Dietary protein and changes in markers of cardiometabolic health across 20 years of follow-up in middle-aged Americans

Abstract

Objective: Dietary protein plays a role in counteracting age-related muscle loss. However, limited long-term data exist on protein intake and markers of cardiometabolic health, which tend to deteriorate with age. Design: Prospective cohort study. Food frequency questionnaire-derived protein intake (g/d) and cardiometabolic markers were assessed up to five times across 20 years. Markers included systolic (SBP) and diastolic blood pressures (DBP), circulating lipids (total, HDL, LDL cholesterol; triglycerides), estimated glomerular filtration rate (eGFR), fasting glucose (FG), weight, and waist circumference (WC). Mixed models accounting for repeated measures were used to estimate adjusted mean annualized changes in outcomes per quartile category of protein. Setting: Framingham Heart Study Offspring cohort, USA Subjects: 3,066 participants with 12,333 unique observations, baseline age [mean (SD)]: 54.0 (9.7) y, BMI: 27.4 (4.9) kg/m2, 53.5% female Results: In fully adjusted models, there were favorable associations (mean (SE)) of total protein with annualized changes in SBP (lowest vs. highest intake: 0.34 [0.06] vs. 0.04 [0.06] mmHg, P trend=0.001) and eGFR (−1.03 [0.06] vs. −0.87 [0.05] mL/min/1.73 m2, P trend=0.046), unfavorable associations with changes in FG (0.013 [0.004] vs. 0.028 [0.004] mmol/L, P trend=0.004), and no associations with weight, WC, DBP, or lipids. Animal protein was favorably associated with SBP and unfavorably with FG and WC; plant protein was favorably associated with FG and WC. Conclusions: The present study provides evidence that protein intake may influence changes in cardiometabolic health independent of change in weight in healthy adults and that protein’s role in cardiometabolic health may depend on the protein source.

Dietary Protein and Changes in Biomarkers of Inflammation and Oxidative Stress in the Framingham Heart Study Offspring Cohort

“…Investigations in populations with higher percentages of protein from plants are merited. Total protein amounts remain nevertheless relevant in aging populations even in the absence of consistently discernible effects on inflammation specifically, owing to potentially favorable associations of higher protein intake with cardiometabolic health (67) and physical function (8, 10, 11). It has been demonstrated that too little protein (e.g., half the RDA compared with the RDA) can have deleterious effects on immune function, lean mass, and muscle function in older women (9).…”

Associations between Dietary Animal and Plant Protein Intake and Cardiometabolic Risk Factors—A Cross-Sectional Study in China Health and Nutrition Survey

“…Results from interventional studies have also demonstrated that plant protein supplementation results in more favorable serum concentrations of high-density lipoprotein cholesterol (HDL-C), TC, triglycerides (TG), LDL-C, and non-HDL-C compared with animal protein [ 15 , 16 ]. In contrast, other observational studies have found no significant associations between animal or plant protein intake and lipid profiles [ 17 , 18 ]. In addition, available data for the associations between dietary animal and plant protein intake and glucose homeostasis biomarkers [ 17 , 19 ], low-grade inflammatory biomarkers [ 20 , 21 ], and uric acid [ 20 , 22 ] also have heterogeneous findings.…”

“…In contrast, other observational studies have found no significant associations between animal or plant protein intake and lipid profiles [ 17 , 18 ]. In addition, available data for the associations between dietary animal and plant protein intake and glucose homeostasis biomarkers [ 17 , 19 ], low-grade inflammatory biomarkers [ 20 , 21 ], and uric acid [ 20 , 22 ] also have heterogeneous findings. Research suggests that the inconsistency may be partially driven by the differential background dietary patterns of study participants [ 23 ].…”

The impact of type of dietary protein, animal versus vegetable, in modifying cardiometabolic risk factors: A position paper from the International Lipid Expert Panel (ILEP)

“…In some experimental studies, the animal protein ingestion raised serum cholesterol level, but it was not consistent in other studies. Some ecologic studies suggested a positive association between animal protein intake and increased risk of CHD, but the prospective data on this association are not definite [3,8,19,90].…”