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The effect of a high-protein, high-sodium diet on calcium and bone metabolism in postmenopausal women and its interaction with vitamin D receptor genotype

  • Mary Harrington (a1), Teresa Bennett (a1), Jette Jakobsen (a2), Lars Ovesen (a2), Christine Brot (a2), Albert Flynn (a1) and Kevin D. Cashman (a1) (a3)...

Abstract

The influence of a high-Na, high-protein (calciuric) diet on Ca and bone metabolism was investigated in postmenopausal women (aged 50–67 years) who were stratified by vitamin D receptor (VDR) genotype. In a crossover trial, twenty-four women were randomly assigned to a diet high in protein (90 g/d) and Na (180 mmol/d) or a diet adequate in protein (70 g/d) and low in Na (65 mmol/d) for 4 weeks, followed by crossover to the alternative dietary regimen for a further 4 weeks. Dietary Ca intake was maintained at usual intakes (about 20 mmol (800 mg)/d). Urinary Na, K, Ca, N and type I collagen cross-linked N-telopeptide (NTx; a marker of bone resorption), plasma parathyroid hormone (PTH), serum 25-hydroxycholecalciferol (25(OH)D3), 1,25-dihydroxycholecalciferol (1,25(OH)2D3), osteocalcin and bone-specific alkaline phosphatase (B-Alkphase) were measured in 24 h urine samples and fasting blood samples collected at the end of each dietary period. The calciuric diet significantly (P<0·05) increased mean urinary Na, N, K, Ca and NTx (by 19 %) compared with the basal diet, but had no effect on circulating 25(OH)D3, 1,25(OH)2D3, PTH, osteocalcin or B-Alkphase in the total group (n 24). There were no differences in serum markers or urinary minerals between the basal and calciuric diet in either VDR genotype groups. While the calciuric diet significantly increased urinary NTx (by 25·6 %, P<0·01) in the f+ VDR group (n 10; carrying one or more (f) Fok I alleles), it had no effect in the f− VDR group (n 14; not carrying any Fok I alleles). It is concluded that the Na- and protein-induced urinary Ca loss is compensated for by increased bone resorption and that this response may be influenced by VDR genotype.

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*Corresponding author: Professor Kevin D. Cashman, fax +353 21 4270244, email k.cashman@ucc.ie

