title: The role of dietary protein and vitamin D in maintaining musculoskeletal health in postmenopausal women: a consensus statement from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).
abstract: From 50 years of age, postmenopausal women are at an increased risk of developing sarcopenia and osteoporosis as a result of deterioration of musculoskeletal health. Both disorders increase the risk of falls and fractures. The risk of developing sarcopenia and osteoporosis may be attenuated through healthy lifestyle changes, which include adequate dietary protein, calcium and vitamin D intakes, and regular physical activity/exercise, besides hormone replacement therapy when appropriate. Protein intake and physical activity are the main anabolic stimuli for muscle protein synthesis. Exercise training leads to increased muscle mass and strength, and the combination of optimal protein intake and exercise produces a greater degree of muscle protein accretion than either intervention alone. Similarly, adequate dietary protein intake and resistance exercise are important contributors to the maintenance of bone strength. Vitamin D helps to maintain muscle mass and strength as well as bone health. These findings suggest that healthy lifestyle measures in women aged >50 years are essential to allow healthy ageing. The European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) recommends optimal dietary protein intake of 1.0-1.2g/kgbodyweight/d with at least 20-25g of high-quality protein at each main meal, with adequate vitamin D intake at 800IU/d to maintain serum 25-hydroxyvitamin D levels >50nmol/L as well as calcium intake of 1000mg/d, alongside regular physical activity/exercise 3-5 times/week combined with protein intake in close proximity to exercise, in postmenopausal women for prevention of age-related deterioration of musculoskeletal health.
authors.affiliation: Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland. Electronic address: rene.rizzoli@unige.ch.
authors.forename: René
authors.initials: R
authors.lastname: Rizzoli
authors.affiliation: National Heart & Lung Institute, Imperial College London, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London SW3 6NP, UK.
authors.forename: John C
authors.initials: JC
authors.lastname: Stevenson
authors.affiliation: Department of Geriatric Medicine, Klinikum, Carl von Ossietzky University, Ammerländer Heerstrasse 114-118, 26129 Oldenburg, Germany.
authors.forename: Jürgen M
authors.initials: JM
authors.lastname: Bauer
authors.affiliation: NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Luc J C
authors.initials: LJ
authors.lastname: van Loon
authors.affiliation: INRA and Clermont Université, Université d'Auvergne, 49, Boulevard François Mitterrand, CS 60032, 63001 Clermont Ferrand Cedex 1, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Walrand
authors.affiliation: Centre for Metabolic Bone Diseases, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, South Yorkshire, UK.
authors.forename: John A
authors.initials: JA
authors.lastname: Kanis
authors.affiliation: MRC Lifecourse Epidemiology Unit and NIHR Nutrition Biomedical Research Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cooper
authors.affiliation: Department of Surgery and Translational Medicine, University of Florence, Piazza San Marco, 4-50121 Florence, Italy.
authors.forename: Maria-Luisa
authors.initials: ML
authors.lastname: Brandi
authors.affiliation: Department of Internal Medicine, Hospital Del Mar/IMIM, Autonomous University of Barcelona and RETICEF, Instituto Carlos III, Barcelona, Spain.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Diez-Perez
authors.affiliation: Department of Public Health Sciences, University of Liège, Liège, Belgium; Bone and Cartilage Metabolism Unit, CHU Centre-Ville, University of Liège, Liège, Belgium.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Reginster
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D015519:Bone Density / Q000502:physiology; D001842:Bone and Bones / Q000502:physiology; D002136:Calcium, Dietary / Q000627:therapeutic use*; D004044:Dietary Proteins / Q000627:therapeutic use*; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009124:Muscle Proteins / Q000502:physiology; D053580:Muscle Strength / Q000502:physiology; D018482:Muscle, Skeletal / Q000502:physiology; D010003:Osteoarthritis / Q000517:prevention & control*; D015663:Osteoporosis, Postmenopausal / Q000178:diet therapy* / Q000188:drug therapy; D017698:Postmenopause / Q000502:physiology*; D055948:Sarcopenia / Q000517:prevention & control; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D002136:Calcium, Dietary; D004044:Dietary Proteins; D009124:Muscle Proteins; D014815:Vitamins; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Menopause; Musculoskeletal health; Osteoporosis; Physical exercise; Prevention; Sarcopenia