PDF(Pubmed)
Abstract：
This umbrella review aimed at assessing whether a protein intake exceeding the current recommendation for younger (0.8 g/kg body weight [BW]/day) and older (1.0 g/kg BW/day) adults affects bone mineral density and fracture risk. Moreover, the effect of animal or plant protein was evaluated. A systematic literature search was conducted in PubMed, Embase, and Cochrane Database of Systematic Reviews for systematic reviews (SRs) with or without meta-analysis of prospective studies published between 11/2008 and 08/2021. Methodological quality, outcome-specific certainty of evidence, and overall certainty of evidence of the retrieved SRs were assessed using established tools and predefined criteria. Eleven SRs of randomized controlled trials (RCTs) and/or cohort studies were included. In SRs of cohort studies and RCTs, protein intake/kg BW/day ranged between 0.21-0.95 g (low intake) and > 1.24 g (high intake), respectively, and between 0.67-1.1 g (control groups) and 1.01-1.69 g (intervention groups), respectively. The vast majority of outcome-specific certainty of evidence was rated \"low\" or \"very low.\" The overall certainty of evidence for an association (cohort studies) or effect (RCTs) of total, animal or plant protein intake on each of the investigated outcomes was rated \"insufficient,\" with the exception of possible evidence for a reduced hip fracture risk by high vs. low protein intake. Since protein intakes in low/control and high/intervention groups were very heterogeneous and with low certainty of evidence, it remains unclear whether a dose above the current recommendation or type of protein intake (animal or plant protein) affects bone health overall. However, there is possible evidence for reduced hip fracture risk with high versus low protein intake.
摘要：
这项综述旨在评估蛋白质摄入量是否超过目前建议的年轻人（0.8g/kg体重[BW]/天）和老年人（1.0g/kg体重/天）影响骨矿物质密度和骨折风险。此外，评估了动物或植物蛋白的作用。在PubMed进行了系统的文献检索，Embase,和Cochrane系统评价数据库，用于系统评价（SRs），有或没有对11/2008和2021之间发表的前瞻性研究进行荟萃分析。方法学质量,结果特定的证据确定性，使用已建立的工具和预定义的标准对检索到的SRs的证据的总体确定性进行评估。纳入11项SR的随机对照试验（RCTs）和/或队列研究。在队列研究和随机对照试验的SRs中，蛋白质摄入量/kgBW/day介于0.21-0.95g（低摄入量）和>1.24g（高摄入量）之间，分别,在0.67-1.1g（对照组）和1.01-1.69g（干预组）之间，分别。绝大多数结果特定的证据确定性被评为“低”或“非常低”。“总体关联（队列研究）或影响（RCT）的证据的总体确定性，每个调查结果的动物或植物蛋白摄入量被评为“不足，“除了可能的证据表明髋部骨折风险较高与蛋白质摄入量低。由于低/对照组和高/干预组的蛋白质摄入量非常不同，并且证据的确定性较低，目前尚不清楚超过当前推荐剂量或蛋白质摄入类型(动物或植物蛋白)是否会影响整体骨骼健康.然而,有可能的证据表明，高与低蛋白质摄入量的髋部骨折风险降低。
