Dietary protein, phosphorus and potassium are beneficial to bone mineral density in adult men consuming adequate dietary calcium

Objective: The purpose of this study was to determine relationships of calcium (Ca), protein (Pr), phosphorus (P) and potassium (K) to measures of bone mineral density in adult men. Methods: Cross-sectional analysis of 57 men ages 39 to 42 years who were participants in an ongoing study. Dietary assessment was conducted using the Block food frequency questionnaire (FFQ). BMD of total body (TB), hip and lumbar spine (LS) were measured with dual X-ray absorptiometry (DXA). Results: Ca, Pr, P and K, as well as lean body mass (LBM), showed significant correlation with BMD at the total body, hip and lumbar spine. Stepwise forward regression selection method identified LBM. height and fat mass as significant predictors of TB-BMD, LBM and height as significant predictors of hip BMD, and LBM as a significant predictor of LS-BMD. As the nutrients tested correlated significantly with each other, only one nutrient was entered into the regression model at a time to accommodate the potential for multicollinearity. In regression analysis, adjusted for site-specific anthropometric variables and energy intake, K, Pr and P intake accounted for significant (p < 0.05) prediction of TB-BNID and LS-BMD values by 7% to 13%. No bone-related nutrient added significantly to the prediction of hip BMD. Ca intake was not significantly associated with BMD at any site in the adjusted models. Conclusions: Our analysis provides support that a moderate protein 0.2 g/kg) diet, plentiful in potassium (>100 mmol/day) and phosphorus (1741 +/- 535 mg) is beneficial for maintaining bone mineral density in adult men when Ca intake was adequate (1200 +/- 515 mg).