Do high-protein diets cause osteoporosis?

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The prospect of stripping off and revealing our true selves on the beach or by the pool this summer will inevitably have some of us taking steps to shed some excess weight. I notice that one tabloid newspaper is spearheading a resurgence of the Atkins diet in the form of a plan specifically targeting those wishing to get slim for their hols. My experience is that the extreme carbohydrate restriction this diet demands is likely to lead to relatively rapid weight loss in those for whom time is of the essence. However, the relative paucity of nutritious fare such as fruit and veg in a diet of this nature means that it is unlikely to represent a particularly healthy way to attain and maintain a healthy weight for seasons to come.

The Atkins diet has come under criticism not just because of its restriction of nourishing plant foods, but for other reasons too including its supposed ability to increase the risk of osteoporosis. The high-protein nature of the Atkins diet will increase acidity in the bloodstream, in response to which the body will tend to liberate alkaline compounds such as carbonate and citrate from the bone. Unfortunately, this process involves loss of calcium from the bone too. This mechanism has generally been taken to explain why it is that when individuals are fed a high-protein diet, higher levels of calcium can be detected in their urine.

However, while this phenomenon is traditionally explained through the potential for protein to leech calcium from the bone, there is research which shows that protein in the diet increases the absorption of calcium from the gut. This mechanism provides an alternative explanation for why a high-protein diet can cause calcium levels to rise in the urine, and also opens up the possibility that protein may actually help supply the body with the calcium it needs for optimal bone formation.

Support for this theory has recently come from a study published in the American Journal of Clinical Nutrition. In it, researchers examined the relationship between in protein consumption and bone health in a more than 1000 women averaging 75 years in age. Higher protein intakes were associated with improvements in both the bone density in the hip, and the quality of the bone in the heel. This study is actually part of a considerable body of research which has explored the relationship between protein intake and bone health. As is often the case in science, the findings of these studies are not utterly consistent. However, most studies have found that higher protein intakes are associated with generally improved bone density.

The evidence suggests that including protein-rich foods including such as meat, fish and eggs in the diet is more likely to contribute to, rather than detract from, bone health in the long term. Other foods likely to boost bone health include fruit and vegetables. These foods ‘alkalinise’ the body, and therefore help to offset any calcium-leeching effects dietary protein may have. It seems that those eating a diet rich in primal foods such as meat, fish, eggs, fruit and vegetables are likely to feel it in their bones.

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