title: Does dietary protein reduce hip fracture risk in elders? The Framingham Osteoporosis Study.
abstract: 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.
  
  
  BACKGROUND
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Rheumatology, Boston University Medical Center, Boston, MA, USA. devyani.misra@bmc.org
authors.forename: D
authors.initials: D
authors.lastname: Misra
authors.forename: S D
authors.initials: SD
authors.lastname: Berry
authors.forename: K E
authors.initials: KE
authors.lastname: Broe
authors.forename: R R
authors.initials: RR
authors.lastname: McLean
authors.forename: L A
authors.initials: LA
authors.lastname: Cupples
authors.forename: K L
authors.initials: KL
authors.lastname: Tucker
authors.forename: D P
authors.initials: DP
authors.lastname: Kiel
authors.forename: M T
authors.initials: MT
authors.lastname: Hannan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004032:Diet / Q000706:statistics & numerical data; D004044:Dietary Proteins / Q000008:administration & dosage*; D004812:Epidemiologic Methods; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D004044:Dietary Proteins