, Persichillo M, Bonaccio M, Bonanni A, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Association of pasta consumption with body mass index and waist-to-hip ratio: results from Moli-sani and INHES studies. Nutr Diabetes 2016; 6:e218. [PMID: 27376700 PMCID: PMC4973136 DOI: 10.1038/nutd.2016.20] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 03/18/2016] [Accepted: 04/27/2016] [Indexed: 01/23/2023] Open
Abstract
Background/Objectives: Pasta as a traditional component of Mediterranean diet (MeD) in Italy has not been studied in detail in the management of body weight. This study aimed at evaluating the association of pasta intake with body mass index (BMI) and waist-to-hip ratio, in two large epidemiological datasets. Subjects/Methods: A total of 14 402 participants aged ⩾35 years randomly recruited from the general population of the Molise region (Moli-sani cohort) and 8964 participants aged >18 years from all over Italy (Italian Nutrition & HEalth Survey, INHES) were separately analyzed. The European Prospective Investigation into Cancer and Nutrition (EPIC)-food frequency questionnaire and one 24-h dietary recall were used for dietary assessment. Weight, height, waist and hip circumference were measured in Moli-sani or self-reported in INHES. Residuals methodology corrected for either total energy intake or body weight was used for the analysis of pasta intake. Results: Higher pasta intake was associated with better adhesion to MeD in both genders (P for both<0.001). In the Moli-sani study, after multivariable analysis, pasta-energy residuals were negatively associated with BMI in women but not in men (β-coef=−0.007, P=0.003 for women and β-coef=−0.001, P=0.58 for men). When pasta intake-body weight residuals were used, pasta intake was significantly and negatively associated with BMI in crude and multi-adjusted models (including adhesion to MeD) in both genders and Moli-sani and INHES studies (for all β-coef<0, P<0.05). In the Moli-sani study, pasta-body weight residuals were significantly and negatively associated with waist and hip circumference and waist-to-hip ratio (for all β-coef<0, P<0.05). Conclusions: As a traditional component of MeD, pasta consumption was negatively associated with BMI, waist circumference and waist-to-hip ratio and with a lower prevalence of overweight and obesity.
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Affiliation(s)
- G Pounis
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - A Di Castelnuovo
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - S Costanzo
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - M Persichillo
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - M Bonaccio
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - A Bonanni
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - C Cerletti
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - M B Donati
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - G de Gaetano
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - L Iacoviello
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
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Sabour H, Nazari M, Latifi S, Soltani Z, Shakeri H, Larijani B, Ghodsi SM, Razavi SHE. The Relationship Between Dietary Intakes of Amino Acids and Bone Mineral Density Among Individuals with Spinal Cord Injury. Oman Med J 2016; 31:22-8. [PMID: 26816565 DOI: 10.5001/omj.2016.05] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES The effect of dietary protein intake on bone mineral density (BMD) has not been explained in patients with spinal cord injury (SCI). In this study, we looked at the relationship between BMD and higher protein intake in patients with SCI while controlling for possible confounders. METHODS Patients with SCI, who were referred to the Brain and Spinal Cord Injury Research Center between November 2010 and April 2012, were included in the study. In total, the dietary intakes of 103 patients were assessed by 24-hour dietary recall interviews. We used dual-energy X-ray absorptiometry to measure BMD in the femoral neck, trochanter, intertrochanteric zone, hip, and lumbar vertebras. RESULTS Eighty-six men and 17 women participated in this study. Protein intake was negatively associated with the BMD of lumbar vertebrae (p = 0.001, r = -0.37 for T-score and p = 0.030, r = -0.24 for Z-score). The BMD of lumbar vertebrae were negatively associated with intake of tryptophan, isoleucine, lysine, cysteine, and tyrosine (p = 0.007, 0.005, 0.009, 0.008, and 0.008 for T-score, respectively). Higher intakes of threonine, leucine, methionine, phenylalanine, valine, and histidine were related to a lower BMD of lumbar vertebrae (p = 0.006, 0.010, 0.009, 0.010, 0.009, and 0.008 respectively for T-scores). CONCLUSIONS We found that high protein intake led to a lower BMD of lumbar vertebrae in patients with SCI after controlling for confounders including demographic and injury-related characteristics and calcium intake. No relationship between higher amino acids intake and BMD of the femur and hip was detected. Intake of alanine, arginine, and aspartic acid were not related to BMD.
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Affiliation(s)
- Hadis Sabour
- Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Nazari
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapour University of Medical Sciences, Ahwaz, Iran
| | - Sahar Latifi
- Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Soltani
- Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hania Shakeri
- Department of Pathology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Mohammad Ghodsi
- Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Curtis E, Litwic A, Cooper C, Dennison E. Determinants of Muscle and Bone Aging. J Cell Physiol 2015; 230:2618-25. [PMID: 25820482 DOI: 10.1002/jcp.25001] [Citation(s) in RCA: 201] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 03/24/2015] [Indexed: 12/12/2022]
Abstract
Loss of bone and muscle with advancing age represent a huge threat to loss of independence in later life. Osteoporosis represents a major public health problem through its association with fragility fractures, primarily of the hip, spine and distal forearm. Sarcopenia, the age related loss of muscle mass and function, may add to fracture risk by increasing falls risk. In the context of muscle aging, it is important to remember that it is not just a decline in muscle mass which contributes to the deterioration of muscle function. Other factors underpinning muscle quality come into play, including muscle composition, aerobic capacity and metabolism, fatty infiltration, insulin resistance, fibrosis and neural activation. Genetic, developmental, endocrine and lifestyle factors, such as physical activity, smoking and poor diet have dual effects on both muscle and bone mass in later life and these will be reviewed here. Recent work has highlighted a possible role for the early environment. Inflammaging is an exciting emerging research field that is likely to prove relevant to future work, including interventions designed to retard to reverse bone and muscle loss with age.
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Affiliation(s)
- Elizabeth Curtis
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Tremona Road, Southampton, England
| | - Anna Litwic
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Tremona Road, Southampton, England
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Tremona Road, Southampton, England
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Tremona Road, Southampton, England
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Protein intake and lumbar bone density: the Multi-Ethnic Study of Atherosclerosis (MESA). Br J Nutr 2014; 112:1384-92. [PMID: 25192416 DOI: 10.1017/s0007114514002220] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Dietary protein has been shown to increase urinary Ca excretion in randomised controlled trials, and diets high in protein may have detrimental effects on bone health; however, studies examining the relationship between dietary protein and bone health have conflicting results. In the present study, we examined the relationship between dietary protein (total, animal and vegetable protein) and lumbar spine trabecular volumetric bone mineral density (vBMD) among participants enrolled in the Multi-Ethnic Study of Atherosclerosis (n 1658). Protein intake was assessed using a FFQ obtained at baseline examination (2000-2). Lumbar spine vBMD was measured using quantitative computed tomography (2002-5), on average 3 years later. Multivariable linear and robust regression techniques were used to examine the associations between dietary protein and vBMD. Sex and race/ethnicity jointly modified the association of dietary protein with vBMD (P for interaction = 0·03). Among white women, higher vegetable protein intake was associated with higher vBMD (P for trend = 0·03), after adjustment for age, BMI, physical activity, alcohol consumption, current smoking, educational level, hormone therapy use, menopause and additional dietary factors. There were no consistently significant associations for total and animal protein intakes among white women or other sex and racial/ethnic groups. In conclusion, data from the present large, multi-ethnic, population-based study suggest that a higher level of protein intake, when substituted for fat, is not associated with poor bone health. Differences in the relationship between protein source and race/ethnicity of study populations may in part explain the inconsistent findings reported previously.
