Dietary Intake of Total, Animal, and Vegetable Protein and Risk of Type 2 Diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-NL Study

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherland.
Diabetes care (Impact Factor: 8.57). 10/2009; 33(1):43-8. DOI: 10.2337/dc09-1321
Source: PubMed

ABSTRACT Dietary recommendations are focused mainly on relative dietary fat and carbohydrate content in relation to diabetes risk. Meanwhile, high-protein diets may contribute to disturbance of glucose metabolism, but evidence from prospective studies is scarce. We examined the association among dietary total, vegetable, and animal protein intake and diabetes incidence and whether consuming 5 energy % from protein at the expense of 5 energy % from either carbohydrates or fat was associated with diabetes risk.
A prospective cohort study was conducted among 38,094 participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)-NL study. Dietary protein intake was measured with a validated food frequency questionnaire. Incident diabetes was verified against medical records.
During 10 years of follow-up, 918 incident cases of diabetes were documented. Diabetes risk increased with higher total protein (hazard ratio 2.15 [95% CI 1.77-2.60] highest vs. lowest quartile) and animal protein (2.18 [1.80-2.63]) intake. Adjustment for confounders did not materially change these results. Further adjustment for adiposity measures attenuated the associations. Vegetable protein was not related to diabetes. Consuming 5 energy % from total or animal protein at the expense of 5 energy % from carbohydrates or fat increased diabetes risk.
Diets high in animal protein are associated with an increased diabetes risk. Our findings also suggest a similar association for total protein itself instead of only animal sources. Consumption of energy from protein at the expense of energy from either carbohydrates or fat may similarly increase diabetes risk. This finding indicates that accounting for protein content in dietary recommendations for diabetes prevention may be useful.

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Available from: Daphne L van der A, Aug 26, 2015
    • "Please cite this article in press as: Djouss e L, et al., Egg consumption and risk of type 2 diabetes among African Americans: The Jackson Heart Study, Clinical Nutrition (2015), were associated with a higher risk of DM [9] whereas a metaanalysis of three studies showed no association of animal proteins with DM [10]. Among individual foods, eggs could play a unique role among dietary factors affecting the risk of DM, partly because they are rich in proteins, cholesterol, and other nutrients. "
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    Clinical nutrition (Edinburgh, Scotland) 04/2015; DOI:10.1016/j.clnu.2015.04.016 · 3.94 Impact Factor
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    • "Previously, the negative association between dietary protein, plant protein, and even animal protein and BP has been observed [11] [12], but a recent systematic review suggested a limited beneficial effect of protein on BP, especially for plant protein [13]. Several mechanisms may explain the effect of protein in relation to BP: higher protein intake increases plasma amino acids, which may affect renal sodium reabsorption, alter cell permeability, and increase glomerular filtration rate, and amino acid arginine, via nitric oxide synthesis, acts as a vasodilator and, subsequently, decreases BP [41] [42]. "
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