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School of Allied Health, University of Connecticut (J.E.K.), Storrs, Connecticut 06269; the Departments of Internal Medicine (M.E.M., A.F.E., K.L.I.), Orthopedics and Rehabilitation (C.M.G.), and Pediatrics (T.O.C.), Yale University School of Medicine, New Haven, Connecticut 06520; and the Adult Clinical Research Center and Food and Nutritional Services, Yale University School of Medicine and Yale New Haven Hospital (D.M.C.), New Haven, Connecticut 06504
Address all correspondence and requests for reprints to: Dr. Jane E. Kerstetter, School of Allied Health, U-2101, 358 Mansfield Road, University of Connecticut, Storrs, Connecticut 06269-2101.
Although high protein diets are known to increase urinary calcium excretion and induce negative calcium balance, the impact of dietary protein on bone turnover and fractures is controversial. We therefore evaluated the effect of dietary protein on markers of bone turnover in 16 healthy young women. The experiment consisted of 2 weeks of a well balanced diet containing moderate amounts of calcium, sodium, and protein followed by 4 days of an experimental diet containing one of three levels of protein (low, medium, or high). On day 4, serum and urinary calcium, serum PTH, 1,25-dihydroxyvitamin D, serum osteocalcin, bone-specific alkaline phosphatase, and urinary N-telopeptide excretion were measured. Urinary calcium excretion was significantly higher on the high than on the low protein diet. Secondary hyperparathyroidism occurred on the low protein diet. Urinary N-telopeptide excretion was significantly greater during the high protein than during the low protein intake (48.2 ± 7.2 vs. 32.7 ± 5.3 nM bone collagen equivalents/mM creatinine; P < 0.05). There was no increase in osteocalcin or bone-specific alkaline phosphatase when comparing the low to the high diet, suggesting that bone resorption was increased without a compensatory increase in bone formation. Our data suggest that at high levels of dietary protein, at least a portion of the increase in urinary calcium reflects increased bone resorption.
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