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Diethelm K, Huybrechts I, Moreno L, De Henauw S, Manios Y, Beghin L, González-Gross M, Le Donne C, Cuenca-García M, Castillo MJ, Widhalm K, Patterson E, Kersting M. Nutrient intake of European adolescents: results of the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. Public Health Nutr 2014; 17:486-97. [PMID: 23472739 PMCID: PMC10282303 DOI: 10.1017/s1368980013000463] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 01/09/2013] [Accepted: 01/22/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE An adequate nutritional intake in childhood and adolescence is crucial for growth and the prevention of youth and adult obesity and nutrition-related morbidities. Improving nutrient intake in children and adolescents is of public health importance. The purpose of the present study was to describe and evaluate the nutrient intake in a European sample using the D-A-CH nutrient intake recommendations and the Nutritional Quality Index (NQI). DESIGN The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study is a cross-sectional study, the main objective of which is to obtain comparable data on a variety of nutritional and health-related parameters in adolescents aged 12·5-17·5 years. SETTING Eight cities in Europe. SUBJECTS The initial sample consisted of 3528 European adolescents. Among these, 1590 adolescents (54% female) had sufficient and plausible dietary data on energy and nutrient intakes from two 24 h recalls using the HELENA-DIAT software. RESULTS The intakes of most macronutrients, vitamins and minerals were in line with the D-A-CH recommendations. While the intakes of SFA and salt were too high, the intake of PUFA was too low. Furthermore, the intakes of vitamin D, folate, iodine and F were less than about 55% of the recommendations. The median NQI was about 71 (of a maximum of 100). CONCLUSIONS The intakes of most nutrients were adequate. However, further studies using suitable criteria to assess nutrient status are needed. Public health initiatives should educate children and adolescents regarding balanced food choices.
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Affiliation(s)
- Katharina Diethelm
- Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms-University Bonn, Heinstueck 11, 44225 Dortmund, Germany
| | - Inge Huybrechts
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Luis Moreno
- Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Health Sciences, Vesalius Hogeschool Gent, Ghent, Belgium
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Laurent Beghin
- Centre d'Investigation Clinique de Lille, Lille, France
- Unité Inserm U995 & Université Lille Nord de France, Lille, France
| | - Marcela González-Gross
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences – INEF, Technical University of Madrid, Madrid, Spain
| | - Cinzia Le Donne
- National Research Institute on Food and Nutrition, Rome, Italy
| | | | - Manuel J Castillo
- Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain
| | - Kurt Widhalm
- Academic Institute for Clinical Nutrition, Vienna, Austria
| | - Emma Patterson
- Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden
- Division of Social Medicine, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Mathilde Kersting
- Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms-University Bonn, Heinstueck 11, 44225 Dortmund, Germany
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Legumes and meat analogues consumption are associated with hip fracture risk independently of meat intake among Caucasian men and women: the Adventist Health Study-2. Public Health Nutr 2013; 17:2333-43. [PMID: 24103482 DOI: 10.1017/s1368980013002693] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE In contrast to non-vegetarians, vegetarians consume more legumes and meat analogues as sources of protein to substitute for meat intake. The present study aimed to assess the association between foods with high protein content (legumes, meat, meat analogues) by dietary pattern (vegetarians, non-vegetarians) and hip fracture incidence, adjusted for selected lifestyle factors. DESIGN A prospective cohort of Adventist Health Study-2 (AHS-2) enrollees who completed a comprehensive lifestyle and dietary questionnaire between 2002 and 2007. SETTING Every two years after enrolment, a short questionnaire on hospitalizations and selected disease outcomes including hip fractures was sent to these members. SUBJECTS Respondents (n 33,208) to a baseline and a follow-up questionnaire. RESULTS In a multivariable model, legumes intake of once daily or more reduced the risk of hip fracture by 64% (hazard ratio = 0·36, 95% CI 0·21, 0·61) compared with those with legumes intake of less than once weekly. Similarly, meat intake of four or more times weekly was associated with a 40% reduced risk of hip fracture (hazard ratio = 0·60, 95% CI 0·41, 0·87) compared with those whose meat intake was less than once weekly. Furthermore, consumption of meat analogues once daily or more was associated with a 49 % reduced risk of hip fracture (hazard ratio = 0·51, 95% CI 0·27, 0·98) compared with an intake of less than once weekly. CONCLUSIONS Hip fracture incidence was inversely associated with legumes intake and, to a lesser extent, meat intake, after accounting for other food groups and important covariates. Similarly, a high intake of meat analogues was associated with a significantly reduced risk of hip fracture.
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Kim J, Kim B, Lee H, Choi H, Won C. The Relationship between Prevalence of Osteoporosis and Proportion of Daily Protein Intake. Korean J Fam Med 2013; 34:43-8. [PMID: 23372905 PMCID: PMC3560339 DOI: 10.4082/kjfm.2013.34.1.43] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 12/28/2012] [Indexed: 11/24/2022] Open
Abstract
Background The association between daily protein intake and osteoporosis is still controversial and only a few studies have explored the issue in Korea. This study investigated the relationship between daily protein intake and the prevalence of osteoporosis in Korean adults. Methods This study analyzed data extracted from the Korean National Health and Nutrition Examination Survey 4. Participants were aged 19 years or older and had never been treated for osteoporosis. The percentage of calories coming from protein intake was assessed by 24-hour recall method, and participants were divided into three groups according to recommended daily dietary protein intake as a proportion of total daily calories (i.e., <10%, 10%-20%, and >20%). A lumbar or femur neck bone mineral density T-score less than -2.5 was indicative of the presence osteoporosis. The influence of daily protein intake on the prevalence of osteoporosis was analyzed. Results In both sexes, the group with the highest protein intake had significantly lower odds of developing lumber osteoporosis when compared to the group with the lowest protein intake, after adjusting for associated factors (females: odds ratio [OR], 0.618; 95% confidence interval [CI], 0.610 to 0.626; P for trend <0.001; males: OR, 0.695; 95% CI, 0.685 to 0.705; P for trend <0.001). Conclusion Sufficient daily protein intake lowered the prevalence of osteoporosis in Korean adults. Further prospective studies are necessary to verify the preventive effect of adequate protein intake on osteoporosis.
