Dietary proteins and protein sources and risk of death: the Kuopio Ischaemic Heart Disease Risk Factor Study.


Journal

The American journal of clinical nutrition
ISSN: 1938-3207
Titre abrégé: Am J Clin Nutr
Pays: United States
ID NLM: 0376027

Informations de publication

Date de publication:
01 05 2019
Historique:
received: 29 06 2018
accepted: 28 01 2019
pubmed: 11 4 2019
medline: 24 12 2019
entrez: 11 4 2019
Statut: ppublish

Résumé

Previous studies investigating protein intake in relation to mortality have provided conflicting results. We investigated the associations of dietary protein and protein sources with risk of disease death in the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study. The study population consisted of 2641 Finnish men, aged 42-60 y at baseline in 1984-1989. We estimated protein intakes with 4-d dietary records at baseline and collected data on disease deaths from the national Causes of Death Register. Cox proportional hazards regression models were used to estimate HRs and 95% CIs. During the average follow-up of 22.3 y, we observed 1225 deaths due to disease. Higher intakes of total protein and animal protein had borderline statistically significant associations with increased mortality risk: multivariable-adjusted HR (95% CI) in the highest compared with the lowest quartile for total protein intake = 1.17 (0.99, 1.39; P-trend across quartiles = 0.07) and for animal protein intake = 1.13 (0.95, 1.35; P-trend = 0.04). Higher animal-to-plant protein ratio (extreme-quartile HR = 1.23; 95% CI: 1.02, 1.49; P-trend = 0.01) and higher meat intake (extreme-quartile HR = 1.23; 95% CI: 1.04, 1.47; P-trend = 0.01) were associated with increased mortality. When evaluated based on disease history at baseline, the association of total protein with mortality appeared more evident among those with a history of type 2 diabetes, cardiovascular disease, or cancer (n = 1094) compared with those without disease history (n = 1547) (P-interaction = 0.05 or 0.07, depending on the model). Intakes of fish, eggs, dairy, or plant protein sources were not associated with mortality. Higher ratio of animal to plant protein in diet and higher meat intake were associated with increased mortality risk. Higher total protein intake appeared to be associated with mortality mainly among those with a predisposing disease. This trial was registered at clinicaltrials.gov as NCT03221127.

Sections du résumé

BACKGROUND
Previous studies investigating protein intake in relation to mortality have provided conflicting results.
OBJECTIVE
We investigated the associations of dietary protein and protein sources with risk of disease death in the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study.
METHODS
The study population consisted of 2641 Finnish men, aged 42-60 y at baseline in 1984-1989. We estimated protein intakes with 4-d dietary records at baseline and collected data on disease deaths from the national Causes of Death Register. Cox proportional hazards regression models were used to estimate HRs and 95% CIs.
RESULTS
During the average follow-up of 22.3 y, we observed 1225 deaths due to disease. Higher intakes of total protein and animal protein had borderline statistically significant associations with increased mortality risk: multivariable-adjusted HR (95% CI) in the highest compared with the lowest quartile for total protein intake = 1.17 (0.99, 1.39; P-trend across quartiles = 0.07) and for animal protein intake = 1.13 (0.95, 1.35; P-trend = 0.04). Higher animal-to-plant protein ratio (extreme-quartile HR = 1.23; 95% CI: 1.02, 1.49; P-trend = 0.01) and higher meat intake (extreme-quartile HR = 1.23; 95% CI: 1.04, 1.47; P-trend = 0.01) were associated with increased mortality. When evaluated based on disease history at baseline, the association of total protein with mortality appeared more evident among those with a history of type 2 diabetes, cardiovascular disease, or cancer (n = 1094) compared with those without disease history (n = 1547) (P-interaction = 0.05 or 0.07, depending on the model). Intakes of fish, eggs, dairy, or plant protein sources were not associated with mortality.
CONCLUSIONS
Higher ratio of animal to plant protein in diet and higher meat intake were associated with increased mortality risk. Higher total protein intake appeared to be associated with mortality mainly among those with a predisposing disease. This trial was registered at clinicaltrials.gov as NCT03221127.

Identifiants

pubmed: 30968137
pii: S0002-9165(22)03199-9
doi: 10.1093/ajcn/nqz025
doi:

Substances chimiques

Animal Proteins, Dietary 0
Dietary Proteins 0
Plant Proteins, Dietary 0

Banques de données

ClinicalTrials.gov
['NCT03221127']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1462-1471

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © American Society for Nutrition 2019.

Auteurs

Heli E K Virtanen (HEK)

Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.

Sari Voutilainen (S)

Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.

Timo T Koskinen (TT)

Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.

Jaakko Mursu (J)

Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.

Petra Kokko (P)

Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.

Maija P T Ylilauri (MPT)

Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.

Tomi-Pekka Tuomainen (TP)

Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.

Jukka T Salonen (JT)

MAS-Metabolic Analytical Services Oy, Helsinki, Finland.
Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland.

Jyrki K Virtanen (JK)

Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.

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