Protein And Bone Density

Protein is at the top of my list when I start working with someone on improving their bone health.  It plays a very important role in maintaining bone density, and becomes even more important as we age, especially for individuals with osteoporosis and osteopenia (low bone density). 

In fact, protein and bone density go hand in hand as it is estimated that protein makes up roughly 50% of bone (1).  Keep reading to learn more about the relationship between protein and bone density and why adequate protein intake is so important for bone health.  I’ll share the recommended daily protein amount for optimal bone health and I’ll also share a few tips for increasing your protein intake.

Jump to recommended daily protein amount HERE and tips for increasing your protein HERE.

Understanding Osteoporosis, Osteopenia and Bone Density

Osteoporosis is a condition characterized by weakened bones that are less dense, making them fragile and more likely to break. Bone density, which refers to the amount of bone tissue in a certain volume of bone, is assessed by having a bone density scan.  

Unfortunately, many that are at risk for lower bone density, like I was (you can read about my story here) don’t have a bone density scan until they either reach 65 or have a condition like breast cancer where treatment can affect bone health.  

And, it is estimated that nearly 80 percent of older Americans who suffer bone breaks are not tested (2). So, I encourage you to be proactive and ask your healthcare provider/doctor for a bone density scan or at least discuss your risks.

Defining Osteoporosis and Osteopenia

Osteoporosis is often referred to as a “silent condition” because bone loss occurs without symptoms and often isn’t discovered until someone breaks a bone. It occurs when the creation of new bone doesn’t keep up with the removal of old bone. This imbalance results in decreased bone density and increased risk of fractures, especially in the hip, spine, and wrist.  

Osteopenia is kind of like the step before osteoporosis.  With osteopenia, bone density is less than normal but not low enough to be called osteoporosis.  

Importance of Bone Density Scans

Bone density scans provide an assessment of bone health for individuals at risk for osteoporosis or osteopenia. A bone density scan is an imaging test used to measure bone mineral content and density using x-rays or CT scans.  

A score (a T or Z score) is given that compares your bone density with the bone density of a healthy adult of your own age, gender and ethnicity.  I won’t go into T and Z scores of bone, which is what a bone density scan provides, but you can read about that here.

Assessing bone density helps in estimating the risk of fractures and plays a key role in the diagnosis and treatment for bone health. If you have low bone density, there are many things that can be done to improve bone health, but protein intake is this focus for this article.

Role of Protein in Maintaining Bone Density

Protein and Bone Health

Protein intake is so important in maintaining bone health and density, like I mentioned already, it is the first nutrition topic I address. In addition to providing structure for bones, proteins are involved in bone metabolism and mineralization. Protein contributes to the formation of collagen, which is a key component of the bone matrix, that helps regulate bone mass and also provides a framework for minerals, like calcium.

Bone is a living tissue and is constantly changing.  When we are younger, the body adds more bone than it takes away but as we get older this process changes and more bone can be removed than the amount that is added if we aren’t doing the right things, like eating enough protein. 

Types of Protein and Their Impact on Bone Density

Different types of protein can have varying impacts on bone density. Dairy products, such as milk and yogurt, contain high-quality proteins and essential nutrients like calcium, which are beneficial for bone health. Plant-based proteins, found in legumes, nuts, and seeds, also contribute to bone health by providing essential amino acids and minerals.  Healthy, grass-fed animal meats are also high-quality proteins that are beneficial for bone health.  

On the other hand, excessive consumption of processed meats or processed plant-based substitutes may have a negative impact on bone density due to their high levels of potential inflammatory effects. While it is helpful to have a balanced intake of different protein sources, most important is to get enough protein and for it to be good quality protein that doesn’t cause inflammation..

Impact of Protein Intake on Osteoporosis Patients

Researchers have found that higher protein intake is associated with increased bone mineral density (3).

However, our natural tendency as we age is to decrease our protein intake.  Among 19 to 30 year olds, the average protein intake is 91 +/- 22 g/day but by the time we are in our late 60’s, the average protein intake is 66 g +/- 17 grams (4).  

It could be that protein intake decreases because our appetite decreases due to aging or being less active.  

Another reason could be that we are encouraged to eat more plants for longevity and those foods could displace higher protein foods.  And, then there’s also the cost of food and access to food as we age that might be a barrier to getting enough protein.  

