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Mixed results 1 year after Forteo: What are your thoughts?
Osteoporosis & Bone Health | Last Active: Aug 15 2:11pm | Replies (86)Comment receiving replies
Quantitive CT might reflect increase in strength in the hip and femur. Bone density and bone strength can be at odds. I have read that Forteo can decrease the density of cortical bone because it makes a bone that is more porous a strength in that it enables hip and femur to be more flexible--more able to negotiate stress without tiny cracks or larger fractures.
Bone markers are elevated in advance of bone density increase, several months in advance. You don't mention CTX. When this marker rises from baseline in greater percentage than P1NP.
0.8 grams of protein per kg of body weight. You can't use more than 25 grams of protein at a sitting. Extra protein intake is stored as (ha, ha) fat. High protein intake may induce trabecular bone loss. https://journals.lww.com/nutritiontodayonline/fulltext/2019/05000/optimizing_dietary_protein_for_lifelong_bone.5.aspx#:~:text=Bone%20mineral%20density%20has%20been,with%20a%20normal%20protein%20diet.
There is some buzz about needing ground reaction force to increase density in femur and hip. Some think walking even with weight doesn't provide enough impact. I'm neutral on this issue. But it's in some of the literature. So you'd need to jog and/or jump.
I was pretty careful not to express an opinion, still I hope someone will object. This is a powerful group.
I would, though, be so happy with the Forteo outcome that I would take it for another year.
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Gently, I have been reading and listening to very different perspectives on protein in relation to bone loss and fracture risk than what you are describing. What I have gathered is that:
1. Higher protein intake than the suggested RDA of .8 grams per kilogram of bodyweight is not detrimental to bone density and probably improves it.
2. Higher protein intake is essential for preventing sarcopenia which is a key factor in fracturing due to muscle loss contributing to balance problems and falls and being unable to catch yourself if you do fall.
3. 25 grams of protein in a meal is nowhere near the max that adults can utilize. Donald Layman a noted protein researcher says that somewhere around 30 grams is needed at a meal for skeletal muscle protein synthesis to occur.
4. "Extra protein" is not stored as fat.
5. The paper you link to does not support what you are saying. In fact the thrust of the paper is that it appears more protein is needed especially in older adults for better bone health. The highlighted quote that I see via your link is confusing due to the way it is written. On careful rereading I see the quote means the opposite of what it might appear to mean. Both pieces of the quote do in fact indicate improved bone density with protein levels higher than the usual .8 gm.
6. In the conclusion to the paper you link there is a single sentence that clarifies what the author is saying: "contrary to the longstanding hypothesis, fairly compelling evidence to date suggests that higher intakes of dietary protein do not have any detrimental effect on bone and likely pose a beneficial effect.".
Most of what I've said above is my take on interviews with Donald Layman who seems to be a real expert in the area. It's easy to just search on him and find his website and youtube interviews and so on. Dr. Gabrielle Lyon is an MD who has studied with Layman and emphasizes protein in her practice and her talks are also readily available on the internet.
Hope this is of use.