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

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

doi:10.1093/ajcn/nqy388

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

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

Obesity Research

10 Citations (Scopus)

Abstract

Background: Data on the relationship between protein intake and the risk of type 2 diabetes are conflicting. Objectives: 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. Am J Clin Nutr 2019;109:1310-1318.

Original language	English
Journal	American Journal of Clinical Nutrition
Volume	109
Issue number	5
Pages (from-to)	1310-1318
Number of pages	9
ISSN	0002-9165
DOIs	https://doi.org/10.1093/ajcn/nqy388
Publication status	Published - 1 May 2019

Keywords

Faculty of Science
Diabetes
Impaired glucose metabolism
Protein intake
Observational studies
Epidemiology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Sluik, D., Brouwer-Brolsma, E. M., Berendsen, A. A. M., Mikkilä, V., Poppitt, S. D., Silvestre, M. P., Tremblay, A., Pérusse, L., Bouchard, C., Raben, A., & Feskens, E. J. M. (2019). Protein intake and the incidence of pre-diabetes and diabetes in 4 population-based studies: the PREVIEW project. American Journal of Clinical Nutrition, 109(5), 1310-1318. https://doi.org/10.1093/ajcn/nqy388

Sluik, D, Brouwer-Brolsma, EM, Berendsen, AAM, Mikkilä, V, Poppitt, SD, Silvestre, MP, Tremblay, A, Pérusse, L, Bouchard, C, Raben, A & Feskens, EJM 2019, 'Protein intake and the incidence of pre-diabetes and diabetes in 4 population-based studies: the PREVIEW project', American Journal of Clinical Nutrition, vol. 109, no. 5, pp. 1310-1318. https://doi.org/10.1093/ajcn/nqy388

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title = "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. Objectives: 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. Am J Clin Nutr 2019;109:1310-1318.",

keywords = "Faculty of Science, Diabetes, Impaired glucose metabolism, Protein intake, Observational studies, Epidemiology",

author = "Diewertje Sluik and Brouwer-Brolsma, {Elske M} and Berendsen, {Agnes A M} and Vera Mikkil{\"a} and Poppitt, {Sally D} and Silvestre, {Marta P} and Angelo Tremblay and Louis P{\'e}russe and Claude Bouchard and Anne Raben and Feskens, {Edith J M}",

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doi = "10.1093/ajcn/nqy388",

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T1 - Protein intake and the incidence of pre-diabetes and diabetes in 4 population-based studies

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AU - Sluik, Diewertje

AU - Brouwer-Brolsma, Elske M

AU - Berendsen, Agnes A M

AU - Mikkilä, Vera

AU - Poppitt, Sally D

AU - Silvestre, Marta P

AU - Tremblay, Angelo

AU - Pérusse, Louis

AU - Bouchard, Claude

AU - Raben, Anne

AU - Feskens, Edith J M

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Background: Data on the relationship between protein intake and the risk of type 2 diabetes are conflicting. Objectives: 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. Am J Clin Nutr 2019;109:1310-1318.

AB - Background: Data on the relationship between protein intake and the risk of type 2 diabetes are conflicting. Objectives: 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. Am J Clin Nutr 2019;109:1310-1318.

KW - Faculty of Science

KW - Diabetes

KW - Impaired glucose metabolism

KW - Protein intake

KW - Observational studies

KW - Epidemiology

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DO - 10.1093/ajcn/nqy388

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JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

IS - 5

ER -

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

Abstract

Keywords

UN SDGs

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