ArticleThe American journal of clinical nutrition2014
Biomarker-calibrated protein intake and bone health in the Women's Health Initiative clinical trials and observational study.
Article in The American journal of clinical nutrition, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 4 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Pooled it
- Association between total and animal proteins with risk of fracture: A systematic review and dose-response meta-analysis of cohort studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Pooled it
- Dietary protein and bone health across the life-course: an updated systematic review and meta-analysis over 40 years.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Pooled it
- The relationship between dietary protein consumption and risk of fracture: a subgroup and dose-response meta-analysis of prospective cohort studies.Scientific reports · 2015Pooled it
- The Effects of 12-Weeks Whey Protein Supplements on Markers of Bone Turnover in Adults With Abdominal Obesity - AFrontiers in endocrinology · 2022Trial
- Whey Protein Supplementation and Higher Total Protein Intake Do Not Influence Bone Quantity in Overweight and Obese Adults Following a 36-Week Exercise and Diet Intervention.The Journal of nutrition · 2017Trial
- Association of Protein Intake with Bone Mineral Density and Bone Mineral Content among Elderly Women: The OSTPRE Fracture Prevention Study.The journal of nutrition, health & aging · 2017Trial
- Risk Factors for Hip Fracture in Older Men: The Osteoporotic Fractures in Men Study (MrOS).Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2016Trial
- Amino Acid Intakes Are Associated With Bone Mineral Density and Prevalence of Low Bone Mass in Women: Evidence From Discordant Monozygotic Twins.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2016Trial
- The Effect of a Whey Protein Supplement on Bone Mass in Older Caucasian Adults.The Journal of clinical endocrinology and metabolism · 2015Trial
- Sex Differences in the Effects of Weight Loss Diets on Bone Mineral Density and Body Composition: POUNDS LOST Trial.The Journal of clinical endocrinology and metabolism · 2015Trial
- Article
- The Effect of Protein Intake on Bone Disease, Kidney Disease, and Sarcopenia: A Systematic Review.Current developments in nutrition · 2025Review
- Is it advisable for Asians to drink milk, especially those at risk of osteoporosis?Frontiers in nutrition · 2025Review
- Impact of Dietary Protein on Osteoporosis Development.Nutrients · 2023Review
- The Influences of Macronutrients on Bone Mineral Density, Bone Turnover Markers, and Fracture Risk in Elderly People: A Review of Human Studies.Nutrients · 2023Review
- Enhancing Capacity for Food and Nutrient Intake Assessment in Population Sciences Research.Annual review of public health · 2023Review
- Article
- Establishing 24-Hour Urinary Sucrose Plus Fructose as a Predictive Biomarker for Total Sugars Intake.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022Article
- Evaluation of potential metabolomic-based biomarkers of protein, carbohydrate and fat intakes using a controlled feeding study.European journal of nutrition · 2021Article
Corrections and comments
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Authors and funding
11 authors at 8 institutions in 2 countries.
Funding
Abstract
backgroundThe effects of dietary protein on bone health are controversial.
objectiveWe examined the relation between protein intake with fracture and bone mineral density (BMD) within the Women's Health Initiative (WHI).
designThis prospective analysis included 144,580 women aged 50-79 y at baseline in the WHI clinical trials (CTs) and observational study (OS) that recruited participants in 1993-1998 with follow-up through 2011. Self-reported clinical fractures were collected semiannually through the original end of the trials (WHI CTs) and annually (WHI OS) by questionnaires. Hip fracture was adjudicated by a central review of radiology reports. BMDs for total body, hip, and spine were measured at baseline and 3 and 6 y in 9062 women at 3 WHI clinics by using dual-energy X-ray absorptiometry. Protein intake was assessed via food-frequency questionnaire and calibrated by using biomarkers of energy and protein intakes. Associations between protein intake and fracture were estimated by using Cox proportional hazards regression, and the relation between protein intake and BMD was estimated by using linear regression.
resultsMedian biomarker-calibrated protein intake was 15% of energy intake. Per 20% increase in calibrated protein intake (percentage of energy), there was no significant association with total fracture (HR: 0.99; 95% CI: 0.97, 1.02) or hip fracture (HR: 0.91; 95% CI: 0.84, 1.00), but there was an inverse association with forearm fracture (HR: 0.93; 95% CI: 0.88, 0.98). Each 20% increase in calibrated protein intake was associated with a significantly higher BMD for total body (mean 3-y change: 0.003 g/cm²; 95% CI: 0.001, 0.005 g/cm²) and hip (mean 3-y change: 0.002 g/cm²; 95% CI: 0.001, 0.004 g/cm²).
conclusionsHigher biomarker-calibrated protein intake within the range of usual intake was inversely associated with forearm fracture and was associated with better maintenance of total and hip BMDs. These data suggest higher protein intake is not detrimental to bone health in postmenopausal women.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.