In older people with osteoporosis , higher protein intake ( ≥ 0.8-g/kg body weight/day , i.e. , above the current RDA ) is associated with higher BMD , a slower rate of bone loss , and reduced risk of hip fracture , provided that dietary calcium intakes are adequate .
Intervention with dietary protein supplements attenuate age-related BMD decrease and reduce bone turnover marker levels , together with an increase in IGF-I and a decrease in PTH .
There is no evidence that diet-derived acid load is deleterious for bone health .
Thus , insufficient dietary protein intakes may be a more severe problem than protein excess in the elderly .
A summary of systematic review s and meta-analyses addressing the benefits and risks of dietary protein intakes  for  bone health in adults suggests that dietary protein levels even above the current RDA may be beneficial in reducing bone loss and hip fracture risk , provided calcium intakes are adequate .
Several systematic review s and meta-analyses have addressed the benefits and risks of dietary protein intakes for bone health in adults .
Adequate supplies of dietary protein are required for optimal bone growth and maintenance of healthy bone .
Variation in protein intakes within the “ normal ” range accounts for 2–4 % of BMD variance in adults .
Effect of potassium citrate on bone density, microarchitecture, and fracture risk in healthy older adults without osteoporosis: a randomized controlled trial.
CONTEXT The acid load imposed by a modern diet may play an important role in the pathophysiology of osteoporosis . OBJECTIVE Our objective was to evaluate the skeletal efficacy and safety and the effect on fracture prediction of K-citrate to neutralize diet-induced acid loads . DESIGN AND SETTING We conducted a r and omized , double-blind , placebo-controlled trial at a teaching hospital . SUBJECTS Subjects included 201 elderly ( > 65 yr old ) healthy men and women ( t-score of -0.6 at lumbar spine ) . INTERVENTION Intervention was 60 mEq of K-citrate daily or placebo by mouth . All subjects received calcium and vitamin D. OUTCOME MEASURES The primary outcome was change in areal bone mineral density ( aBMD ) at the lumbar spine by dual-energy x-ray absorptiometry after 24 months . Secondary endpoints included changes in volumetric density and microarchitectural parameters by high-resolution peripheral quantitative computed tomography in both radii and both tibiae and fracture risk assessment by FRAX ( Switzerl and ) . RESULTS K-citrate  increased aBMD at lumbar spine from baseline by 1.7 ± 1.5 % [ 95 % confidence interval ( CI ) = 1.0 - 2.3 , P < 0.001 ] net of placebo after 24 months . High-resolution peripheral quantitative computed tomography-measured trabecular densities increased at nondominant tibia ( 1.3 ± 1.3 % , CI = 0.7 - 1.9 , P < 0.001 ) and nondominant radius ( 2.0 ± 2.0 % , CI = 1.4 - 2.7 , P < 0.001 ) . At nondominant radius , trabecular bone volume/tissue volume increased by 0.9 ± 0.8 % , ( CI = 0.1 - 1.7 ) , trabecular thickness by 1.5 ± 1.6 % ( CI = 0.7 - 2.3 ) , and trabecular number by 1.9 ± 1.8 % ( CI = 0.7 - 3.1 , for all , P < 0.05 ) . K-citrate  diminished fracture prediction score by FRAX significantly in both sexes . CONCLUSIONS Among a group of healthy elderly persons without osteoporosis , treatment with K-citrate for 24 months result ed in a significant increase in aBMD and volumetric BMD at several sites tested , while also improving bone microarchitecture . Based on the effect on fracture prediction , an effect on future fractures by K-citrate is possible
In older people with osteoporosis , higher protein intake ( ≥ 0.8-g/kg body weight/day , i.e. , above the current RDA ) is associated with higher BMD , a slower rate of bone loss , and reduced risk of hip fracture , provided that dietary calcium intakes are adequate .
Intervention with dietary protein supplements attenuate age-related BMD decrease and reduce bone turnover marker levels , together with an increase in IGF-I and a decrease in PTH .
There is no evidence that diet-derived acid load is deleterious for bone health .
Thus , insufficient dietary protein intakes may be a more severe problem than protein excess in the elderly .
A summary of systematic review s and meta-analyses addressing the benefits and risks of dietary protein intakes  for  bone health in adults suggests that dietary protein levels even above the current RDA may be beneficial in reducing bone loss and hip fracture risk , provided calcium intakes are adequate .
Several systematic review s and meta-analyses have addressed the benefits and risks of dietary protein intakes for bone health in adults .
Adequate supplies of dietary protein are required for optimal bone growth and maintenance of healthy bone .
Variation in protein intakes within the “ normal ” range accounts for 2–4 % of BMD variance in adults .