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Affiliation(s)
- Junga Kim
- Department of Family Medicine, Kyung Hee University School of Medicine, Seoul, Korea
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Yoon EH, Noh H, Lee HM, Hwang HS, Park HK, Park YS. Bone Mineral Density and Food-frequency in Korean Adults: The 2008 and 2009 Korea National Health and Nutrition Examination Survey. Korean J Fam Med 2012; 33:287-95. [PMID: 23115703 PMCID: PMC3481028 DOI: 10.4082/kjfm.2012.33.5.287] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 08/16/2012] [Indexed: 11/03/2022] Open
Abstract
Background Diet and Nutrition are important modulators of bone health in men and women. We investigated the associations between frequency of food intake among certain food groups and bone mineral density (BMD) in a large population of Korean adults. Methods We used the data from Korea National Health and Nutrition Examination Survey during 2008 to 2009. Participants were aged 20 years and over. BMDs were measured at lumbar spine and femoral neck with dual-energy X-ray absorptiometry. Dietary and supplement intakes were assessed by food-frequency questionnaire. We used multiple linear regression analysis to evaluate the relationships between annual food-frequency of each food group and BMD. Results After adjustment of multiple covariates, femoral neck and lumbar BMD significantly increased as the frequency of fruit consumption increased in both men and women. Frequency of other carbohydrates consumption was significantly associated with greater femoral neck and lumbar BMD for women. Frequency of milk and dairy product consumption was significantly associated with greater femoral neck BMD in men. Other food groups, however, had no significant associations with BMDs. Conclusion Frequent consumption of fruit has a positive association with BMDs in men and women. Milk and dairy products and other carbohydrates also had positive effects on BMD for men and women, respectively.
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Affiliation(s)
- Eui-Hyun Yoon
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea
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Abstract
This review considers the definition of a healthy bone phenotype through the life course and the modulating effects of muscle function and nutrition. In particular, it will emphasise that optimal bone strength (and how that is regulated) is more important than simple measures of bone mass. The forces imposed on bone by muscle loading are the primary determinants of musculoskeletal health. Any factor that changes muscle loading on the bone, or the response of bone to loading results in alterations of bone strength. Advances in technology have enhanced the understanding of a healthy bone phenotype in different skeletal compartments. Multiple components of muscle strength can also be quantified. The critical evaluation of emerging technologies for assessment of bone and muscle phenotype is vital. Populations with low and moderate/high daily Ca intakes and/or different vitamin D status illustrate the importance of nutrition in determining musculoskeletal phenotype. Changes in mass and architecture maintain strength despite low Ca intake or vitamin D status. There is a complex interaction between body fat and bone which, in addition to protein intake, is emerging as a key area of research. Muscle and bone should be considered as an integrative unit; the role of body fat requires definition. There remains a lack of longitudinal evidence to understand how nutrition and lifestyle define musculoskeletal health. In conclusion, a life-course approach is required to understand the definition of healthy skeletal phenotype in different populations and at different stages of life.
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Maalouf NM, Moe OW, Adams-Huet B, Sakhaee K. Hypercalciuria associated with high dietary protein intake is not due to acid load. J Clin Endocrinol Metab 2011; 96:3733-40. [PMID: 21976719 PMCID: PMC3232614 DOI: 10.1210/jc.2011-1531] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT AND OBJECTIVE Dietary intake of animal proteins is associated with an increase in urinary calcium and nephrolithiasis risk. We tested the hypothesis that the acid load imposed by dietary proteins causes this hypercalciuria. DESIGN AND SETTING In a short-term crossover metabolic study, an alkali salt was provided with a high-protein diet (HPD) to neutralize the acid load imparted by dietary proteins. PARTICIPANTS AND INTERVENTIONS Eleven healthy volunteers were evaluated at the end of each of four phases while consuming metabolic diets with fixed calcium and sodium content. Phases 1 and 3 consisted of a control diet (CD). Phases 2 and 4 consisted of a eucaloric HPD (60 g/d animal proteins added to CD). Along with HPD in phases 2 and 4, subjects ingested 30 mEq twice daily of either potassium citrate (KCitrate, alkaline salt) or potassium chloride (KCl, control neutral salt). RESULTS KCitrate completely neutralized the acid load imparted by HPD (based on changes in urine pH and net acid excretion) and increased urinary citrate. Urinary calcium increased during both HPD phases compared with CD but was not significantly different between the HPD + KCl and HPD + KCitrate phases (182 ± 85 vs. 170 ± 85 mg/d; P = 0.28). Increased urinary saturation with respect to calcium oxalate and uric acid with HPD was abrogated by KCitrate. CONCLUSIONS This study suggests that, at least in the short-term, mechanism(s) other than acid load account for hypercalciuria induced by HPD. The beneficial effect of KCitrate on nephrolithiasis risk with HPD is through correction of declines in urine pH and citrate.
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Affiliation(s)
- Naim M Maalouf
- Department of Internal Medicine and Charles, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-8885, USA.
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Martin-Bautista E, Martin-Matillas M, Martin-Lagos JA, Miranda-Leon MT, Muñoz-Torres M, Ruiz-Requena E, Rivero M, Quer J, Puigdueta I, Campoy C. A nutritional intervention study with hydrolyzed collagen in pre-pubertal spanish children: influence on bone modeling biomarkers. J Pediatr Endocrinol Metab 2011; 24:147-53. [PMID: 21648282 DOI: 10.1515/jpem.2011.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM The aim of the study was to investigate the influence of dietary intake of commercial hydrolyzed collagen (Gelatine Royal) on bone remodeling in pre-pubertal children. METHODS A randomized double-blind study was carried out in 60 children (9.42 +/- 1.31 years) divided into three groups according to the amount of partially hydrolyzed collagen taken daily for 4 months: placebo (G-I, n=18), collagen (G-II, n=20) and collagen+calcium (G-III, n=22) groups. Analyses of the following biochemical markers were carried out: total and bone alkaline phosphatase (tALP and bALP), osteocalcin, tartrate-resistant acid phosphatase (TRAP), type I collagen carboxy-terminal telopeptide, lipids, calcium, 25-hydroxyvitamin D, insulin-like growth factor-1 (IGF-1), thyroid-stimulating hormone, free thyroxin and intact parathormone. RESULTS There was a significantly greater increase in serum IGF-1 in G-III than in G-II (p < 0.01) or G-I (p < 0.05) during the study period, and a significantly greater increase in plasma tALP in G-III than in G-I (p < 0.05). Serum bALP behavior significantly (p < 0.05) differed between G-II (increase) and G-I (decrease). Plasma TRAP behavior significantly differed between G-II and G-I (p < 0.01) and between G-III and G-II (p < 0.05). CONCLUSION Daily dietary intake of hydrolyzed collagen seems to have a potential role in enhancing bone remodeling at key stages of growth and development.
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Comparison of the effects of dietary protein, androstenediol and forearm muscle area on radial bone variables in healthy prepubertal children. Br J Nutr 2010; 105:428-35. [PMID: 20854701 DOI: 10.1017/s0007114510003508] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Adequate dietary habits are supposed to be one of the most important modifiable factors in osteoporosis prevention. However, the importance of specific nutrients is controversial. We examined relevant nutrients which are supposed to have an impact on bone parameters and compared their effect sizes with those of two known predictors of bone development: bone-related muscle mass and androgen levels. We analysed nutritional, hormonal and anthropometric data from 107 prepubertal children participating in the Dortmund Nutritional and Anthropometric Longitudinally Designed Study. Diaphyseal bone mineral content (BMC), cortical area (CA), periosteal circumference, strength strain index and muscle area of the non-dominant forearm were measured by peripheral quantitative computed tomography. Data on long-term nutrient intakes (e.g. protein, Ca and vitamin D) were derived from 3 d weighed dietary records. Twenty-four hour urinary excretion rates of androgen metabolites including the sex steroid androstenediol were measured using GC-MS. Of all considered nutrients, only protein showed a trend for an association with BMC (β = +0·11; P = 0·073) and CA (β = +0·11; P = 0·056) in stepwise linear regression models. None of the other considered dietary variables was associated with bone parameters. The size of the bone anabolic effect of protein was partly comparable with that of androstenediol. Even though boys gained more bone mass in comparison with girls, the protein effect did not differ between sexes. Bone-related muscle area and sex steroids have the strongest effects on prepubertal diaphyseal bone. However, dietary protein may have a similar bone anabolic influence compared with androstenediol. In children without explicit nutrient deficits, protein seems to be the most important dietary component for diaphyseal bone status.
