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The Effects of Protein Supplementation on Bone Mass in Chinese Postmenopausal Women

  • Qian ZhangEmail author
  • Feitong Wu
  • Xiaoqi Hu
  • Ying Liu
  • Cuixia Wang
  • Richard Prince
  • Kun Zhu
Chapter
  • 1.4k Downloads

Abstract

Background: Sufficient calcium intake is essential for the maintenance of bone health in older people. However, the effect of dietary protein on bone mass of older women has been controversial. To the best of our knowledge, there has been no clinical trial evaluating the effect of protein supplementation on bone mass in older Chinese women.

Objective: To evaluate the effect of 1-year protein and calcium supplementation on bone mass in older Chinese women compared to calcium supplementation alone.

Design: A 1-year randomized controlled trial was conducted in 283 Chinese postmenopausal women aged 68.1 ± 0.5 years (range 60–86 years). Study participants were randomized to receive either protein powder containing 30 g soybean protein and 1,000 mg calcium as calcium carbonate (Pro + Ca group, n = 142) or only 1,000 mg calcium per day (Ca group, n = 141). Measurements performed include dietary intakes by 1-year food-frequency questionnaire, physical activity by International Physical Activity Questionnaire (IPAQ)-Short Form, and areal bone mineral density (aBMD) at hip, lumbar spine (L2–L4), and total body by DXA at baseline and 1 year later.

Results: There were no significant differences between the two groups in baseline characteristics. With supplementation, both groups had significantly higher calcium intake compared to the baseline (1,647 ± 53 mg/day vs. 879 ± 30 mg/day, P = 0.01), and the average dietary protein intake was significantly higher in the Pro + Ca group compared to the Ca group (107.8 ± 4.6 g/day vs. 75.7 ± 3.1 g/day, P < 0.001).

After 1-year supplementation, there was a slight but significant increase in aBMD at total body, femoral neck, trochanter, and total hip in both groups after adjusting for baseline age, BMI, calcium intake, physical activity level, and serum 25(OH)D level (time effect, all P < 0.05). There were no significant time effects on lumbar spine aBMD in either group.

The Pro + Ca group had significantly greater increase in total-body aBMD (9.5 mg/cm2) compared to the Ca group (0.4 mg/cm2) after 1 year of supplementation before adjustment for covariates (time × group interaction, P < 0.05). There were no significant effects of protein supplementation on aBMD of other sites.

Conclusion: Higher intake of dietary protein might have a positive effect on total-body bone mass in Chinese postmenopausal women when calcium intake is sufficient.

Keywords

Protein Bone mineral density Calcium Postmenopausal women 

References

  1. 1.
    Zhao D, Wu H, Liu Z. The epidemiology of osteoporosis in China. Chin J Osteoporos. 2004;10:614–8.Google Scholar
  2. 2.
    Pannemans D, Schaafsma G, Westerterp K. Calcium excretion, apparent calcium absorption and calcium balance in young and elderly subjects: influence of protein intake. Br J Nutr. 1997;77:721–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Hannan M, Tucker K, Dawson-Hughes B, Cupples L, Felson D, Kiel D. Effect of dietary protein on bone loss in elderly men and women: the Framingham Osteoporosis Study. J Bone Miner Res. 2000;15:2504–12.PubMedCrossRefGoogle Scholar
  4. 4.
    Promislow J, Goodman-Gruen D, Slymen D, Barrett-Connor E. Protein consumption and bone mineral density in the elderly: the Rancho Bernardo Study. Am J Epidemiol. 2002;155:636–44.PubMedCrossRefGoogle Scholar
  5. 5.
    Devine A, Dick I, Islam A, Dhaliwal S, Prince R. Protein consumption is an important predictor of lower limb bone mass in elderly women. Am J Clin Nutr. 2005;81:1423–8.PubMedGoogle Scholar
  6. 6.
    Wengreen H, Munger R, Cutler D, Corcoran C, Zhang J, Sassano N. Dietary protein intake and risk of ­osteoporotic hip fracture in elderly residents of Utah. J Bone Miner Res. 2004;19:537–45.PubMedCrossRefGoogle Scholar
  7. 7.
    Rapuri P, Gallagher J, Haynatzka V. Protein intake: effects on bone mineral density and the rate of bone loss in elderly women. Am J Clin Nutr. 2003;77:1517–25.PubMedGoogle Scholar
  8. 8.
    Wang DL. Report of China National Nutrition and Health Survey in 2002 I: total report. Beijing: Public Health; 2005.Google Scholar
  9. 9.
    Yang Y, Wang G, Pan X. China food composition 2002. Beijing: Peking University Medical Press; 2002.Google Scholar
  10. 10.
    Yang Y. China food composition 2004-book 2. Beijing: Peking University Medical Press; 2004.Google Scholar
  11. 11.
    Chinese Nutrition Society. Chinese DRIs. Beijing: Chinese Light Industry Press; 2000.Google Scholar
  12. 12.
    Zhu K, Meng X, Kerr D, Devine A, Solah V, Binns C, et al. The effects of a two-year randomised controlled trial of whey protein supplementation on bone structure, IGF-I and urinary calcium excretion in older postmenopausal women. J Bone Miner Res. 2011;26(9):2298–306.PubMedCrossRefGoogle Scholar
  13. 13.
    National Health and Medical Research Council. Dietary guidelines for protein intake affects bone mass 1427. Canberra: Australian Government Publishing Service; 1991.Google Scholar
  14. 14.
    Dawson-Hughes B, Harris S. Calcium intake influences the association of protein intake with rates of bone loss in elderly men and women. Am J Clin Nutr. 2002;75:773–9.PubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Qian Zhang
    • 1
    Email author
  • Feitong Wu
    • 2
    • 3
  • Xiaoqi Hu
    • 3
  • Ying Liu
    • 3
  • Cuixia Wang
    • 3
  • Richard Prince
    • 4
  • Kun Zhu
    • 4
  1. 1.National Institute of Nutrition and Food Safety, Chinese Centre for Disease Control and PreventionXuan Wu District, BeijingChina
  2. 2.Anhui Medical SchoolAnhuiChina
  3. 3.National Institute of Nutrition and Food Safety, Chinese Centre for Disease Control and PreventionBeijingChina
  4. 4.Department of Endocrinology and DiabetesSir Charles Gairdner HospitalNedlandsAustralia

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