Association of Major Dietary Protein Sources With All‐Cause and Cause‐Specific Mortality: Prospective Cohort Study

Yangbo Sun; Buyun Liu; Linda G Snetselaar; Robert B Wallace; Aladdin H Shadyab; Candyce H Kroenke; Bernhard Haring; Barbara V Howard; James M Shikany; Carolina Valdiviezo; Wei Bao

doi:10.1161/JAHA.119.015553

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Association of Major Dietary Protein Sources With All‐Cause and Cause‐Specific Mortality: Prospective Cohort Study

Journal article

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Association of Major Dietary Protein Sources With All‐Cause and Cause‐Specific Mortality: Prospective Cohort Study

Yangbo Sun, Buyun Liu, Linda G Snetselaar, Robert B Wallace, Aladdin H Shadyab, Candyce H Kroenke, Bernhard Haring, Barbara V Howard, James M Shikany, Carolina Valdiviezo, …

Journal of the American Heart Association, Vol.10(5), pp.1-24

03/02/2021

DOI: 10.1161/JAHA.119.015553

PMCID: PMC8174240

PMID: 33624505

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Abstract

Background Dietary recommendations regarding protein intake have been focused on the amount of protein. However, such recommendations without considering specific protein sources may be simplistic and insufficient. Methods and Results We included 102 521 postmenopausal women enrolled in the Women’s Health Initiative between 1993 and 1998, and followed them through February 2017. During 1 876 205 person‐years of follow‐up, 25 976 deaths occurred. Comparing the highest with the lowest quintile, plant protein intake was inversely associated with all‐cause mortality (hazard ratio [HR], 0.91 [0.86, 0.96]), cardiovascular disease mortality (HR, 0.88 [0.79, 0.97]), and dementia mortality (HR, 0.79 [0.67, 0.94]). Among major protein sources, comparing the highest with the lowest quintile of consumption, processed red meat (HR, 1.06 [1.01, 1.10]) or eggs (HR, 1.14 [1.10, 1.19]) was associated with higher risk of all‐cause mortality. Unprocessed red meat (HR, 1.12 [1.02, 1.23]), eggs (HR, 1.24 [1.14, 1.34]), or dairy products (HR, 1.11 [1.02, 1.22]) was associated with higher risk of cardiovascular disease mortality. Egg consumption was associated with higher risk of cancer mortality (HR, 1.10 [1.02, 1.19]). Processed red meat consumption was associated with higher risk of dementia mortality (HR, 1.20 [1.05, 1.32]), while consumption of poultry (HR, 0.85 [0.75, 0.97]) or eggs (HR, 0.86 [0.75, 0.98]) was associated with lower risk of dementia mortality. In substitution analysis, substituting of animal protein with plant protein was associated with a lower risk of all‐cause mortality, cardiovascular disease mortality, and dementia mortality, and substitution of total red meat, eggs, or dairy products with nuts was associated with a lower risk of all‐cause mortality. Conclusions Different dietary protein sources have varying associations with all‐cause mortality, cardiovascular disease mortality, and dementia mortality. Our findings support the need for consideration of protein sources in future dietary guidelines.

Details

Title: Subtitle: Association of Major Dietary Protein Sources With All‐Cause and Cause‐Specific Mortality: Prospective Cohort Study
Creators: Yangbo Sun - Department of Epidemiology College of Public Health University of Iowa Iowa City IA
Buyun Liu - Department of Epidemiology College of Public Health University of Iowa Iowa City IA
Linda G Snetselaar - Department of Epidemiology College of Public Health University of Iowa Iowa City IA
Robert B Wallace - Department of Epidemiology College of Public Health University of Iowa Iowa City IA
Aladdin H Shadyab - Department of Family Medicine and Public Health School of Medicine University of California, San Diego La Jolla CA
Candyce H Kroenke - Division of Research Kaiser Permanente Northern California Oakland CA
Bernhard Haring - Department of Medicine I/Cardiology University of Würzburg Germany
Barbara V Howard - MedStar Health Research Institute and Georgetown/Howard Universities Center for Clinical and Translational Science Washington DC
James M Shikany - Division of Preventive Medicine School of Medicine University of Alabama at Birmingham Birmingham AL
Carolina Valdiviezo - Medstar Washington Hospital Center and Georgetown University School of Medicine Washington DC
Wei Bao - Department of Epidemiology College of Public Health University of Iowa Iowa City IA, Obesity Research and Education Initiative University of Iowa Iowa City IA, Fraternal Order of Eagles Diabetes Research Center University of Iowa Iowa City IA
Resource Type: Journal article
Publication Details: Journal of the American Heart Association, Vol.10(5), pp.1-24
DOI: 10.1161/JAHA.119.015553
PMID: 33624505
PMCID: PMC8174240
NLM abbreviation: J Am Heart Assoc
ISSN: 2047-9980
eISSN: 2047-9980
Language: English
Date published: 03/02/2021
Academic Unit: Epidemiology; Fraternal Order of Eagles Diabetes Research Center; Injury Prevention Research Center; Internal Medicine
Record Identifier: 9984215047402771

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