Dietary Protein Sources and All-Cause and Cause-Specific Mortality: The Golestan Cohort Study in Iran

Abstract

Introduction Dietary protein comes from foods with greatly different compositions that may not relate equally with mortality risk. Few cohort studies from non-Western countries have examined the association between various dietary protein sources and cause-specific mortality. Therefore, the associations between dietary protein sources and all-cause, cardiovascular disease, and cancer mortality were evaluated in the Golestan Cohort Study in Iran. Methods Among 42,403 men and women who completed a dietary questionnaire at baseline, 3,291 deaths were documented during 11 years of follow up (2004–2015). Cox proportional hazards models estimated age-adjusted and multivariate-adjusted hazard ratios (HRs) and 95% CIs for all- cause and disease-specific mortality in relation to dietary protein sources. Data were analyzed from 2015 to 2016. Results Comparing the highest versus the lowest quartile, egg consumption was associated with lower all-cause mortality risk (HR=0.88, 95% CI=0.79, 0.97, ptrend=0.03). In multivariate analysis, the highest versus the lowest quartile of fish consumption was associated with reduced risk of total cancer (HR=0.79, 95% CI=0.64, 0.98, ptrend=0.03) and gastrointestinal cancer (HR=0.75, 95% CI=0.56, 1.00, ptrend=0.02) mortality. The highest versus the lowest quintile of legume consumption was associated with reduced total cancer (HR=0.72, 95% CI=0.58, 0.89, ptrend=0.004), gastrointestinal cancer (HR=0.76, 95% CI=0.58, 1.01, ptrend=0.05), and other cancer (HR=0.66, 95% CI=0.47, 0.93, ptrend=0.04) mortality. Significant associations between total red meat and poultry intake and all- cause, cardiovascular disease, or cancer mortality rate were not observed among all participants. Conclusions These findings support an association of higher fish and legume consumption with lower cancer mortality, and higher egg consumption with lower all-cause mortality.

Usual energy and macronutrient intakes in a large sample of Iranian middle‐aged and elderly populations

“…24 Nevertheless, because of the harmful impacts of high levels of red meat consumption on cardio-metabolic-related diseases, the choice of protein sources should be selected cautiously in this at-risk population. 25 In the present study, the contributions of total fat (25.74%) and saturated fatty acids (9.5%) to total energy intake were within the range of recommended guidelines (i.e. 20-35% for total fat and < 10% for SFA).…”

“…In addition, protein is a key nutritional element in the elderly to prevent diseases such as sarcopenia and osteoporosis and to improve muscle mass, strength and function . Nevertheless, because of the harmful impacts of high levels of red meat consumption on cardio‐metabolic‐related diseases, the choice of protein sources should be selected cautiously in this at‐risk population …”

Red meat, processed meat, and other dietary protein sources and risk of overall and cause-specific mortality in The Netherlands Cohort Study

“…Apart from red and processed meat, other dietary protein sources have been studied to varying extent with regard to mortality (e.g., [ 5 – 17 ]). These sources include poultry, eggs, fish, legumes, nuts, and dairy foods.…”

Meat consumption, health, and the environment

“…In highincome Western countries, a lower meat intake may be a marker of a health-conscious lifestyle, but in low-income countries, lower meat intakes are more likely to be markers of poverty and associated with other risk factors for poor health. In a pooled analysis of Asian studies, and a recent cohort study in Iran, meat intake was substantially lower than in the United States and was not associated with risk of overall mortality or mortality from cardiovascular disease or cancer (35,36).…”