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Beasley JM, Ichikawa LE, Ange BA, Spangler L, LaCroix AZ, Ott SM, Scholes D. Is protein intake associated with bone mineral density in young women? Am J Clin Nutr 2010; 91:1311-6. [PMID: 20219968 PMCID: PMC2854905 DOI: 10.3945/ajcn.2009.28728] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The range of protein intakes for optimizing bone health among premenopausal women is unclear. Protein is a major constituent of bone, but acidic amino acids may promote bone resorption. OBJECTIVE The objective was to examine cross-sectional and longitudinal associations between baseline dietary protein and bone mineral density (BMD) among 560 females aged 14-40 y at baseline enrolled in a Pacific Northwest managed-care organization. The role of protein source (animal or vegetable) and participant characteristics were considered. DESIGN Dietary protein intake was assessed by using a semiquantitative food-frequency questionnaire in participants enrolled in a study investigating associations between hormonal contraceptive use and bone health. Annual changes in hip, spine, and whole-body BMD were measured by using dual-energy X-ray absorptiometry. Cross-sectional and longitudinal associations between baseline protein intake (% of energy) and BMD were examined by using linear regression analysis and generalized estimating equations adjusted for confounders. RESULTS The mean (+/-SD) protein intake at baseline was 15.5 +/- 3.2%. After multivariable adjustment, the mean BMD was similar across each tertile of protein intake. In cross-sectional analyses, low vegetable protein intake was associated with a lower BMD (P = 0.03 for hip, P = 0.10 for spine, and P = 0.04 for whole body). For every percentage increase in the percentage of energy from protein, no significant longitudinal changes in BMD were observed at any anatomic site over the follow-up period. CONCLUSIONS Data from this longitudinal study suggest that a higher protein intake does not have an adverse effect on bone in premenopausal women. Cross-sectional analyses suggest that low vegetable protein intake is associated with lower BMD.
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Affiliation(s)
- Jeannette M Beasley
- Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA.
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RIBEIRO SML, ROGERO MM, BACURAU RFP, CAMPOS PLD, LUZ SDS, LANCHA Jr AH, TIRAPEGUI J. Effects of Different Levels of Protein Intake and Physical Training on Growth and Nutritional Status of Young Rats. J Nutr Sci Vitaminol (Tokyo) 2010. [DOI: 10.3177/jnsv.56.177] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Darling AL, Millward DJ, Torgerson DJ, Hewitt CE, Lanham-New SA. Dietary protein and bone health: a systematic review and meta-analysis. Am J Clin Nutr 2009; 90:1674-92. [PMID: 19889822 DOI: 10.3945/ajcn.2009.27799] [Citation(s) in RCA: 183] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There has been a resurgence of interest in the controversial relation between dietary protein and bone health. OBJECTIVE This article reports on the first systematic review and meta-analysis of the relation between protein and bone health in healthy human adults. DESIGN The MEDLINE (January 1966 to September 2007) and EMBASE (1974 to July 2008) databases were electronically searched for all relevant studies of healthy adults; studies of calcium excretion or calcium balance were excluded. RESULTS In cross-sectional surveys, all pooled r values for the relation between protein intake and bone mineral density (BMD) or bone mineral content at the main clinically relevant sites were significant and positive; protein intake explained 1-2% of BMD. A meta-analysis of randomized placebo-controlled trials indicated a significant positive influence of all protein supplementation on lumbar spine BMD but showed no association with relative risk of hip fractures. No significant effects were identified for soy protein or milk basic protein on lumbar spine BMD. CONCLUSIONS A small positive effect of protein supplementation on lumbar spine BMD in randomized placebo-controlled trials supports the positive association between protein intake and bone health found in cross-sectional surveys. However, these results were not supported by cohort study findings for hip fracture risk. Any effects found were small and had 95% CIs that were close to zero. Therefore, there is a small benefit of protein on bone health, but the benefit may not necessarily translate into reduced fracture risk in the long term.
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Affiliation(s)
- Andrea L Darling
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom.
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Animal protein and bone growth - Scientific substantiation of a health claim related to animal protein and bone growth pursuant to Article 14 of Regulation (EC) No 1924/2006 - Scientific Opinion of the Panel on Dietetic Products, Nutrition and Allergies. EFSA J 2008. [DOI: 10.2903/j.efsa.2008.858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Huttunen MM, Pekkinen M, Ahlström MEB, Lamberg-Allardt CJE. Long-term effects of tripeptide Ile-Pro-Pro on osteoblast differentiation in vitro. J Nutr Biochem 2008; 19:708-15. [PMID: 18328689 DOI: 10.1016/j.jnutbio.2007.09.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2007] [Revised: 08/28/2007] [Accepted: 09/10/2007] [Indexed: 02/03/2023]
Abstract
Bone mineralization is a result of the function of bone-forming osteoblasts. Osteoblast differentiation from their precursors is a carefully controlled process that is affected by many signaling molecules. Protein-rich food-derived bioactive peptides are reported to express a variety of functions in vivo. We studied the long-term in vitro effect of bioactive tripeptide Ile-Pro-Pro (IPP) on osteoblasts differentiated from human mesenchymal stem cells. Osteoblast bone alkaline phosphatase activity (bALP), bone-forming capacity and gene expression were investigated. Treatment with 50 microM IPP had no effect on bALP activity, but osteoblast mineralization was increased. Gene expression of beta-catenin, Cbfa1/Runx2, PTHrP, CREB-5, osteoglycin, osteocalcin, caspase-8, osteoprotegerin (OPG) and RANKL was analyzed by quantitative real-time PCR on Days 13, 17 and 20 of culture. The results indicate that IPP increased mineral formation due to enhanced cell survival and matrix formation. In addition, IPP reduced the RANKL/OPG ratio. Bioactive peptides, such as IPP, could be one method by which a protein-rich diet promotes bone integrity.
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Affiliation(s)
- Minna M Huttunen
- Calcium Research Unit, Department of Applied Chemistry and Microbiology, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland.
