Diewertje Sluik1, Elske M Brouwer-Brolsma1, Agnes A M Berendsen1, Vera Mikkilä2,3, Sally D Poppitt4, Marta P Silvestre4, Angelo Tremblay, Louis Pérusse5,6, Claude Bouchard7, Anne Raben8, Edith J M Feskens1. 1. Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands. 2. Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland. 3. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. 4. Human Nutrition Unit, Department of Medicine and School of Biological Sciences, University of Auckland, Auckland, New Zealand. 5. Department of Kinesiology, Université Laval, Québec City, Canada. 6. Institute of Nutrition and Functional Foods, Université Laval, Québec City, Canada. 7. Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA. 8. Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark.
Abstract
BACKGROUND: Data on the relationship between protein intake and the risk of type 2 diabetes are conflicting. OBJECTIVE: We studied prospective associations between the intake of total, plant-based, and animal protein and the risk of pre-diabetes and diabetes in 4 population-based studies included in the PREVIEW project. METHODS: Analyses were conducted with the use of data from 3 European cohorts and 1 Canadian cohort, including 78,851 participants. Protein intake was assessed through the use of harmonized data from food-frequency questionnaires or 3-d dietary records. Cohort-specific incidence ratios (IRs) were estimated for pre-diabetes and diabetes, adjusting for general characteristics, lifestyle and dietary factors, disease history, and body mass index (BMI) and waist circumference; results were pooled based on a random-effects meta-analysis. RESULTS: Higher total protein intake (g · kg-1 · d-1) was associated with lower incidences of pre-diabetes and diabetes (pooled IRs: 0.84; 95% CI: 0.82, 0.87 and 0.49; 95% CI: 0.28, 0.83, respectively); plant-based protein intake was the main determinant (pooled IRs: 0.83; 95% CI: 0.81, 0.86 and 0.53; 95% CI: 0.36, 0.76, respectively). Substituting 2 energy percentage (E%) protein at the expense of carbohydrates revealed increased risks of pre-diabetes and diabetes (pooled IRs: 1.04; 95% CI: 1.01, 1.07 and 1.09; 95% CI: 1.01, 1.18, respectively). Except for the associations between intakes of total protein and plant-based protein (g · kg-1 · d-1) and diabetes, all other associations became nonsignificant after adjustment for BMI and waist circumference. CONCLUSIONS: Higher protein intake (g · kg-1 · d-1) was associated with a lower risk of pre-diabetes and diabetes. Associations were substantially attenuated after adjustments for BMI and waist circumference, which demonstrates a crucial role for adiposity and may account for previous conflicting findings. This study was registered at ISRCTN as ISRCTN31174892.
BACKGROUND: Data on the relationship between protein intake and the risk of type 2 diabetes are conflicting. OBJECTIVE: We studied prospective associations between the intake of total, plant-based, and animal protein and the risk of pre-diabetes and diabetes in 4 population-based studies included in the PREVIEW project. METHODS: Analyses were conducted with the use of data from 3 European cohorts and 1 Canadian cohort, including 78,851 participants. Protein intake was assessed through the use of harmonized data from food-frequency questionnaires or 3-d dietary records. Cohort-specific incidence ratios (IRs) were estimated for pre-diabetes and diabetes, adjusting for general characteristics, lifestyle and dietary factors, disease history, and body mass index (BMI) and waist circumference; results were pooled based on a random-effects meta-analysis. RESULTS: Higher total protein intake (g · kg-1 · d-1) was associated with lower incidences of pre-diabetes and diabetes (pooled IRs: 0.84; 95% CI: 0.82, 0.87 and 0.49; 95% CI: 0.28, 0.83, respectively); plant-based protein intake was the main determinant (pooled IRs: 0.83; 95% CI: 0.81, 0.86 and 0.53; 95% CI: 0.36, 0.76, respectively). Substituting 2 energy percentage (E%) protein at the expense of carbohydrates revealed increased risks of pre-diabetes and diabetes (pooled IRs: 1.04; 95% CI: 1.01, 1.07 and 1.09; 95% CI: 1.01, 1.18, respectively). Except for the associations between intakes of total protein and plant-based protein (g · kg-1 · d-1) and diabetes, all other associations became nonsignificant after adjustment for BMI and waist circumference. CONCLUSIONS: Higher protein intake (g · kg-1 · d-1) was associated with a lower risk of pre-diabetes and diabetes. Associations were substantially attenuated after adjustments for BMI and waist circumference, which demonstrates a crucial role for adiposity and may account for previous conflicting findings. This study was registered at ISRCTN as ISRCTN31174892.