But, my experience working with younger people is that they are not getting enough protein either.  It seems the majority of their energy comes from carbohydrates.  Carbs are easier to eat, especially processed ones.  But, this is just my observation.  Either way, I suggest tracking your protein intake for a few days to see what your average protein intake is.

How Much Protein Do We Need For Bone Health

A recent review in 2023 reveals that protein intake between 1.2 and 1.5 g/kg of body weight per day is ideal for preserving muscle function/bone in older adults (5).  This provides enough protein to support bone density and muscle strength while minimizing the risk of bone fractures.

Adequate protein intake can be achieved through a well-balanced diet that includes lean meats, poultry, fish, dairy products, legumes, and nuts. Incorporating protein-rich foods into each meal and snack can help osteoporosis patients meet their daily protein requirements and support optimal bone health. 

If you follow a plant-based diet, you can work to make sure you are getting enough protein, but a protein supplement might be needed to get you to the recommended amount of 1.2-1.5 g/kg of body weight.

Best Sources of Protein for Osteoporosis Patients

Animal-Based Protein Sources

Animal-based protein sources are excellent for osteoporosis patients as they provide high-quality protein and crucial nutrients for bone health. Examples of these sources include lean meats such as grass-fed beef, chicken, turkey, and fish. These options are rich in protein, as well as vital minerals like calcium and phosphorus, which are fundamental for maintaining bone density. 

Additionally, incorporating dairy products such as low-fat yogurt (especially greek or skyr yogurt) and cheese into the diet can significantly contribute to the protein intake required for bone health. These dairy products are excellent sources of both protein and calcium, making them valuable for individuals managing osteoporosis.  This doesn’t mean you have to eat dairy as some people are lactose intolerant or find it to be inflammatory. 

Plant-Based Protein Sources

For individuals seeking plant-based protein sources, legumes, seeds, and nuts are excellent alternatives to animal-based proteins. Legumes such as lentils, chickpeas, and black beans are not only rich in protein but also provide a variety of essential nutrients, including magnesium, which supports bone strength. 

Additionally, incorporating seeds and nuts like chia seeds, almonds, and sunflower seeds into the diet can contribute to protein intake while offering plant-based sources of calcium and other bone-supporting nutrients. Plant-based protein powerhouses are tofu, tempeh and seitan.  They provide a substantial amount of protein alongside bone-healthy nutrients.

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A Few Tips For Increasing Your Protein

• Make protein a priority.  Double your protein food and eat your carbs last.
• Add protein collagen to your coffee (unflavored, chocolate or vanilla) – I like PaleoValley.com.
• Use a “clean” protein powder for protein smoothies.  There are grass-fed whey options (I like TransparentLabs.com and LevelsProtein.com) that don’t have a lot of fillers or unnecessary added ingredients and a good plant-based option is Kachava.com.  There are lots of protein powders out there!  I also like PaleoValley.com – they have a grass-fed bone broth collagen protein.
• Add protein powder to your coffee, unsweetened greek/skyr yogurt, oatmeal, etc.
• Use bone broth instead of plain chicken broth or mix the two.  Bone broth has around 9 grams of protein per cup.
• If you eat grains, choose sprouted grains.  The sprouting process increases the protein content a little.  1 slice of sprouted grain bread has ~5 grams compared to 1-2 g for whole wheat bread.
• Choose carbs that are higher protein (beans, peas, edamame, quinoa).
• Try eating dinner for breakfast.  Many breakfast foods (cereal) are very low in protein.
• Add in healthy fats that also have protein (chia seeds, flax seed, nut butters).
• Veggies, if you are eating enough, can bump up your protein intake.  For example, 1 cup of kale provides 3.5 g of protein.  Non-starchy veggie protein adds up, especially since it’s low calorie.
• Use an app like Cronometer (free version is great) or My Fitness Pal to track your protein intake for a few days to see what your average is, then start increasing your protein.   I’d start with breakfast!
• Add tofu to your protein smoothie.  It blends nice and doesn’t change the taste much.  You can also add kale or any veggie.  

Conclusion

I hope this blog post about protein and bone density helps you realize how important protein is for optimal bone health and gives you some ideas for increasing your protein intake.  Since bone is 50% protein, protein is bone density…sort of!  I’ll continue to address other important nutrients like calcium, magnesium, vitamin D, etc. but since protein is so important, I had to write about it first.  More to come!