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Review
. 2018 Feb 23;13(2):e0192459.
doi: 10.1371/journal.pone.0192459. eCollection 2018.

Animal Versus Plant Protein and Adult Bone Health: A Systematic Review and Meta-Analysis From the National Osteoporosis Foundation

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Free PMC article
Review

Animal Versus Plant Protein and Adult Bone Health: A Systematic Review and Meta-Analysis From the National Osteoporosis Foundation

Marissa M Shams-White et al. PLoS One. .
Free PMC article

Abstract

Background: Protein may have both beneficial and detrimental effects on bone health depending on a variety of factors, including protein source.

Objective: The aim was to conduct a systematic review and meta-analysis evaluating the effects of animal versus plant protein intake on bone mineral density (BMD), bone mineral content (BMC) and select bone biomarkers in healthy adults.

Methods: Searches across five databases were conducted through 10/31/16 for randomized controlled trials (RCTs) and prospective cohort studies in healthy adults that examined the effects of animal versus plant protein intake on 1) total body (TB), total hip (TH), lumbar spine (LS) or femoral neck (FN) BMD or TB BMC for at least one year, or 2) select bone formation and resorption biomarkers for at least six months. Strength of evidence (SOE) was assessed and random effect meta-analyses were performed.

Results: Seven RCTs examining animal vs. isoflavone-rich soy (Soy+) protein intake in 633 healthy peri-menopausal (n = 1) and post-menopausal (n = 6) women were included. Overall risk of bias was medium. Limited SOE suggests no significant difference between Soy+ vs. animal protein on LS, TH, FN and TB BMD, TB BMC, and bone turnover markers BSAP and NTX. Meta-analysis results showed on average, the differences between Soy+ and animal protein groups were close to zero and not significant for BMD outcomes (LS: n = 4, pooled net % change: 0.24%, 95% CI: -0.80%, 1.28%; TB: n = 3, -0.24%, 95% CI: -0.81%, 0.33%; FN: n = 3, 0.13%, 95% CI: -0.94%, 1.21%). All meta-analyses had no statistical heterogeneity.

Conclusions: These results do not support soy protein consumption as more advantageous than animal protein, or vice versa. Future studies are needed examining the effects of different protein sources in different populations on BMD, BMC, and fracture.

Conflict of interest statement

Competing Interests: TW is a consultant for the National Osteoporosis Foundation and the Egg Nutrition Center through his consulting firm, the Think Healthy Group, Inc. CW is a board member for Pharmavite. MK receives royalties from two published books related to a plant-based diet. MSW, MC, ZF, KI, ML, SS, JoS, and JiS report no conflicts of interest. The specific roles of all authors are articulated in the ‘author contributions’ section. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Literature search and study selection process.
Fig 2
Fig 2. Effect of isoflavone-rich soy protein vs. animal protein intake on lumbar spine BMD in postmenopausal women.
Fig 3
Fig 3. Effect of isoflavone-rich soy protein vs. animal protein intake on femoral neck BMD in postmenopausal women.
Fig 4
Fig 4. Effect of isoflavone-rich soy protein vs. animal protein intake on total body BMD in postmenopausal women.

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