title: Protein intake and lumbar bone density: the Multi-Ethnic Study of Atherosclerosis (MESA).
abstract: Dietary protein has been shown to increase urinary Ca excretion in randomised controlled trials, and diets high in protein may have detrimental effects on bone health; however, studies examining the relationship between dietary protein and bone health have conflicting results. In the present study, we examined the relationship between dietary protein (total, animal and vegetable protein) and lumbar spine trabecular volumetric bone mineral density (vBMD) among participants enrolled in the Multi-Ethnic Study of Atherosclerosis (n 1658). Protein intake was assessed using a FFQ obtained at baseline examination (2000-2). Lumbar spine vBMD was measured using quantitative computed tomography (2002-5), on average 3 years later. Multivariable linear and robust regression techniques were used to examine the associations between dietary protein and vBMD. Sex and race/ethnicity jointly modified the association of dietary protein with vBMD (P for interaction = 0·03). Among white women, higher vegetable protein intake was associated with higher vBMD (P for trend = 0·03), after adjustment for age, BMI, physical activity, alcohol consumption, current smoking, educational level, hormone therapy use, menopause and additional dietary factors. There were no consistently significant associations for total and animal protein intakes among white women or other sex and racial/ethnic groups. In conclusion, data from the present large, multi-ethnic, population-based study suggest that a higher level of protein intake, when substituted for fat, is not associated with poor bone health. Differences in the relationship between protein source and race/ethnicity of study populations may in part explain the inconsistent findings reported previously.
authors.affiliation: Department of Epidemiology,Tulane University School of Public Health and Tropical Medicine,1440 Canal Street, SL-18, Suite 2000,New Orleans,LA70112,USA.
authors.forename: Tian
authors.initials: T
authors.lastname: Hu
authors.affiliation: Department of Family and Community Medicine,University of Texas Medical School,Houston,TX,USA.
authors.forename: Nahid J
authors.initials: NJ
authors.lastname: Rianon
authors.affiliation: Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center School of Public Health,Houston,TX,USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Nettleton
authors.affiliation: Department of Anesthesiology, Mayo Clinic,Rochester,MN,USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Hyder
authors.affiliation: Department of Epidemiology,Tulane University School of Public Health and Tropical Medicine,1440 Canal Street, SL-18, Suite 2000,New Orleans,LA70112,USA.
authors.forename: Jiang
authors.initials: J
authors.lastname: He
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota School of Public Health,Minneapolis,MN,USA.
authors.forename: Lyn M
authors.initials: LM
authors.lastname: Steffen
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota School of Public Health,Minneapolis,MN,USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.affiliation: Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California,San Diego,CA,USA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Criqui
authors.affiliation: Department of Epidemiology,Tulane University School of Public Health and Tropical Medicine,1440 Canal Street, SL-18, Suite 2000,New Orleans,LA70112,USA.
authors.forename: Lydia A
authors.initials: LA
authors.lastname: Bazzano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects* / Q000208:ethnology; D004044:Dietary Proteins / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D014674:Plant Proteins, Dietary / Q000009:adverse effects; D012306:Risk; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology; D044465:White People
chemical_list: D004044:Dietary Proteins; D014674:Plant Proteins, Dietary