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Budek AZ, Hoppe C, Ingstrup H, Michaelsen KF, Bügel S, Mølgaard C. Dietary protein intake and bone mineral content in adolescents-The Copenhagen Cohort Study. Osteoporos Int 2007; 18:1661-7. [PMID: 17639346 DOI: 10.1007/s00198-007-0422-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2007] [Accepted: 06/13/2007] [Indexed: 11/24/2022]
Abstract
UNLABELLED Data indicate that various protein sources may exhibit a differential effect on bone metabolism. We investigated associations of milk and meat protein intake with bone mineral content (BMC) in adolescents. Milk, but not meat, protein intake was positively associated with size-adjusted BMC. Milk-derived protein may be beneficial for bone mineralization. INTRODUCTION Milk and meat protein intake has been reported to exhibit a differential effect on serum insulin-like growth factor-I (IGF-I). IGF-I plays a key role in bone metabolism. Therefore, we investigated associations of different protein sources with BMC and bone area (BA) in adolescents. METHODS This was a cross-sectional study of 17-year-old girls (n = 63) and boys (n = 46) participating in the second follow-up of The Copenhagen Cohort Study. We measured dietary intake (7-day food record), BMC and BA (dual-energy X-ray absorptiometry), serum markers for bone turnover and serum IGF-I (immunoassays). RESULTS The mean total protein intake ( approximately 1.2 g/kg) was modestly higher than that recommended. Total and milk ( approximately 0.3 g/kg) protein intake, but not meat protein intake ( approximately 0.4 g/kg), was positively associated with size-adjusted BMC (P <or= 0.05). The positive association between milk protein intake and size-adjusted BMC remained significant after correction for energy, calcium, and physical activity (P <or= 0.01) and did not seem to be mediated via current serum IGF-I. None of the analyzed protein sources was significantly associated with size-adjusted BA. CONCLUSIONS Our results suggest that some components of milk protein may promote bone mineralization. Further studies are needed to elucidate this phenomenon.
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Affiliation(s)
- A Z Budek
- Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Rolighedsvej 30, 1958, Frederiksberg, Denmark.
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Campbell B, Kreider RB, Ziegenfuss T, La Bounty P, Roberts M, Burke D, Landis J, Lopez H, Antonio J. International Society of Sports Nutrition position stand: protein and exercise. J Int Soc Sports Nutr 2007; 4:8. [PMID: 17908291 PMCID: PMC2117006 DOI: 10.1186/1550-2783-4-8] [Citation(s) in RCA: 131] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2007] [Accepted: 09/26/2007] [Indexed: 12/02/2022] Open
Abstract
Position Statement The following seven points related to the intake of protein for healthy, exercising individuals constitute the position stand of the Society. They have been approved by the Research Committee of the Society. 1) Vast research supports the contention that individuals engaged in regular exercise training require more dietary protein than sedentary individuals. 2) Protein intakes of 1.4 – 2.0 g/kg/day for physically active individuals is not only safe, but may improve the training adaptations to exercise training. 3) When part of a balanced, nutrient-dense diet, protein intakes at this level are not detrimental to kidney function or bone metabolism in healthy, active persons. 4) While it is possible for physically active individuals to obtain their daily protein requirements through a varied, regular diet, supplemental protein in various forms are a practical way of ensuring adequate and quality protein intake for athletes. 5) Different types and quality of protein can affect amino acid bioavailability following protein supplementation. The superiority of one protein type over another in terms of optimizing recovery and/or training adaptations remains to be convincingly demonstrated. 6) Appropriately timed protein intake is an important component of an overall exercise training program, essential for proper recovery, immune function, and the growth and maintenance of lean body mass. 7) Under certain circumstances, specific amino acid supplements, such as branched-chain amino acids (BCAA's), may improve exercise performance and recovery from exercise.
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Affiliation(s)
- Bill Campbell
- Exercise and Performance Nutrition Laboratory, Dept. of Physical Education and Exercise Science, University of South Florida, 4202 E. Fowler Avenue, PED 214, Tampa, FL 33620, USA
| | - Richard B Kreider
- Exercise and Sport Nutrition Laboratory, Dept. of Health, Human Performance, and Recreation, Baylor University, One Bear Place 97313, Waco, TX 76798-7313, USA
| | - Tim Ziegenfuss
- Ohio Research Group of Exercise Science & Sports Nutrition, Wadsworth Medical Center, 323 High St, STE 103A, Wadsworth, OH 44281, USA
| | - Paul La Bounty
- Exercise and Sport Nutrition Laboratory, Dept. of Health, Human Performance, and Recreation, Baylor University, One Bear Place 97313, Waco, TX 76798-7313, USA
| | - Mike Roberts
- Applied Biochemistry and Molecular Physiology Laboratory, Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK 73019, USA
| | - Darren Burke
- Exercise Science Laboratory, Dept. of Human Kinetics, St. Francis Xavier University, P.O. Box 5000 Antigonish, Nova Scotia, B2G 2W5, Canada
| | - Jamie Landis
- Department of Biology, Lakeland Community College, 7700 Clocktower Drive, Kirtland, Ohio 44094-5198, USA
| | - Hector Lopez
- Northwestern University Feinberg School of Medicine, Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago, 345 East Superior Street, Chicago, IL 60611, USA
| | - Jose Antonio
- Department of Exercise Science and Health Promotion, Florida Atlantic University, 2912 College Avenue, Davie, FL 33314, USA
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Pavy-Le Traon A, Heer M, Narici MV, Rittweger J, Vernikos J. From space to Earth: advances in human physiology from 20 years of bed rest studies (1986-2006). Eur J Appl Physiol 2007; 101:143-94. [PMID: 17661073 DOI: 10.1007/s00421-007-0474-z] [Citation(s) in RCA: 375] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2007] [Indexed: 01/11/2023]
Abstract
Bed rest studies of the past 20 years are reviewed. Head-down bed rest (HDBR) has proved its usefulness as a reliable simulation model for the most physiological effects of spaceflight. As well as continuing to search for better understanding of the physiological changes induced, these studies focused mostly on identifying effective countermeasures with encouraging but limited success. HDBR is characterised by immobilization, inactivity, confinement and elimination of Gz gravitational stimuli, such as posture change and direction, which affect body sensors and responses. These induce upward fluid shift, unloading the body's upright weight, absence of work against gravity, reduced energy requirements and reduction in overall sensory stimulation. The upward fluid shift by acting on central volume receptors induces a 10-15% reduction in plasma volume which leads to a now well-documented set of cardiovascular changes including changes in cardiac performance and baroreflex sensitivity that are identical to those in space. Calcium excretion is increased from the beginning of bed rest leading to a sustained negative calcium balance. Calcium absorption is reduced. Body weight, muscle mass, muscle strength is reduced, as is the resistance of muscle to insulin. Bone density, stiffness of bones of the lower limbs and spinal cord and bone architecture are altered. Circadian rhythms may shift and are dampened. Ways to improve the process of evaluating countermeasures--exercise (aerobic, resistive, vibration), nutritional and pharmacological--are proposed. Artificial gravity requires systematic evaluation. This review points to clinical applications of BR research revealing the crucial role of gravity to health.
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Affiliation(s)
- A Pavy-Le Traon
- Service D'explorations Fonctionnelles Respiratoires Et d'analyses Physiologiques, Hopital La Cavale Blanche, University Hospital of Brest, 29609, Brest Cedex, France.
