Skip to main content
SpringerLink
Log in

Does dietary protein reduce hip fracture risk in elders? The Framingham osteoporosis study

  • Short Communication
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

Association between dietary protein and fracture risk is unclear. We examined association between energy-adjusted protein intake and hip fracture risk in elders. The risk of hip fracture was reduced in upper quartiles of protein intake when compared with lowest quartile.

Introduction

Studies of the association between dietary protein intake and hip fracture risk are conflicting. Therefore, we examined protein intake and hip fracture risk in a population-based group of elderly men and women.

Methods

Five hundred seventy-six women and 370 men from the Framingham Osteoporosis Study with no previous history of hip fracture completed Food Frequency Questionnaires. Energy-adjusted protein intake was evaluated as a continuous variable and as quartiles. Incidence rates and hazard ratios were calculated, adjusting for age, BMI, sex, and energy intake.

Results

Among 946 participants (mean age 75 years), mean protein intake was found to be 68 gm/d. Increased protein intake was associated with a decreased risk of hip fracture compared to those in the lowest quartile of protein intake (Q2 HR = 0.70, Q3 HR = 0.56, and Q4 HR = 0.63; all p values ≥ 0.044), p for trend was 0.07. When a threshold effect was considered (Q2–4 vs Q1), intakes in the higher quartiles combined were associated with a significantly lower risk for hip fracture (HR = 0.63; p = 0.04).

Conclusion

Our results are consistent with reduced risk of hip fracture with higher dietary protein intake. Larger prospective studies are needed to confirm and extend this finding in elderly men and women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. NOF, America’s Bone Health: The State of Osteoporosis and Low Bone Mass in our Nation. 2002, National Osteoporosis Foundation.

  2. Barzel US (1995) The skeleton as an ion exchange system: implications for the role of acid-base imbalance in the genesis of osteoporosis. J Bone Miner Res 10:1431–1436

    Article  CAS  PubMed  Google Scholar 

  3. Hannan MT et al (2000) Effect of dietary protein on bone loss in elderly men and women: the Framingham osteoporosis study. J Bone Miner Res 15(12):2504–2512

    Article  CAS  PubMed  Google Scholar 

  4. Munger RG, Cerhan JR, Chiu BC (1999) Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women [see comments]. Am J Clin Nutr 69(1):147–152

    CAS  PubMed  Google Scholar 

  5. Wengreen HJ et al (2004) Dietary protein intake and risk of osteoporotic hip fracture in elderly residents of Utah. J Bone Miner Res 19(4):537–545

    Article  PubMed  Google Scholar 

  6. Feskanich D et al (1996) Protein consumption and bone fractures in women. Am J Epidemiol 143:472–479

    CAS  PubMed  Google Scholar 

  7. Dawber TR, Meadors GF, Moore FE (1951) Epidemiological approaches to heart disease: the Framingham study. Am J Publ Health 41:279–286

    Article  CAS  Google Scholar 

  8. Willett WC et al (1985) Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 122(1):51–65

    CAS  PubMed  Google Scholar 

  9. Kiel DP et al (1987) Hip fracture and the use of estrogens in postmenopausal women. The Framingham study. N Engl J Med 317(19):1169–1174

    Article  CAS  PubMed  Google Scholar 

  10. Houston D et al (2008) Dietary protein intake is associated with lean mass change in older, community-dwelling adults: the health, aging, and body composition. Am J Clin Nutr 87(1):150–155

    CAS  PubMed  Google Scholar 

  11. Dargent-Molina P, Sabia S, boutron-Ruault M (2008) Proteins, dietary acid load, and calium and risk of postmenopausal fractures in the E3N French women prospective study. J Bone Miner Res 23:1915–1922

    Article  CAS  PubMed  Google Scholar 

  12. Kerstetter JE, Insognam KL (2005) Impact of dietary protein on calcium absorption and kinetic measures of bone turnover in women. J Clin Endocrinol Metab 90(1):26–31

    Article  CAS  PubMed  Google Scholar 

  13. Chevalley T et al (1998) Arginine increases insulin-like growth factor-I production and collagen synthesis in osteoblast-like cells. Bone 23(2):103–109

    Article  CAS  PubMed  Google Scholar 

  14. Parto K et al (1993) Osteoporosis in lysinuric protein intolerance. J Inherit Metab Dis 16:441–450

    Article  CAS  PubMed  Google Scholar 

  15. Oxlund H et al (1995) Reduced concentrations of collagen cross-links are associated with reduced strength of bone. Bone 17(suppl):365S–371S

    CAS  PubMed  Google Scholar 

  16. Yakar S, Canalis E, Jepsen K (2009) Serum IGF-1 determines skeletal strength by regulating subperiosteal expansion and trait interactions. J Bone Miner Res 24:1481–1492

    Article  CAS  PubMed  Google Scholar 

  17. Salimen H et al (2008) The role of IGF-I and IGFBP-1 status and secondary hyperparathyroidism in relation to osteoporosis in elderly Swedish women. Osteoporos Int 19(2):201–209

    Article  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Rheumatology, Boston University Medical Center, Boston, MA, USA

    D. Misra

  2. Hebrew SeniorLife, Institute for Aging Research, 1200 Centre Street, Boston, MA, 02131, USA

    S. D. Berry, K. E. Broe, R. R. McLean, D. P. Kiel & M. T. Hannan

  3. Division of Gerontology and Geriatrics, Harvard Medical School, BIDMC, Boston, MA, USA

    S. D. Berry, R. R. McLean, D. P. Kiel & M. T. Hannan

  4. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA

    L. A. Cupples

  5. Framingham Heart Study, Framingham, MA, USA

    L. A. Cupples

  6. Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA

    K. L. Tucker

  7. Department of Health Sciences, Northeastern University, Boston, MA, USA

    K. L. Tucker

Authors
  1. D. Misra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. D. Berry
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. E. Broe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. R. McLean
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. A. Cupples
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K. L. Tucker
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. D. P. Kiel
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M. T. Hannan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. T. Hannan.

Additional information

Support

This work was supported by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS R01 AR053205), National Institute on Aging (AG14759), National Institute of Arthritis and Musculoskeletal and Skin Diseases and National Institute on Aging (AR/AG41398), and from Framingham Heart Study of National Heart Lung and Blood Institute of National Institutes of Health and Boston University School of Medicine (N01-HC-25195), and by USDA contract 58-1950-7-707.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Misra, D., Berry, S.D., Broe, K.E. et al. Does dietary protein reduce hip fracture risk in elders? The Framingham osteoporosis study. Osteoporos Int 22, 345–349 (2011). https://doi.org/10.1007/s00198-010-1179-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-010-1179-4

Keywords

Search

Navigation