(P22-054-23) Protein Intake and Exercise as Modulators of Bone Outcomes in Adults: A Systematic Review Protocol

Objectives: Dietary protein and regular exercise are known to support a healthy skeleton. Moreover, the potential for protein supplementation to support the decline in musculoskeletal function during aging is an active area of investigation. However, the potential synergy of consuming levels of dietary protein that are above the dietary recommended allowance in combination with exercise is less understood. This combination could have important implications for reducing the risk of fragility fractures which often lower an individual’s quality of life.

The objective of this systematic review is to examine the effect of protein intakes, both above and below the recommended dietary level, combined with exercise on bone outcomes defined by fracture, BMD, and/or biochemical markers of bone turnover, in adults over 18 years of age.

Methods: This systematic review was previously registered on PROSPERO (CRD42022310980). An extensive search strategy has been developed and is currently being performed in MEDLINE, Embase, and CINAHL Complete to identify relevant studies. Included studies will be either randomized controlled trials or prospective cohort studies that have compared a protein intake below or above the recommended level (0.8 g protein/kg body weight/day) combined with exercise (intervention) with a protein intake at the recommended level and with non-exercise (or a maintenance of current physical activity level; control) in community dwelling adults over 18 years of age. One or more of the bone outcomes of interest (fracture, bone mineral density, or a biochemical marker of bone formation or resorption) will have been reported. Quality appraisal will be performed using the Cochrane Risk of Bias Assessment tool or Risk of Bias in Non-randomized Studies – of Interventions. A narrative synthesis will be defined by: 1) protein source; 2) type, amount and duration of exercise; and 3) bone site and method for analysis.

Results: This is a study protocol.

Conclusions: Findings from this review will identify gaps in knowledge about the potential benefits of combining higher protein intakes with exercise interventions to benefit bone health. Thus, these findings will help guide future studies that may ultimately lead to preventive strategies that reduce the risk of fragility fractures.

Funding Sources: A general research account at Brock University.