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Lata PF, Elliott ME. Patient assessment in the diagnosis, prevention, and treatment of osteoporosis. Nutr Clin Pract 2007; 22:261-75. [PMID: 17507727 DOI: 10.1177/0115426507022003261] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Assessment of the patient with osteoporosis includes history and physical examination, laboratory testing, and imaging studies. Information gathered during this assessment assists clinicians in targeting strategies to prevent fractures. The medical history should contain items such as personal and family history of fractures, lifestyle, intake of substances such as vitamin D, calcium, corticosteroids, and other medications. The physical examination can reveal relevant information such as height loss and risk of falls. Bone mineral density (BMD), most commonly determined by dual-energy x-ray absorptiometry, best predicts fracture risk in patients without previous fracture. BMD testing is most efficient in women over 65 years old but is also helpful for men and women with risk factors. Serial BMD tests can identify individuals losing bone mass, but clinicians should be aware of what constitutes a significant change. Laboratory testing can detect other risk factors and can provide clues to etiology. Selection of laboratory tests should be individualized, as there is no consensus regarding which tests are optimal. Biochemical markers of bone turnover have a potential role in fracture risk assessment and in gauging response to therapy, but are not widely used at present. Clinicians should be aware of problems with vitamin D measurement, including seasonal variation, variability among laboratories, and the desirable therapeutic range. Careful assessment of the osteoporotic patient is essential in developing a comprehensive plan that reduces fracture risk and improves quality of life.
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Affiliation(s)
- Paul F Lata
- Bay Area Medical Center, Case Management Services, 3100 Shore Drive, Marinette, WI 54143, USA.
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Budek AZ, Bjornvad CR, Mølgaard C, Bügel S, Vestergaard M, Pulkkinen P, Michaelsen KF, Sangild PT. Effects of casein, whey and soy proteins on volumetric bone density and bone strength in immunocompromised piglets. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/j.eclnm.2007.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Budek AZ, Hoppe C, Michaelsen KF, Bügel S, Mølgaard C. Associations of total, dairy, and meat protein with markers for bone turnover in healthy, prepubertal boys. J Nutr 2007; 137:930-4. [PMID: 17374656 DOI: 10.1093/jn/137.4.930] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We previously reported that high intake of milk, but not meat, equal in protein content, increased serum insulin-like growth factor-I (sIGF-I) in prepubertal boys. sIGF-I plays a key role in bone metabolism. Therefore, the aim of this cross-sectional study was to investigate associations of total, dairy, and meat protein intake with markers for bone turnover and sIGF-I in prepubertal, healthy boys (n = 81). We measured bone turnover (enzyme-linked immunoassay) in serum osteocalcin (sOC), bone-specific alkaline phosphatase (sBAP), and C-terminal telopeptide of collagen type-I (sCTX); dietary intake was estimated from a 3-d weighed food record. sIGF-I and its binding protein-3 were assessed (immunoassay) in a subgroup of 56 boys. All statistical models included effects of age, BMI, and energy intake. Dairy protein was negatively associated with sOC (P = 0.05) but not significantly associated with sBAP and sCTX. Further analyses showed that dairy protein decreased (P = 0.05) sOC at a high meat protein intake (>0.8 g/kg), whereas meat protein increased (P = 0.03) sOC at a low dairy protein intake (<0.4 g/kg). Total and meat protein intake was positively associated with sBAP (P < or = 0.04) but not significantly associated with sOC and sCTX. Free sIGF-I was positively associated with total (P < 0.01) and dairy (P = 0.06) protein but not with meat protein. Our results indicate that dairy and meat protein may exhibit a distinct regulatory effect on different markers for bone turnover. Future studies should focus on differential effects of dairy and meat protein on bone health during growth.
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Affiliation(s)
- Alicja Z Budek
- Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, 1958 Frederiksberg, Denmark.
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Welch AA, Bingham SA, Reeve J, Khaw KT. More acidic dietary acid-base load is associated with reduced calcaneal broadband ultrasound attenuation in women but not in men: results from the EPIC-Norfolk cohort study. Am J Clin Nutr 2007; 85:1134-41. [PMID: 17413116 DOI: 10.1093/ajcn/85.4.1134] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dietary patterns that promote mild metabolic acidosis may have a negative effect on bone density. OBJECTIVE We investigated the relation between a measure of dietary acid-base load, potential renal acid load (PRAL), and calcaneal broadband ultrasound attenuation (BUA) after adjustment for confounders and also compared the results with different estimates of acid-base load. DESIGN A cross-sectional study was conducted in 14 563 men and women aged 42-82 y living in Norfolk, United Kingdom, in which measures of calcaneal BUA and dietary PRAL were estimated by using the European Prospective Investigation into Cancer and Nutrition Norfolk (EPIC-Norfolk) food-frequency questionnaire. RESULTS A more acidic dietary intake (high PRAL) was significantly associated with lower calcaneal BUA in women but not in men; there was a difference of approximately 2% in BUA between the highest and lowest quintiles of PRAL, independent of age, body mass index, smoking habit, physical activity, diagnosed osteoporosis, and history of fracture, and (in women) hormone replacement therapy. No relation was observed between history of fracture or incident fracture and PRAL. Those with the greatest PRAL had higher intakes of meat, fish, eggs, and cereal and cereal products and lower intakes of fruit and vegetables, tea, and coffee. CONCLUSION PRAL was inversely associated with bone ultrasound measures in women, but the magnitude of the association was relatively small compared with other known risk factors. Further longitudinal studies are required to establish whether, in the long term, these small effects are important in overall fracture risk in populations.
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Affiliation(s)
- Ailsa A Welch
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Site, Cambridge, United Kingdom.
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Prentice A, Schoenmakers I, Ann Laskey M, de Bono S, Ginty F, Goldberg GR. Symposium on ‘Nutrition and health in children and adolescents’ Session 1: Nutrition in growth and development Nutrition and bone growth and development. Proc Nutr Soc 2007. [DOI: 10.1079/pns2006519] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Key TJ, Appleby PN, Spencer EA, Roddam AW, Neale RE, Allen NE. Calcium, diet and fracture risk: a prospective study of 1898 incident fractures among 34 696 British women and men. Public Health Nutr 2007; 10:1314-20. [PMID: 17381900 DOI: 10.1017/s1368980007696402] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The risk factors for fractures are incompletely understood. An outstanding question concerns the optimal amount of dietary calcium needed to minimise the risk of fracture. DESIGN We examined the associations of dietary calcium and other nutrients with self-reported fracture risk in a prospective cohort study. Nutrient intakes were estimated using a semi-quantitative food-frequency questionnaire administered at recruitment. SETTING The UK. PARTICIPANTS A total of 26 749 women and 7947 men aged 20-89 years. RESULTS Over an average of 5.2 years of follow-up, 1555 women and 343 men reported one or more fractures, 72% of these resulting from a fall. Among women, fracture risk was higher at lower calcium intakes, with a relative risk of 1.75 (95% confidence interval (CI) 1.33-2.29) among women with a calcium intake of < 525 mg day- 1 compared with women with a calcium intake of at least 1200 mg day- 1 (test for linear trend, P < 0.001). The association of dietary calcium with fracture risk was stronger among women aged under 50 years at recruitment than among women aged 50 and above. Dietary calcium intake was not associated with fracture risk in men. Fracture risk was not related to the dietary intake of any other nutrient examined. CONCLUSION In this population, women with a low dietary calcium intake had an increased risk of bone fracture, and this association was more marked among younger women than among older women.
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Affiliation(s)
- Timothy J Key
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK.
