Protein intake and the incidence of pre-diabetes and diabetes in 4 population-based studies: the PREVIEW project.

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.

• Authors: Diewertje Sluik, Elske M Brouwer-Brolsma, Agnes A M Berendsen, Vera Mikkilä, Sally D Poppitt, Marta P Silvestre, Angelo Tremblay, Louis Pérusse, Claude Bouchard, Anne Raben, Edith J M Feskens
• Journal: The American journal of clinical nutrition (Am J Clin Nutr) Vol. 109 Issue 5 Pg. 1310-1318 (05 01 2019) ISSN: 1938-3207 [Electronic] United States
• PMID: 31051510 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © American Society for Nutrition 2019.

Chemical References

• Dietary Proteins
• Plant Proteins, Dietary

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Body Mass Index
• Canada
• Diabetes Mellitus, Type 2 (etiology, prevention & control)
• Diet Records
• Diet Surveys
• Dietary Proteins (administration & dosage, therapeutic use)
• Energy Intake
• Europe
• Feeding Behavior
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Obesity (complications)
• Plant Proteins, Dietary (administration & dosage, therapeutic use)
• Prediabetic State (etiology, prevention & control)
• Prospective Studies
• Waist Circumference
• Young Adult