Authors: Laura Paalanen; Satu Männistö; Mikko J Virtanen; Paul Knekt; Leena Räsänen; Jukka Montonen; Pirjo Pietinen Journal: J Clin Epidemiol Date: 2006-05-30 Impact factor: 6.437
Authors: N Santesso; E A Akl; M Bianchi; A Mente; R Mustafa; D Heels-Ansdell; H J Schünemann Journal: Eur J Clin Nutr Date: 2012-04-18 Impact factor: 4.016
Authors: Elske Maria Brouwer-Brolsma; Linde van Lee; Martinette T Streppel; Diewertje Sluik; Anne M van de Wiel; Jeanne H M de Vries; Anouk Geelen; Edith J M Feskens Journal: BMJ Open Date: 2018-07-30 Impact factor: 2.692
Authors: Monique van Nielen; Edith J M Feskens; Marco Mensink; Ivonne Sluijs; Esther Molina; Pilar Amiano; Eva Ardanaz; Beverly Balkau; Joline W J Beulens; Heiner Boeing; Françoise Clavel-Chapelon; Guy Fagherazzi; Paul W Franks; Jytte Halkjaer; José Maria Huerta; Verena Katzke; Timothy J Key; Kay Tee Khaw; Vittorio Krogh; Tilman Kühn; Virginia V M Menéndez; Peter Nilsson; Kim Overvad; Domenico Palli; Salvatore Panico; Olov Rolandsson; Isabelle Romieu; Carlotta Sacerdote; Maria-José Sánchez; Matthias B Schulze; Annemieke M W Spijkerman; Anne Tjonneland; Rosario Tumino; Daphne L van der A; Anne M L Würtz; Raul Zamora-Ros; Claudia Langenberg; Stephen J Sharp; Nita G Forouhi; Elio Riboli; Nicholas J Wareham Journal: Diabetes Care Date: 2014-04-10 Impact factor: 19.112
Authors: Elske M Brouwer-Brolsma; Martinette T Streppel; Linde van Lee; Anouk Geelen; Diewertje Sluik; Anne M van de Wiel; Jeanne H M de Vries; Pieter van 't Veer; Edith J M Feskens Journal: Nutrients Date: 2017-10-18 Impact factor: 5.717
Authors: Venkata Sukumar Gurugubelli; Hua Fang; James M Shikany; Salvador V Balkus; Joshua Rumbut; Hieu Ngo; Honggang Wang; Jeroan J Allison; Lyn M Steffen Journal: Smart Health (Amst) Date: 2022-01-13
Authors: María M Adeva-Andany; Carlos Fernández-Fernández; Lucía Adeva-Contreras; Natalia Carneiro-Freire; Alberto Domínguez-Montero; David Mouriño-Bayolo Journal: Curr Cardiol Rev Date: 2021
Authors: Anne Raben; Pia Siig Vestentoft; Jennie Brand-Miller; Elli Jalo; Mathjis Drummen; Liz Simpson; J Alfredo Martinez; Teodora Handjieva-Darlenska; Gareth Stratton; Maija Huttunen-Lenz; Tony Lam; Jouko Sundvall; Roslyn Muirhead; Sally Poppitt; Christian Ritz; Kirsi H Pietiläinen; Margriet Westerterp-Plantenga; Moira A Taylor; Santiago Navas-Carretero; Svetoslav Handjiev; Melitta A McNarry; Sylvia Hansen; Laura Råman; Shannon Brodie; Marta P Silvestre; Tanja C Adam; Ian A Macdonald; Rodrigo San-Cristobal; Nadka Boyadjieva; Kelly A Mackintosh; Wolfgang Schlicht; Amy Liu; Thomas M Larsen; Mikael Fogelholm Journal: Diabetes Obes Metab Date: 2020-11-03 Impact factor: 6.577