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A population study of bone health and dietary acid-base load: The UK EPIC-Norfolk study. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/j.ics.2007.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Appleby P, Roddam A, Allen N, Key T. Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford. Eur J Clin Nutr 2007; 61:1400-6. [PMID: 17299475 DOI: 10.1038/sj.ejcn.1602659] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To compare fracture rates in four diet groups (meat eaters, fish eaters, vegetarians and vegans) in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford). DESIGN Prospective cohort study of self-reported fracture risk at follow-up. SETTING The United Kingdom. SUBJECTS A total of 7947 men and 26,749 women aged 20-89 years, including 19,249 meat eaters, 4901 fish eaters, 9420 vegetarians and 1126 vegans, recruited by postal methods and through general practice surgeries. METHODS Cox regression. RESULTS Over an average of 5.2 years of follow-up, 343 men and 1555 women reported one or more fractures. Compared with meat eaters, fracture incidence rate ratios in men and women combined adjusted for sex, age and non-dietary factors were 1.01 (95% CI 0.88-1.17) for fish eaters, 1.00 (0.89-1.13) for vegetarians and 1.30 (1.02-1.66) for vegans. After further adjustment for dietary energy and calcium intake the incidence rate ratio among vegans compared with meat eaters was 1.15 (0.89-1.49). Among subjects consuming at least 525 mg/day calcium the corresponding incidence rate ratios were 1.05 (0.90-1.21) for fish eaters, 1.02 (0.90-1.15) for vegetarians and 1.00 (0.69-1.44) for vegans. CONCLUSIONS In this population, fracture risk was similar for meat eaters, fish eaters and vegetarians. The higher fracture risk in the vegans appeared to be a consequence of their considerably lower mean calcium intake. An adequate calcium intake is essential for bone health, irrespective of dietary preferences. SPONSORSHIP The EPIC-Oxford study is supported by The Medical Research Council and Cancer Research UK.
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Affiliation(s)
- P Appleby
- Cancer Research UK Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
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Budek AZ, Hoppe C, Michaelsen KF, Mølgaard C. High intake of milk, but not meat, decreases bone turnover in prepubertal boys after 7 days. Eur J Clin Nutr 2007; 61:957-62. [PMID: 17228345 DOI: 10.1038/sj.ejcn.1602605] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To compare the short-term effect of a high milk and a high meat intake, identical in protein amount, on bone turnover during prepuberty. SETTING A University department. DESIGN AND SUBJECTS From 28, randomly recruited, 8-year-old boys, first 14 were assigned to the milk group and next 14 to the meat group. In each group, 12 boys finished the dietary intervention. INTERVENTION Milk (1.5 l/day) and meat (250 g/d), both containing approximately 53 g of protein, were given together with the habitual diet for 7 days. At baseline and day-7, serum osteocalcin (s-OC), bone-specific alkaline phosphatase (s-BAP) and C-terminal telopeptides of type I collagen (s-CTX) were measured (immunoassay) and dietary intake was estimated (a 3-day weighted food record). RESULTS Baseline s-OC, s-BAP and s-CTX were not significantly different between the groups. After 7 days, the average protein intake increased in both groups by 47.5 g; the milk group had higher (P<0.0001) calcium intake; s-OC and s-CTX decreased (P< or =0.04) in the milk group (-30.9%; -18.7%, respectively) compared with the meat group (+6.4%; -1.0%, respectively) and s-BAP decreased (P=0.06) both in the milk (-3.9%) and the meat group (-7.5%). CONCLUSIONS At the equal protein intake, milk, but not meat, decreased bone turnover in prepubertal boys after 7 days. This effect was probably due to some milk-derived compounds, rather than to the total protein intake. Future studies should elucidate the mechanism(s) of milk-related decline of bone turnover and its relevance for peak bone mass during growth. SPONSORSHIP University PhD scholarships.
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Affiliation(s)
- A Z Budek
- Department of Human Nutrition, Faculty of Life Science, University of Copenhagen, Rolighedsvej 30, DK-1958 Frederiksberg, Denmark.
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Prentice A, Schoenmakers I, Laskey MA, de Bono S, Ginty F, Goldberg GR. Nutrition and bone growth and development. Proc Nutr Soc 2006; 65:348-60. [PMID: 17181901 PMCID: PMC2039894 DOI: 10.1017/s0029665106005192] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The growth and development of the human skeleton requires an adequate supply of many different nutritional factors. Classical nutrient deficiencies are associated with stunting (e.g. energy, protein, Zn), rickets (e.g. vitamin D) and other bone abnormalities (e.g. Cu, Zn, vitamin C). In recent years there has been interest in the role nutrition may play in bone growth at intakes above those required to prevent classical deficiencies, particularly in relation to optimising peak bone mass and minimising osteoporosis risk. There is evidence to suggest that peak bone mass and later fracture risk are influenced by the pattern of growth in childhood and by nutritional exposures in utero, in infancy and during childhood and adolescence. Of the individual nutrients, particular attention has been paid to Ca, vitamin D, protein and P. There has also been interest in several food groups, particularly dairy products, fruit and vegetables and foods contributing to acid-base balance. However, it is not possible at the present time to define dietary reference values using bone health as a criterion, and the question of what type of diet constitutes the best support for optimal bone growth and development remains open. Prudent recommendations (Department of Health, 1998; World Health Organization/Food and Agriculture Organization, 2003) are the same as those for adults, i.e. to consume a Ca intake close to the reference nutrient intake, optimise vitamin D status through adequate summer sunshine exposure (and diet supplementation where appropriate), be physically active, have a body weight in the healthy range, restrict salt intake and consume plenty of fruit and vegetables.
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Affiliation(s)
- Ann Prentice
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge CB1 9NL, UK.
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NII Y, OSAWA T, KUNII D, FUKUTA K, SAKAI K, KONDO M, YAMAMOTO S. Effect of Citrus Fruit (Sudachi) Juice on Absorption of Calcium from Whole Small Fish in Healthy Young Men. FOOD SCIENCE AND TECHNOLOGY RESEARCH 2006. [DOI: 10.3136/fstr.12.27] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kristensen M, Jensen M, Kudsk J, Henriksen M, Mølgaard C. Short-term effects on bone turnover of replacing milk with cola beverages: a 10-day interventional study in young men. Osteoporos Int 2005; 16:1803-8. [PMID: 15886860 DOI: 10.1007/s00198-005-1935-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2005] [Accepted: 04/16/2005] [Indexed: 11/24/2022]
Abstract
In the Western world, increased consumption of carbonated soft drinks combined with a decreasing intake of milk may increase the risk of osteoporosis. This study was designed to reflect the trend of replacing milk with carbonated beverages in a group of young men on a low-calcium diet and studies the effects of this replacement on calcium homeostasis and bone turnover. This controlled crossover intervention study included 11 healthy men (22-29 years) who were given a low-calcium basic diet in two 10-day intervention periods with an intervening 10-day washout. During one period, they drank 2.5 l of Coca Cola per day and during the other period 2.5 l of semi-skimmed milk. Serum concentrations of calcium, phosphate, 25-hydroxycholecalciferol, 1,25-dihydroxycholecalciferol (1,25(OH)2D), osteocalcin, bone-specific alkaline phosphatase (B-ALP) and cross-linked C-telopeptides (CTX), plasma intact parathyroid hormone (PTH) and urinary cross-linked N-telopeptides (NTX) were determined at baseline and endpoint of each intervention period. An increase in serum phosphate (P<0.001), 1,25(OH)2D (P<0.001), PTH (P=0.046) and osteocalcin (P<0.001) was observed in the cola period compared to the milk period. Also, bone resorption was significantly increased following the cola period, seen as increased serum CTX (P<0.001) and urinary NTX (P<0.001) compared to the milk period. No changes were observed in serum concentrations of calcium or B-ALP. This study demonstrates that over a 10-day period high intake of cola with a low-calcium diet induces increased bone turnover compared to a high intake of milk with a low-calcium diet. Thus, the trend towards a replacement of milk with cola and other soft drinks, which results in a low calcium intake, may negatively affect bone health as indicated by this short-term study.