References

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Allen, LH, Bartlett, RS & Block, GD (1979 a) Reduction of renal calcium reabsorption in man by consumption of dietary protein. J Nutr 109, 13451350.
Allen, LH, Oddoye, EA & Margen, S (1979 b) Protein-induced hypercalciuria: a longer term study. Am J Clin Nutr 32, 741749.
Ames, SK, Ellis, KJ, Gunn, SK, Copeland, KC & Abrams, SA (1999) Vitamin D receptor gene Fok1 polymorphism predicts calcium absorption and bone mineral density in children. J Bone Miner Res 14, 740746.
Arai, H, Miyamoto, K & Taketani, Y, et al. (1997) A vitamin D receptor gene polymorphism in the translation initiation codon: effect on protein activity and relation to bone mineral density in Japanese women. J Bone Miner Res 12, 915921.
Association of Official Analytical Chemists (AOAC) (1995). Official Methods of Analysis of the AOAC [Cunniff, P, editor]. Arlington, VA: The Association of Official Analytical Chemists International.
Bell, RR, Eldrid, MM & Watson, FR (1992) The influence of NaCl and KCl on urinary calcium excretion in healthy young women. Nutr Res 12, 1726.
Breslau, NA, McGuire, JL, Zerwekh, JE & Pak, CY (1982) The role of dietary sodium on renal excretion and intestinal absorption of calcium and on vitamin D metabolism. J Clin Endocrinol Metab 55, 369373.
Breslau, NA, Sakhaee, K & Pak, CY (1985) Impaired adaptation to salt-induced urinary calcium losses in postmenopausal osteoporosis. Trans Assoc Am Physicians 98, 107115.
Castenmiller, JJ, Mensink, RP, van der Heijden, L, et al. (1985) The effect of dietary sodium on urinary calcium and potassium excretion in normotensive men with different calcium intakes. Am J Clin Nutr 41, 5260.
Chan, EL, Ho, CS, MacDonald, D, Ho, SC, Chan, TY & Swaminathan, R (1992) Interrelationships between urinary sodium, calcium, hydroxyproline and serum PTH in healthy subjects. Acta Endocrinol 127, 242245.
Chan, EL & Swaminathan, R (1994) The effect of high protein and high salt intake for 4 months on calcium and hydroxyproline excretion in normal and oophorectomized rats. J Lab Clin Med 124, 3741.
Chan, W, Brown, J & Buss, DH (1994) Miscellaneous Foods. Fourth supplement to McCance & Widdowson's The Composition of Foods, 6th ed. Royal Society of Chemistry and Ministry of Agriculture, Fisheries and Food. London: H. M. Stationery Office.
Chan, W, Brown, J, Lee, SM & Buss, DH (1995) Meat, Poultry and Game. Supplement to McCance & Widdowson's The Composition of Foods, 5th ed. Royal Society of Chemistry and Ministry of Agriculture, Fisheries and Food. London: H. M. Stationery Office.
Chan, W, Brown, J, Lee, SM & Buss, DH (1996) Meat Products and Dishes. Supplement to McCance & Widdowson's The Composition of Foods, 5th ed. Royal Society of Chemistry and Ministry of Agriculture, Fisheries and Food. London: H. M. Stationery Office.
Cohen, AJ & Roe, FJC (2000) Review of risk factors for osteoporosis with particular reference to a possible aetiological role of dietary salt. Food Chem Toxicol 38, 237253.
Dawson-Hughes, B & Harris, SS (2002) Calcium intake influences the association of protein intake with rates of bone loss in elderly men and women. Am J Clin Nutr 75, 773779.
Draper, HH, Piche, LA & Gibson, RS (1991) Effects of a high protein intake from common foods on calcium metabolism in a cohort of postmenopausal women. Nutr Res 11, 273281.
Englyst, HN & Cummings, JH (1988) Improved method for measurement of dietary fibre as non-starch polysaccharides in plant foods. J Assoc Off Anal Chem 71, 808814.
Eriksen, EF, Melsen, F & Mosekilde, L (1984) Reconstruction of the resorptive site in iliac trabecular bone: a kinetic model for bone resorption in 20 normal individuals. Metab Bone Dis Relat Res 5, 235242.
Evans, CEL, Chughtai, AY, Blumsohn, A, Giles, M & Eastell, R (1997) The effect of dietary sodium on calcium metabolism in premenopausal and postmenopausal women. Eur J Clin Nutr 51, 394399.
Garel, JM (1987) Hormonal control of calcium metabolism during the reproductive cycle in mammals. Physiol Rev 67, 166.
Garnero, P, Sornay-Rendu, E, Claustrat, B & Delmas, PD (2000) Biochemical markers of bone turnover, endogenous hormones and the risk of fractures in postmenopausal women; the OFELY study. J Bone Mineral Res 15, 15261536.
Garnero, P, Hausherr, E & Chapuy, MC, et al. (1996) Markers of bone resorption predict hip fracture in elderly women: the EPIDOS Prospective Study. J Bone Mineral Res 11, 15311538.
