Department of Nutrition, Simmons College, 300 The Fenway, Boston, MA, 02115, USA.
Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Osteoporos Int. 2017 Apr;28(4):1401-1411. doi: 10.1007/s00198-016-3898-7. Epub 2017 Jan 10.
In this study, we followed postmenopausal women and men aged 50 and above for up to 32 years and found no evidence that higher protein intake increased the risk of hip fracture. Protein intake from specific sources was inversely associated with risk, but these associations appeared to differ by gender.
We examined the association between intakes of total and specific sources of protein and hip fracture risk in postmenopausal women and men over 50 years of age. Our hypothesis was that a higher protein intake would not be associated with a higher risk of hip fractures.
In this analysis, we followed 74,443 women in the Nurses' Health Study between 1980 and 2012 and 35,439 men from the Health Professionals Follow-up Study between 1986 and 2012. Health and lifestyle information and hip fractures were self-reported on biennial questionnaires. Protein was assessed approximately every 4 years with a food frequency questionnaire. Relative risks (RR) were computed for hip fracture by quintiles of total, animal, dairy, and plant protein intakes using Cox proportional hazard models, adjusting for potential confounders.
During follow-up, we ascertained 2156 incident hip fractures in women and 595 fractures in men. Among men, we observed significant inverse associations for each 10 g increase of total protein (RR = 0.92, 95% CI = 0.85-0.99) and animal protein (RR = 0.91, 95% CI = 0.85-0.98) intakes. Total and animal proteins were not significantly associated with hip fractures in women. Both plant (RR = 0.88, 95% CI 0.79-0.99 per 10 g) and dairy protein (RR = 0.92, 95% CI 0.86-0.97) were associated with significantly lower risks of hip fracture when results for men and women were combined. None of these associations were modified by BMI, smoking, physical activity, age, or calcium intake.
We found no evidence that higher protein intake increases risk of hip fracture in these Caucasian men and women. Protein intake from specific sources was inversely associated with risk, but these associations appeared to differ by gender.
本研究对 50 岁及以上绝经后女性和男性进行了长达 32 年的随访,结果并未发现高蛋白饮食会增加髋部骨折风险。特定蛋白质来源的摄入量与风险呈负相关,但这些关联似乎因性别而异。
在这项分析中,我们对参加 1980 年至 2012 年期间的护士健康研究的 74443 名女性和参加 1986 年至 2012 年期间的健康专业人员随访研究的 35439 名男性进行了随访。健康和生活方式信息以及髋部骨折情况通过每两年一次的调查问卷进行自我报告。蛋白质摄入量大约每 4 年通过食物频率问卷进行评估。使用 Cox 比例风险模型,根据潜在混杂因素对总蛋白、动物蛋白、乳制品蛋白和植物蛋白摄入量的五分位数进行髋部骨折的相对风险(RR)计算。
在随访期间,我们确定了 2156 例女性和 595 例男性髋部骨折事件。在男性中,我们观察到总蛋白(RR=0.92,95%可信区间[CI]:0.85-0.99)和动物蛋白(RR=0.91,95% CI:0.85-0.98)摄入量每增加 10g,髋部骨折的风险呈显著负相关。总蛋白和动物蛋白与女性髋部骨折无显著相关性。植物蛋白(RR=0.88,95%可信区间 0.79-0.99 每 10g)和乳制品蛋白(RR=0.92,95% CI 0.86-0.97)与髋部骨折风险显著降低相关,当将男性和女性的结果合并时。这些关联在 BMI、吸烟、体力活动、年龄或钙摄入量方面均无变化。
我们在这些白种人男性和女性中未发现高蛋白饮食会增加髋部骨折风险的证据。特定蛋白质来源的摄入量与风险呈负相关,但这些关联似乎因性别而异。