Curneen J M G, Casey M, Laird E
University College Dublin, Belfield, Dublin 4, County Dublin, Ireland.
Department of Geriatric Medicine, St James' Hospital, James' Street, Dublin 8, County Dublin, Ireland.
Ir J Med Sci. 2018 Feb;187(1):111-121. doi: 10.1007/s11845-017-1642-8. Epub 2017 Jul 3.
Previously, no large-scale literature reviews have focussed on the relationship between dietary protein and its impact on bone mineral density (BMD) and fracture risk-as measures of bone health-in older adults and its potential impact as a primary prevention tool.
The aim of this study was to assess the impact of varying dietary protein levels on bone health.
A literature review of trials concerning older adults' (>50 years of age) and animals' varying protein intake in the diet and its effect on BMD (human and animal) and fracture risk (human only) was carried out. Additionally, a review of dietary assessment tools used in these studies was also analysed.
Ten out of fourteen trials assessing BMD and dietary protein quantity in humans and 3/4 in animal trials found a positive relationship between these two parameters. Four out of seven trials investigating the relationship between dietary protein quantity and fracture risk displayed a positive, protective effect of dietary protein levels on fracture risk. Sixty-two percent of studies used the Food-Frequency Questionnaire assessment method.
Increased protein intake in the diet is beneficial to bone health and reduces morbidity and mortality. The importance of using dietary protein, along with calcium and vitamin D, as a primary preventative strategy should be stressed, given the health and cost benefits that this would deliver, with a possible need for a higher level of protein in the diet of an elderly person than what is currently recommended.
此前,尚无大规模文献综述聚焦于老年人饮食蛋白质与其对骨矿物质密度(BMD)及骨折风险(作为骨骼健康指标)的影响之间的关系,以及其作为一级预防工具的潜在影响。
本研究旨在评估不同饮食蛋白质水平对骨骼健康的影响。
对有关老年人(>50岁)及动物饮食中不同蛋白质摄入量及其对BMD(人类和动物)和骨折风险(仅人类)影响的试验进行了文献综述。此外,还分析了这些研究中使用的饮食评估工具。
在评估人类BMD与饮食蛋白质数量的14项试验中,有10项以及动物试验中的3/4发现这两个参数之间存在正相关关系。在调查饮食蛋白质数量与骨折风险之间关系的7项试验中,有4项显示饮食蛋白质水平对骨折风险具有积极的保护作用。62%的研究使用了食物频率问卷评估方法。
饮食中蛋白质摄入量增加有益于骨骼健康,并降低发病率和死亡率。鉴于这样做会带来健康和成本效益,应强调将饮食蛋白质与钙和维生素D一起用作主要预防策略的重要性,老年人饮食中可能需要比目前建议的更高水平的蛋白质。