The effects of dietary protein on bone mineral mass in young adults may be modulated by adolescent calcium intake.

The effect of dietary protein on bone mass measures at different life stages is controversial. We investigated the influence of protein intake on bone mass measures in young adults, considering the influence of calcium intake through adolescence. Subjects were 133 young adults (59 males, 74 females) who were participating in the Saskatchewan Pediatric Bone Mineral Accrual Study (1991-1997, 2003-2006). At adulthood, their mean age was 23 y. We assessed dietary intake via serial 24-h recalls carried out at least once yearly. Total body (TB) bone mineral content (BMC) and TB bone mineral density (BMD) were assessed annually using Dual energy X-ray absorptiometry. We determined TB-BMC net gain from the age of peak height velocity (PHV) to early adulthood. We analyzed data from all subjects and subsets based on sex and calcium intake using multiple regression. TB-BMC significantly increased from age at PHV to early adulthood by 41% in males and 37% in females. Height, weight, physical activity, and sex were significant predictors of TB-BMC, TB-BMC net gain, and TB-BMD among all subjects. Protein intake predicted TB-BMC net gain in all subjects (beta = 0.11; P = 0.015). In females at peri-adolescence or early adulthood with adequate calcium intake (>1000 mg/d), protein intake positively predicted TB-BMC, TB-BMC net gain, and TB-BMD (P < 0.05). Our results indicate that when calcium intake is adequate, protein intake has a beneficial effect on the bone mass of young adult females. Protein, in the absence of sufficient calcium, does not confer as much benefit to bone.