The Effect of Protein Supplementation on Bone Health in Healthy Older Men and Women

Phase 1

Completed

Conditions: Bone Resorption
Osteoporosis

Interventions: Dietary Supplement: Whey protein supplement
Dietary Supplement: Placebo

Registration Number: NCT00421408

Lead Sponsor: Yale University

Brief Summary: Women and men consuming a low protein diet may be at risk for bone loss. The purpose of this study is to determine whether a daily protein supplement will improve bone health among healthy older adults.

Detailed Description: Dietary protein plays an important role in maintaining balanced calcium levels in the body. Protein's impact on skeletal health remains unclear. It is well accepted that increasing dietary protein results in greater excretion of calcium through urine. The excreted calcium is thought to come in part from bone, which would suggest a negative effect on bone health. However, recent studies have found that higher protein intake is, in fact, associated with higher bone mineral density and lower rates of bone loss. The purpose of this study is to determine if a daily protein supplement will improve bone health and hormonal measures of bone metabolism among healthy older men and women who consume low-to-normal levels of dietary protein.

This study will last 18 months. For the duration of the study, participants will be randomly assigned to receive either a 40-gram protein supplement or placebo daily. There will be a total of nine study visits that will occur at screening, study entry, Month 1.5, and every three months thereafter. Dietary records, nutritional counseling, glucose finger stick tests, and questionnaires related to falls, physical activity, habits, and study satisfaction will occur at all study visits. Blood and urine collection, functional testing, and bone mineral density (BMD) testing will occur at selected visits. At Months 0 and 18, half of the participants will undergo a quantitative computed tomography (CT) scan to determine bone mineral density.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 208

Inclusion Criteria

Willing to travel to one of the study sites
Women age 60 years or greater, men age 70 years or greater
Dietary protein intake level between 0.6 g/kg and 1.0 g/kg at baseline

Exclusion Criteria

Active Paget's disease
Primary hyperparathyroidism or unexplained hypercalcemia
Untreated hyperthyroidism or hyperthyroidism that has resulted from medical treatment
Diabetes mellitus type 1
Cancer diagnosis for solid malignancies (e.g., cancer of the colon, breast,prostate, lungs, lymphocytes) within the 18 months prior to study entry
Long-term use of chemotherapeutic drugs, aromatase inhibitors, or tamoxifen
Active treatment for leukemia or multiple myeloma
Active inflammatory bowel disease
Life expectancy of less than 2 years
Current and ongoing use of methotrexate, phenytoin, phenobarbital, or inhaled corticosteroids at a dose of greater than 800 mcg/day
Use of raloxifene, estrogen, androgen, progesterone, soy isoflavones, oral glucocorticoids, or herbal supplements with estrogenic activity OR a change in dosage of thyroid medications within the 1 year prior to study entry if unwilling to avoid such agents during the duration of the study
Current use of antiresorptive agents (e.g., calcitonin or bisphosphonates). More information about this criterion can be found in the protocol.
serum creatinine greater than 1.2 mg/dl
History of chronic liver disease or evidence of liver disease at screening
Bilateral hip replacement
women who have a bone mineral density T-score < -2.5 at either the hip or spine unless they have decided to decline treatment with conventional anti-osteoporotic medications
Body mass index (BMI) greater than 32 or less than 19
Use of proton-pump inhibitors taken twice daily
Fasting glucose level greater than 110 mg/dl
Serum albumin level less than 3.0 mg/dl
Kidney stones or history of kidney stones within the 3 years prior to study entry

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Protein powder	Whey protein supplement	Participants will receive a protein supplement daily (40 g whey protein supplement).
Placebo carbohydrate	Placebo	Participants will receive a placebo supplement daily (40 g maltodextrin).

Primary Outcome Measures

Name	Time	Method
Change in Spine Bone Mineral Density Measured by Quantitative Computed Tomography (QCT) Compared to Baseline	Measured at baseline and 18 months	There is no normative data for quantitative computed tomography it is based on local experience.
Spine Bone Mineral Density Measured by Quantitative Computed Tomography (QCT) at Baseline	Measured at 0 months	There is no normative data for quantitative computed tomography it is based on local experience.
Anterior-posterior Spine Bone Mineral Density Measured by Dual Energy X-ray Absorptiometry (DXA) at 18 Months	Measured at 18 months	There is no absolute normative range for bone mineral density. Population norms have been established for specific races and men and women for the hip based on data collected by National Health Examination Nutrition Surveys (NHANES) and for the spine based largely on data collected by individual manufacturers. Values within 1 standard deviation of the population mean are generally considered normal. Values below 1 standard deviation from the population mean are generally considered to reflect reduced bone mass.
Change in Anterior-posterior Spine Bone Mass Density Measured by Dual Energy X-ray Absorptiometry (DXA) Compared to Baseline	Measured at baseline and 18 months	There is no absolute normative range for bone mineral density. Population norms have been established for specific races and men and women for the hip based on data collected by National Health Examination Nutrition Surveys (NHANES) and for the spine based largely on data collected by individual manufacturers. Values within 1 standard deviation of the population mean are generally considered normal. Values below 1 standard deviation from the population mean are generally considered to reflect reduced bone mass.
Anterior-posterior Spine Bone Mineral Density Measured by Dual Energy X-ray Absorptiometry (DXA) at Baseline	Measured at 0 months	There is no absolute normative range for bone mineral density. Population norms have been established for specific races and men and women for the hip based on data collected by National Health Examination Nutrition Surveys (NHANES) and for the spine based largely on data collected by individual manufacturers. Values within 1 standard deviation of the population mean are generally considered normal. Values below 1 standard deviation from the population mean are generally considered to reflect reduced bone mass.
Anterior-posterior Spine Bone Mineral Density Measured by Dual Energy X-ray Absorptiometry (DXA) at 9 Months	Measured at 9 months	There is no absolute normative range for bone mineral density. Population norms have been established for specific races and men and women for the hip based on data collected by National Health Examination Nutrition Surveys (NHANES) and for the spine based largely on data collected by individual manufacturers. Values within 1 standard deviation of the population mean are generally considered normal. Values below 1 standard deviation from the population mean are generally considered to reflect reduced bone mass.
Spine Bone Mineral Density Measured by Quantitative Computed Tomography (QCT) at 18 Months	Measured at 18 months	There is no normative data for quantitative computed tomography it is based on local experience.

Secondary Outcome Measures

Name	Time	Method

Trial Locations

Locations (2): University of Connecticut Health Center
🇺🇸
Farmington, Connecticut, United States
Yale University
🇺🇸
New Haven, Connecticut, United States