Ginty, F, Cashman, KD & Flynn, A (1998 a) An investigation of the relationships between urinary potassium, sodium, calcium and deoxypyridinoline excretion in healthy young adults. Osteoporos Int 8, 74.
Ginty, F, Flynn, A & Cashman, KD (1998 b) The effect of dietary sodium intake on biochemical markers of bone metabolism in young women. Br J Nutr 79, 343350.
Goulding, A & Campbell, D (1984) Hypocalciuric effects of hydrochlorothiazide in the rat during NaHCO 3, NaCl and NH 4 Cl loading. Ren Physiol 7, 185191.
Gross, C, Eccleshall, TR, Malloy, PJ, Villa, ML, Marcus, R & Feldman, D (1996) The presence of a polymorphism at the translation initiation site of the vitamin D receptor gene is associated with low bone mineral density in post-menopausal Mexican-American women. J Bone Mineral Res 11, 18501855.
Heaney, RP (1993) Protein intake and the calcium economy. J Am Diet Assoc 93, 12591260.
Heaney, RP (1998) Excess dietary protein may not adversely affect bone. J Nutr 128, 10541057.
Heaney, RP & Recker, RR (1982) Effects of nitrogen, phosphorus, and caffeine on calcium balance in women. J Lab Clin Med 99, 4655.
Hegsted, M, Schuette, SA, Zemel, MB & Linkswiler, HM (1981) Urinary calcium and calcium balance in young men as affected by level of protein and phosphorus intake. J Nutr 111, 553562.
Holland, B, Brown, J & Buss, DH (1993) Fish and Fish Products. Third Supplement to McCance & Widdowson's The Composition of Foods, 5th ed. Royal Society of Chemistry and Ministry of Agriculture, Fisheries and Food. London: H. M. Stationery Office.
Holland, B, Unwin, ID & Buss, DH (1988) Cereals and Cereal Products. Third Supplement to McCance & Widdowson's The Composition of Foods, 5th ed. Royal Society of Chemistry and Ministry of Agriculture, Fisheries and Food. London: H. M. Stationery Office.
Holland, B, Unwin, ID & Buss, DH (1989) Milk Products and Eggs. Fourth Supplement to McCance & Widdowson's The Composition of Foods, 4th ed. Royal Society of Chemistry and Ministry of Agriculture, Fisheries and Food. London: H. M. Stationery Office.
Holland, B, Unwin, ID & Buss, DH (1991) Vegetables, Herbs and Spices. Fifth Supplement to McCance & Widdowson's The Composition of Foods, 4th ed. Royal Society of Chemistry and Ministry of Agriculture, Fisheries and Food. London: H. M. Stationery Office.
Holland, B, Unwin, ID & Buss, DH (1992) Fruits and Nuts. The First Supplement to McCance & Widdowson's The Composition of Foods, 5th ed. Royal Society of Chemistry and Ministry of Agriculture, Fisheries and Food. London: H. M. Stationery Office.
Holland, B, Welch, AA & Buss, DH (1996) Vegetable dishes. Second Supplement to McCance & Widdowson's The Composition of Foods 5th ed. Royal Society of Chemistry and Ministry of Agriculture, Fisheries and Food. London: H. M. Stationery Office.
Holland, B, Welch, AA, Unwin, ID, Buss, DH, Paul, AA & Southgate, DAT (1995) McCance & Widdowson's The Composition of Foods, 5th ed. Royal Society of Chemistry and Ministry of Agriculture, Fisheries and Food. London: H. M. Stationery Office Foods.
Itoh, R, Nishiyama, N & Suyama, Y (1998) Dietary protein intake and urinary excretion of calcium: a cross-sectional study in a healthy Japanese population. Am J Clin Nutr 67, 438444.
Itoh, R & Suyama, Y (1996) Sodium excretion in relation to calcium and hydroxyproline excretion in a healthy Japanese population. Am J Clin Nutr 63, 735740.
Jones, B & Kenward, MG (1989) Design and Analysis of Cross-Over Trials, [Cox, D, Hinkley, D, Rubin, D and Silverman, B, editors]. London: Chapman and Hall.
Jubiz, W, Canterbury, JM, Reiss, E & Tyler, FH (1972) Circadian rhythm in serum parathyroid hormone concentration in human subjects: correlation with serum calcium, phosphate, albumin, and growth hormone levels. J Clin Invest 51, 20402046.
Kerstetter, JE & Allen, LH (1990) Dietary protein increases urinary calcium. J Nutr 120, 134136.
Kerstetter, JE & Allen, LH (1994) Protein intake and calcium homeostasis. Adv Nutr Res 9, 167181.
Kerstetter, JE, O'Brien, KO & Insogna, KL (1998) Dietary protein affects intestinal calcium absorption. Am J Clin Nutr 68, 859865.
Kerstetter, JE, Mitnick, ME, Gundberg, CM, et al. (1999) Changes in bone turnover in young women consuming different levels of dietary protein. J Clin Endocrinol Metab 84, 10521055.
Kim, Y & Linkswiler, HM (1979) Effect of level of protein intake on calcium metabolism and on parathyroid and renal function in the adult human male. J Nutr 109, 13991404.
