title: Effects of dietary protein and glycaemic index on biomarkers of bone turnover in children.
abstract: For decades, it has been debated whether high protein intake compromises bone mineralisation, but no long-term randomised trial has investigated this in children. In the family-based, randomised controlled trial DiOGenes (Diet, Obesity and Genes), we examined the effects of dietary protein and glycaemic index (GI) on biomarkers of bone turnover and height in children aged 5-18 years. In two study centres, families with overweight parents were randomly assigned to one of five ad libitum-energy, low-fat (25-30% energy (E%)) diets for 6 months: low protein/low GI; low protein/high GI; high protein/low GI; high protein/high GI; control. They received dietary instructions and were provided all foods for free. Children, who were eligible and willing to participate, were included in the study. In the present analyses, we included children with data on plasma osteocalcin or urinary N-terminal telopeptide of collagen type I (U-NTx) from baseline and at least one later visit (month 1 or month 6) (n 191 in total, n 67 with data on osteocalcin and n 180 with data on U-NTx). The level of osteocalcin was lower (29.1 ng/ml) in the high-protein/high-GI dietary group than in the low-protein/high-GI dietary group after 6 months of intervention (95% CI 2.2, 56.1 ng/ml, P=0.034). The dietary intervention did not affect U-NTx (P=0.96) or height (P=0.80). Baseline levels of U-NTx and osteocalcin correlated with changes in height at month 6 across the dietary groups (P<0.001 and P=0.001, respectively). The present study does not show any effect of increased protein intake on height or bone resorption in children. However, the difference in the change in the level of osteocalcin between the high-protein/high-GI group and the low-protein/high-GI group warrants further investigation and should be confirmed in other studies.
authors: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 30, 1958 Frederiksberg C, Denmark.
authors: Stine-Mathilde
authors: SM
authors: Dalskov
authors: Department of Mathematical Sciences, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
authors: Martha
authors: M
authors: Müller
authors: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 30, 1958 Frederiksberg C, Denmark.
authors: Christian
authors: C
authors: Ritz
authors: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 30, 1958 Frederiksberg C, Denmark.
authors: Camilla T
authors: CT
authors: Damsgaard
authors: Department of Social Medicine, Preventive Medicine and Nutrition Clinic, University of Crete, Heraklion, Greece.
authors: Angeliki
authors: A
authors: Papadaki
authors: Department of Human Biology, NUTRIM, Maastricht University Medical Center, Maastricht, The Netherlands.
authors: Wim H M
authors: WH
authors: Saris
authors: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 30, 1958 Frederiksberg C, Denmark.
authors: Arne
authors: A
authors: Astrup
authors: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 30, 1958 Frederiksberg C, Denmark.
authors: Kim Fleischer
authors: KF
authors: Michaelsen
authors: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 30, 1958 Frederiksberg C, Denmark.
authors: Christian
authors: C
authors: Mølgaard
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001827:Body Height; D001846:Bone Development; D016723:Bone Remodeling; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003094:Collagen / Q000652:urine; D018752:Diet, Fat-Restricted / Q000009:adverse effects; D018753:Diet, Protein-Restricted / Q000009:adverse effects; D004044:Dietary Proteins / Q000008:administration & dosage / Q000009:adverse effects*; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D038321:Glycemic Index; D006801:Humans; D008297:Male; D015675:Osteocalcin / Q000097:blood*; D050177:Overweight / Q000178:diet therapy / Q000517:prevention & control; D010290:Parents
chemical_list: D015415:Biomarkers; D004044:Dietary Proteins; C461299:urinary N-telopeptide of type I collagen, human; D015675:Osteocalcin; D003094:Collagen