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Protein Intake and Risk of Prediabetes and Type 2 Diabetes
Author(s) -
Voortman Trudy,
Chen Zhangling,
Franco Oscar H.
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.167.2
Subject(s) - prediabetes , medicine , type 2 diabetes , cohort study , prospective cohort study , epidemiology , cohort , population , hazard ratio , diabetes mellitus , demography , environmental health , endocrinology , confidence interval , sociology
Objective Studies indicated that certain amino acids could affect glucose metabolism. However, few epidemiological studies examined the association between protein intake and risk of type 2 diabetes (T2D), and reported mixed findings. Furthermore, no study examined the association between protein intake and risk of prediabetes and for different types of protein are unclear. Therefore, we aimed to examine the associations of intake of different sources of protein on the development of T2D in large population‐based cohort study. Methods The Rotterdam Study is a prospective cohort study of subjects aged 45 years or older in the Netherlands. Prediabetes and T2D were diagnosed on the basis of WHO criteria using medical records and fasting glucose and insulin concentrations, measured in our research center. We included 6805 subjects who were free of T2D at baseline, of whom 5794 were without prediabetes. Protein intake was assessed at baseline with the use of validated food‐frequency questionnaires and expressed in energy percentages (E%). We used multivariable cox proportional hazard regression to analyze the associations between protein intake and risk of prediabetes and T2D. We used nutrient density substitution models to examine macronutrient substitution effects. Results During a mean follow‐up of 8.0 years, we documented 643 incident cases of T2D among 6805 subjects. For prediabetes, we documented 931 incident cases among the 5794 subjects who were free of prediabetes at baseline, during a median follow‐up of 7.6 years. In multivariable models including age, sex, physical activity, smoking status, education level, diet quality and family history of diabetes, a higher intake of total protein was associated with a higher risk of prediabetes (hazard ratio (HR)=1.19, 95% CI: 1.05–1.34, per 5E%) and a higher risk of T2D (HR=1.35, 95% CI: 1.18–1.54 per 5E%). Results were similar for a higher protein intake at the expense of of lower fat or at the expense of a lower carbohydrate intake. The association of protein was driven by a higher animal protein intake (prediabetes: HR=1.35, 95%CI: 1.20–1.51; and T2D: HR=1.35, 95%CI: 1.18–1.53); and not protein from plant sources. In line with this, a higher intake of animal protein at the expense of plant protein was positively associated with risk of prediabetes and T2D. After additional adjustment for body mass index or waist circumference associations attenuated, but still remained significant. Conclusions Our results suggest that a higher intake of animal protein, but not plant protein, is associated with a higher risk of developing prediabetes and type 2 diabetes.