title: The relation between dietary protein, calcium and bone health in women: results from the EPIC-Potsdam cohort.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany. Weikert@mail.dife.de
authors.forename: Cornelia
authors.initials: C
authors.lastname: Weikert
authors.forename: Dietmar
authors.initials: D
authors.lastname: Walter
authors.forename: Kurt
authors.initials: K
authors.lastname: Hoffmann
authors.forename: Anja
authors.initials: A
authors.lastname: Kroke
authors.forename: Manuela M
authors.initials: MM
authors.lastname: Bergmann
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
mesh_terms: D000328:Adult; D000368:Aged; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000378:metabolism*; D002136:Calcium, Dietary / Q000008:administration & dosage* / Q000378:metabolism; D015331:Cohort Studies; D004044:Dietary Proteins / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D016014:Linear Models; D008460:Meat; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000209:etiology / Q000517:prevention & control*; D014674:Plant Proteins, Dietary / Q000008:administration & dosage*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014463:Ultrasonography
chemical_list: D002136:Calcium, Dietary; D004044:Dietary Proteins; D014674:Plant Proteins, Dietary