High dietary protein intake is associated with an increased body weight and total death risk. Issue 2 (April 2016)

• Record Type: Journal Article
• Authors: Hernández-Alonso, Pablo; Salas-Salvadó, Jordi; Ruiz-Canela, Miguel; Corella, Dolores; Estruch, Ramón; Fitó, Montserrat; Arós, Fernando; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Basora, Josep; Serra-Majem, Lluis; Muñoz, Miguel Ángel; Buil-Cosiales, Pilar; Saiz, Carmen; Bulló, Mònica
• Is Part Of: Clinical nutrition. Volume 35:Issue 2(2016:Apr.)
• Page Start: 496
• Page End: 506
• Publication Date: 2016-04
• Subjects: Protein -- Cardiovascular -- Body weight -- Death -- Risk; BMI body mass index -- BW body weight -- CI confidence interval -- CVD cardiovascular disease -- E% percentage of energy -- EPIC European Prospective Investigation into Cancer and Nutrition -- FFQ food frequency questionnaire -- g prot/kg BW/d g protein/kg body weight/day -- HDL high-density lipoprotein -- HPD high-protein diet -- HPFS Health Professionals' Follow-up Study -- HR hazard ratio -- LC low carbohydrate -- LCHP LC-high protein -- LDL low-density lipoprotein -- LPD low-protein diet -- NHS Nurses' Health Study -- q-trend quadratic-trend -- RCT randomized controlled trial -- T2D type 2 diabetes -- WC waist circumference; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2015.03.016
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background & aims: High dietary protein diets are widely used to manage overweight and obesity. However, there is a lack of consensus about their long-term efficacy and safety. Therefore, the aim of this study was to assess the effect of long-term high-protein consumption on body weight changes and death outcomes in subjects at high cardiovascular risk. Methods: A secondary analysis of the PREDIMED trial was conducted. Dietary protein was assessed using a food-frequency questionnaire during the follow-up. Cox proportional hazard models were used to estimate the multivariate-adjusted hazard ratio (HR) and 95% confidence intervals (95%CI) for protein intake in relation to the risk of body weight and waist circumference changes, cardiovascular disease, cardiovascular death, cancer death and total death. Results: Higher total protein intake, expressed as percentage of energy, was significantly associated with a greater risk of weight gain when protein replaced carbohydrates (HR: 1.90; 95%CI: 1.05, 3.46) but not when replaced fat (HR: 1.69; 95%CI: 0.94, 3.03). However, no association was found between protein intake and waist circumference. Contrary, higher total protein intake was associated with a greater risk of all-cause death in both carbohydrate and fat substitution models (HR: 1.59; 95%CI: 1.08, 2.35; and HR: 1.66; 95%CI: 1.13, 2.43, respectively). A higher consumption of animal protein was associated with an increased risk of fatal and non-fatal outcomes when protein substituted carbohydrates or fat. Conclusions: Higher dietary protein intake is associated with long-term increased risk of body weight gain and overall death in a Mediterranean population at high cardiovascular risk. Highlights: Higher protein intake is related to a high risk of weight gain and death at long-term. Higher animal protein intake is related to fatal and non-fatal cardiovascular outcomes. No association was found between protein intake and abdominal obesity.