Protein and bone health across the lifespan
Protein and bone health across the lifespan
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DOI：
10.1017/s0029665118001180
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发表时间：
2019-02-01
影响因子：
7
通讯作者：
Sale, Craig
中科院分区：
文献类型：
--
作者：
Dolan, Eimear;Sale, Craig
骨骼健康取决于生命早期的骨质增生率，其次是与年龄相关的骨质流失率。膳食蛋白质摄入可能通过多效性机制途径在这两个阶段的骨骼健康中发挥作用。在此，我们总结了蛋白质对骨骼产生积极或消极影响的途径。在引言中，我们描述了酸灰假说，该假说指出，高蛋白质摄入可能会导致酸性残留物，必须通过从骨骼中浸出钙和其他矿物质来中和，从而导致脱矿质和骨质弱化。相反，正如“反对：蛋白质可能对骨骼产生负面影响的机制”部分所述，蛋白质摄入可能通过刺激各种合成代谢激素和生长因子的活性，或通过优化肌肉质量和功能来强化骨骼，而肌肉质量和功能本身具有成骨作用。这些对比途径的净效应在“对于：蛋白质可能对骨骼产生积极影响的机制”部分进行了描述，其中许多荟萃分析表明，较高的蛋白质摄入量对骨量和骨折风险具有较小的积极影响。有时建议摄入高于推荐的蛋白质摄入量，例如在生命周期的早期和后期或能源可用性降低期间。我们得出的结论是，蛋白质是骨骼健康的重要营养素，尽管需要进一步研究来阐明其发挥影响的机制途径，并阐明其数量、食物来源和时间，以优化这种保护性影响并最终降低骨折风险。
Bone health is determined by the rate of accrual in early life, followed by the rate of age-associated bone loss. Dietary protein intake might have a role in bone health across both of these phases via pleiotropic mechanistic pathways. Herein we summarise the pathways through which protein may exert either a positive or negative influence on bone. In the introduction, we describe the acid-ash hypothesis, which states that a high-protein intake may lead to an acidic residue that must be neutralised through the leaching of calcium and other minerals from the bone, subsequently leading to demineralisation and bone weakening. Conversely, and as described in the 'Against: mechanisms through which protein may negatively impact bone' section, protein intake may act to strengthen the bone by stimulating the activity of various anabolic hormones and growth factors, or by optimising muscle mass and functionality, which itself has an osteogenic influence. The net effect of these contrasting pathways is described in the 'For: mechanisms through which protein may positively impact bone' section, where a number of meta-analyses have demonstrated that higher protein intakes have a small positive impact on bone mass and fracture risk. Sometimes higher than recommended protein intakes are advised, e.g. during the earlier and later phases of the lifespan or during reduced energy availability. We conclude that protein is an essential nutrient for bone health, although further research is required to clarify the mechanistic pathways through which it exerts its influence, along with the clarification of the quantities, food sources and timing to allow for the optimisation of this protective influence and ultimately a reduction in fracture risk.