Kurtz, TW, Al-Bander, HA & Morris, RC Jr (1987) "Salt-sensitive" essential hypertension in men. Is the sodium ion alone important? N Engl J Med 317, 10431048.
Lietz, G, Avenell, A & Robins, SP (1997) Short-term effects of dietary sodium intake on bone metabolism in postmenopausal women measured using urinary deoxypyridinoline excretion. Br J Nutr 78, 7382.
McCarron, DA, Rankin, LI, Bennett, WM, Krutzik, S, McClung, MR & Luft, FC (1981) Urinary calcium excretion at extremes of sodium intake in normal man. Am J Nephrol 1, 8490.
McParland, BE, Goulding, A & Campbell, AJ (1989) Dietary salt affects biochemical markers of resorption and formation of bone in elderly women. Br Med J 299, 834835.
Mahalko, JR, Sandstead, HH, Johnson, LK & Milne, DB (1983) Effect of a moderate increase in dietary protein on the retention and excretion of Ca, Cu, Fe, Mg, P, and Zn by adult males. Am J Clin Nutr 37, 814.
Massey, LK (1998) Does excess dietary protein adversely affect bone? Symposium overview. J Nutr 128, 10481050.
Massey, LK & Whiting, SJ (1996) Dietary salt, urinary calcium and bone loss. J Bone Miner Res 11, 731736.
Massey, LK & Wise, KJ (1984) The effect of dietary caffeine on urinary excretion of calcium, magnesium, sodium and potassium in healthy young females. Nutr Res 4, 4350.
Ministry of Agriculture, Fisheries and Food (1997) Food Portion Sizes London: H. M. Stationery Office.
Morris, RC Jr, Sebastian, A, Forman, A, Tanaka, M & Schmidlin, O (1999) Normotensive salt sensitivity: effects of race and dietary potassium. Hypertension 33, 1823.
Nordin, BEC, Need, AG, Morris, HA & Horowitz, M (1993) The nature and significance of the relationship between urinary sodium and urinary calcium in women. J Nutr 123, 16151622.
Pannemans, DLE, Schafsma, G & Westerterp, KR (1997) Calcium excretion, apparent calcium absorption and calcium balance in young and elderly subjects: influence of protein intake. Br J Nutr 77, 721729.
Rapuri, PB, Gallagher, JC, Kinyamu, HK & Ryschon, KL (2001) Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes. Am J Clin Nutr 74, 694700.
Rosen, HN, Dresner-Pollak, R, Moses, AC, et al. (1994) Specificity of urinary excretion of cross-linked N-telopeptides of type I collagen as a marker of bone turnover. Calcif Tissue Int 54, 2629.
Schuette, SA, Hegsted, M, Zemel, MB & Linkswiler, HM (1981) Renal acid, urinary cyclic AMP, and hydroxyproline excretion as affected by level of protein, sulfur amino acid, and phosphorus intake. J Nutr 111, 21062116.
Schuette, SA & Linkswiler, HM (1982) Effects on Ca and P metabolism in humans by adding meat, meat plus milk, or purified proteins plus Ca and P to a low protein diet. J Nutr 112, 338349.
Schuette, SA, Zemel, MB & Linkswiler, HM (1980) Studies on the mechanism of protein-induced hypercalciuria in older men and women. J Nutr 110, 305315.
Sellmeyer, DE, Schloetter, M & Sebastian, A (2002) Potassium citrate prevents increased urine calcium excretion and bone resorption induced by a high sodium chloride diet. J Clin Endocrinol Metab 87, 20082012.
Shapses, SA, Robins, SP, Schwartz, EI & Chowdhury, H (1995) Short-term changes in calcium but not protein intake alter the rate if bone resorption in healthy subjects as assessed by urinary pyridinium cross-link excretion. J Nutr 125, 28142821.
Shortt, C & Flynn, A (1990) Sodium-calcium inter-relationships with specific reference to osteoporosis. Nutr Res Rev 3, 101115.
Shortt, C, Madden, A, Flynn, A & Morrissey, PA (1988) Influence of dietary sodium intake on urinary calcium excretion in selected Irish individuals. Eur J Clin Nutr 42, 595603.
Slatopolsky, E, Martin, K, Morrissey, J & Hruska, K (1982) Current concepts of the metabolism and radioimmunoassay of parathyroid hormone. J Lab Clin Med 99, 309316.
Tofteng, CL, Jensen, JEB, Abrahamsen, B, Odum, L & Brot, C (2002) Two polymorphisms in the vitamin D receptor gene-association with bone mass and 5-year change in bone mass with or without hormone-replacement therapy in postmenopausal women: the Danish Osteoporosis Prevention Study. J Bone Miner Res 17, 15351544.
Walker, RM & Linkswiler, HM (1972) Calcium retention in the adult human male as affected by protein intake. J Nutr 102, 12971302.
Zarkadas, M, Gougeon-Reyburn, R, Marliss, EB, Block, E & Alton-Mackey, M (1989) Sodium chloride supplementation and urinary calcium excretion in postmenopausal women. Am J Clin Nutr 50, 10881094.

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