Cross-Cultural Association Between Dietary Animal Protein and Hip Fracture: An Hypothesis

Benjamin Jac Abelow


Age-adjusted female hip fracture incidence has been noted to be higher in industrialized countries than non-industrialized countries. A possible explanation which has received little attention is that elevated metabolic acid production associated with a high animal protein diet might lead to chronic bone buffering and bone dissolution. In an attempt to examine this hypothesis, cross-cultural variations in animal protein consumption and hip fracture incidence were studied. When female fracture rates derived from 34 published studies in 16 countries were regressed against estimates of dietary animal protein, a strong, positive association was found. This association could not plausibly be explained by variations in either dietary calcium or total caloric intake. Recent studies suggest that the animal protein-hip fracture association could have a biologically tenable basis. We conclude that further study of the metabolic acid-osteoporosis hypothesis is warranted.