Protein intake and bone health: an umbrella review of systematic reviews for the evidence-based guideline of the German Nutrition Society

Zittermann A, Schmidt A, Haardt J, Kalotai N, Lehmann A, Egert S, Ellinger S, Kroke A, Lorkowski S, Louis SB, Schulze M, Schwingshackl L, Siener RI, Stangl G, Volkert D, Watzl BA, Bischoff-Ferrari H (2023)

Publication Type: Journal article, Review article

Publication year: 2023

Journal

Osteoporosis international Springer Verlag (Germany)

DOI: 10.1007/s00198-023-06709-7

Abstract

This umbrella review aimed at assessing whether a protein intake exceeding the current recommendation for younger (0.8 g/kg body weight [BW]/day) and older (1.0 g/kg BW/day) adults affects bone mineral density and fracture risk. Moreover, the effect of animal or plant protein was evaluated. A systematic literature search was conducted in PubMed, Embase, and Cochrane Database of Systematic Reviews for systematic reviews (SRs) with or without meta-analysis of prospective studies published between 11/2008 and 08/2021. Methodological quality, outcome-specific certainty of evidence, and overall certainty of evidence of the retrieved SRs were assessed using established tools and predefined criteria. Eleven SRs of randomized controlled trials (RCTs) and/or cohort studies were included. In SRs of cohort studies and RCTs, protein intake/kg BW/day ranged between 0.21–0.95 g (low intake) and > 1.24 g (high intake), respectively, and between 0.67–1.1 g (control groups) and 1.01–1.69 g (intervention groups), respectively. The vast majority of outcome-specific certainty of evidence was rated “low” or “very low.” The overall certainty of evidence for an association (cohort studies) or effect (RCTs) of total, animal or plant protein intake on each of the investigated outcomes was rated “insufficient,” with the exception of possible evidence for a reduced hip fracture risk by high vs. low protein intake. Since protein intakes in low/control and high/intervention groups were very heterogeneous and with low certainty of evidence, it remains unclear whether a dose above the current recommendation or type of protein intake (animal or plant protein) affects bone health overall. However, there is possible evidence for reduced hip fracture risk with high versus low protein intake.

Authors with CRIS profile

Dorothee Volkert Professur für Klinische Ernährung im Alter

Involved external institutions

Ruhr-Universität Bochum (RUB) DE Germany (DE) Deutsche Gesellschaft für Ernährung e.V. DE Germany (DE) Rheinische Friedrich-Wilhelms-Universität Bonn DE Germany (DE) Hochschule Fulda DE Germany (DE) Friedrich-Schiller-Universität Jena DE Germany (DE) Max-Rubner-Institut - Bundesforschungsinstitut für Ernährung und Lebensmittel DE Germany (DE) Deutsches Institut für Ernährungsforschung (DIfE) DE Germany (DE) Albert-Ludwigs-Universität Freiburg DE Germany (DE) Universitätsklinikum Bonn DE Germany (DE) Martin-Luther-Universität Halle-Wittenberg (MLU) DE Germany (DE) University of Zurich / Universität Zürich (UZH) CH Switzerland (CH)

How to cite

APA:

Zittermann, A., Schmidt, A., Haardt, J., Kalotai, N., Lehmann, A., Egert, S.,... Bischoff-Ferrari, H. (2023). Protein intake and bone health: an umbrella review of systematic reviews for the evidence-based guideline of the German Nutrition Society. Osteoporosis international. https://dx.doi.org/10.1007/s00198-023-06709-7

MLA:

Zittermann, Armin, et al. "Protein intake and bone health: an umbrella review of systematic reviews for the evidence-based guideline of the German Nutrition Society." Osteoporosis international (2023).

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