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American Journal of Clinical Nutrition, Vol. 70, No. 2, 303, August 1999
© 1999 American Society for Clinical Nutrition

Letters to the Editor

Protein intake and the risk of hip fracture in postmenopausal women

Jay B Lavine

PO Box 45409 Phoenix, AZ 85064-5409

Dear Sir:

I read with interest the study by Munger et al (1), who reported a negative association between protein intake and the risk of hip fracture in postmenopausal women. They also reported a negative association between total carbohydrate intake, which was higher in the women with hip fractures than in those without hip fractures, and animal protein intake. A high consumption of sugars increases the urinary excretion of calcium and magnesium (2–4) and may well be a risk factor for osteoporosis (5). It would have been useful, therefore, to have controlled for simple carbohydrate intake in the multivariate analyses. Similarly, a high sodium intake increases the urinary excretion of calcium and represents a risk factor for osteoporosis (6, 7). Controlling for dietary sodium would also have been of value.

REFERENCES

  1. Munger RG, Cerhan JR, Chiu BC-H. Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. Am J Clin Nutr 1999;69:147–52.[Abstract/Free Full Text]
  2. Lindeman RD, Adler S, Yiengst MJ, Beard ES. Influence of various nutrients on urinary divalent cation excretion. J Lab Clin Med 1967;70:236–45.[Medline]
  3. Lemann J Jr, Lennon EJ, Piering WR, Prien EL Jr, Ricanati ES. Evidence that glucose ingestion inhibits net renal tubular reabsorption of calcium and magnesium in man. J Lab Clin Med 1970;75:578–85.[Medline]
  4. Nguyen NU, Dumoulin G, Wolf JP, Berthelay S. Urinary calcium and oxalate excretion during oral fructose or glucose load in man. Horm Metab Res 1989;21:96–9.[Medline]
  5. Trichopoulou A, Georgiou E, Bassiakos Y, et al. Energy intake and monounsaturated fat in relation to bone mineral density among women and men in Greece. Prev Med 1997;26:395–400.[Medline]
  6. Cappuccio FP. Dietary prevention of osteoporosis: are we ignoring the evidence? Am J Clin Nutr 1996;63:787 (letter).[Free Full Text]
  7. Evans CEL, Chughtai AY, Blumsohn A, Giles M, Eastell R. The effect of dietary sodium on calcium metabolism in premenopausal and postmenopausal women. Eur J Clin Nutr 1997;51:394–9.[Medline]




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