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Affiliation(s)
- Mette Kristensen
- Department of Human Nutrition and Center for Advanced Food Studies (LMC), The Royal Veterinary and Agricultural University, Rolighedsvej 30, 1958, Frederiksberg, Denmark
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Alexy U, Remer T, Manz F, Neu CM, Schoenau E. Long-term protein intake and dietary potential renal acid load are associated with bone modeling and remodeling at the proximal radius in healthy children. Am J Clin Nutr 2005; 82:1107-14. [PMID: 16280446 DOI: 10.1093/ajcn/82.5.1107] [Citation(s) in RCA: 153] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Protein and alkalizing minerals are increasingly described as playing a major role in influencing bone status, not only in the elderly but also in children and adolescents. OBJECTIVE We examined whether the long-term dietary protein intake and diet net acid load are associated with bone status in children. DESIGN In a prospective study design in 229 healthy children and adolescents aged 6-18 y, long-term dietary intakes were calculated from 3-d weighed dietary records that were collected yearly over the 4-y period before a one-time bone analysis. Dietary acid load was characterized as potential renal acid load (PRAL) by using an algorithm including dietary protein, phosphorus, magnesium, and potassium. Proximal forearm bone variables were measured by peripheral quantitative computed tomography. RESULTS After adjustment for age, sex, and energy intake and control for forearm muscularity, BMI, growth velocity, and pubertal development, we observed that long-term dietary protein intake was significantly positively associated with periosteal circumference (P < 0.01), which reflected bone modeling, and with cortical area (P < 0.001), bone mineral content (P < 0.01), and polar strength strain index (P < 0.0001), which reflected a combination of modeling and remodeling. Children with a higher dietary PRAL had significantly less cortical area (P < 0.05) and bone mineral content (P < 0.01). Long-term calcium intake had no significant effect on any bone variable. CONCLUSIONS Long-term dietary protein intake appears to act anabolically on diaphyseal bone strength during growth, and this may be negated, at least partly, if dietary PRAL is high, ie, if the intake of alkalizing minerals is low.
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Affiliation(s)
- Ute Alexy
- Research Institute of Child Nutrition, Dortmund, Germany
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Weikert C, Walter D, Hoffmann K, Kroke A, Bergmann MM, Boeing H. The relation between dietary protein, calcium and bone health in women: results from the EPIC-Potsdam cohort. ANNALS OF NUTRITION AND METABOLISM 2005; 49:312-8. [PMID: 16088096 DOI: 10.1159/000087335] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2004] [Accepted: 03/23/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS The role of dietary protein in bone health is controversial. The objective of the present study was to examine the association between protein intake, dietary calcium, and bone structure measured by broadband ultrasound attenuation (BUA). METHODS Our analysis includes 8,178 female study participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) Potsdam Study. Ultrasound bone measurements were performed on the right os calcis, and BUA was determined. Dietary intake was assessed by a standardized food frequency questionnaire. We applied linear regression models to estimate the association between dietary protein and BUA. RESULTS After multivariate adjustment, high intake of animal protein was associated with decreased BUA values (beta = -0.03; p = 0.010) whereas high vegetable protein intake was related to an increased BUA (beta = 0.11; p = 0.007). The effect of dietary animal protein on BUA was modified by calcium intake. CONCLUSION High consumption of protein from animal origin may be unfavourable, whereas a higher vegetable protein intake may be beneficial for bone health. Our results strengthen the hypothesis that high calcium intake combined with adequate protein intake based on a high ratio of vegetable to animal protein may be protective against osteoporosis.
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Affiliation(s)
- Cornelia Weikert
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
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Abstract
High-protein (HP) weight-loss diets have existed in the United States for decades, although their popularity has recently surged as obesity has become more common. Despite their widespread use, valid concerns exist that HP diets may induce clinically important alterations in renal function and health. HP consumption has been found, under various conditions, to lead to glomerular hyperfiltration and hyperemia; acceleration of chronic kidney disease (CKD); increased proteinuria; diuresis, natriuresis, and kaliuresis with associated blood pressure changes; increased risk for nephrolithiasis; and various metabolic alterations. Unfortunately, a comprehensive understanding of the implications of HP diets is limited by the lack of a universally accepted definition for HP intake, a paucity of rigorous long-term human interventional studies that necessitate relying on short-term or fairly circumstantial evidence, and sparse data on the effects of HP consumption in obese individuals. In addition, matters are further complicated because the renal impact HP diets for limited periods is most likely different than that for more chronic consumption. Nevertheless, although there are no clear renal-related contraindications to HP diets in individuals with healthy kidney function, the theoretical risks should be reviewed carefully with the patient. In contrast, HP diets have the potential for significant harm in individuals with CKD and should be avoided if possible. Because CKD is often a silent disease, all individuals should undergo a screening serum creatinine measurement and urinary dipstick test for proteinuria before the initiation of such a diet.
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Affiliation(s)
- Allon N Friedman
- Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
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Manninen AH. High-Protein Weight Loss Diets and Purported Adverse Effects: Where is the Evidence? J Int Soc Sports Nutr 2004. [PMCID: PMC2129142 DOI: 10.1186/1550-2783-1-1-45] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Results of several recent studies show that high-protein, low-carbohydrate weight loss diets indeed have their benefits. However, agencies such as the American Heart Association (AHA) have some concerns about possible health risks. The purpose of this review is to evaluate the scientific validity of AHA Nutrition Committee's statement on dietary protein and weight reduction (St. Jeor ST et al. Circulation 2001;104:1869–1874), which states: "Individuals who follow these [high-protein] diets are risk for ... potential cardiac, renal, bone, and liver abnormalities overall. Simply stated, there is no scientific evidence whatsoever that high-protein intake has adverse effects on liver function. Relative to renal function, there are no data in the scientific literature demonstrating that healthy kidneys are damaged by the increased demands of protein consumed in quantities 2–3 times above the Recommended Dietary Allowance (RDA). In contrast with the earlier hypothesis that high-protein intake promotes osteoporosis, some epidemiological studies found a positive association between protein intake and bone mineral density. Further, recent studies studies suggest, at least in the short term, that RDA for protein (0.8 g/kg) does not support normal calcium homeostasis. Finally, a negative correlation has been shown between protein intake and systolic and diastolic blood pressures in several epidemiological surveys. In conclusion, there is little if any scientific evidence supporting above mentioned statement. Certainly, such public warnings should be based on a thorough analysis of the scientific literature, not unsubstantiated fears and misrepresentations. For individuals with normal renal function, the risks are minimal and must be balanced against the real and established risk of continued obesity.
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