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Clin Nutr. 2016 Apr;35(2):496-506. doi: 10.1016/j.clnu.2015.03.016. Epub 2015 Apr 7.

High dietary protein intake is associated with an increased body weight and total death risk.

Author information

  • 1Human Nutrition Unit from the Department of Biochemistry and Biotechnology, Hospital Universitari de Sant Joan de Reus, Faculty of Medicine and Health Sciences, IISPV (Institut d'Investigació Sanitària Pere Virgili), Universitat Rovira i Virgili, Reus, Spain.
  • 2Human Nutrition Unit from the Department of Biochemistry and Biotechnology, Hospital Universitari de Sant Joan de Reus, Faculty of Medicine and Health Sciences, IISPV (Institut d'Investigació Sanitària Pere Virgili), Universitat Rovira i Virgili, Reus, Spain; CIBER de la Fisiopatología de Obesidad y la Nutrición (ciberobn), Instituto de Salud Carlos III, Spain. Electronic address: jordi.salas@urv.cat.
  • 3CIBER de la Fisiopatología de Obesidad y la Nutrición (ciberobn), Instituto de Salud Carlos III, Spain; Primary Health Care, Servicio Navarro de Salud, Health Care Centre of Azpilagaña, Pamplona, Spain.
  • 4CIBER de la Fisiopatología de Obesidad y la Nutrición (ciberobn), Instituto de Salud Carlos III, Spain; Department of Preventive Medicine, University of Valencia, València, Spain.
  • 5CIBER de la Fisiopatología de Obesidad y la Nutrición (ciberobn), Instituto de Salud Carlos III, Spain; Department of Internal Medicine, Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain.
  • 6CIBER de la Fisiopatología de Obesidad y la Nutrición (ciberobn), Instituto de Salud Carlos III, Spain; Cardiovascular Risk and Nutrition Research Group (Regicor Study Group), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
  • 7CIBER de la Fisiopatología de Obesidad y la Nutrición (ciberobn), Instituto de Salud Carlos III, Spain; Department of Cardiology, University Hospital Txagorritxu, Vitoria, Spain.
  • 8CIBER de la Fisiopatología de Obesidad y la Nutrición (ciberobn), Instituto de Salud Carlos III, Spain; Department of Preventive Medicine, University of Malaga, Malaga, Spain.
  • 9Health Research Institute of Palma (IdISPa). Hospital Son Espases, Palma de Mallorca, Spain.
  • 10CIBER de la Fisiopatología de Obesidad y la Nutrición (ciberobn), Instituto de Salud Carlos III, Spain; Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud San Pablo, Sevilla, Spain.
  • 11Human Nutrition Unit from the Department of Biochemistry and Biotechnology, Hospital Universitari de Sant Joan de Reus, Faculty of Medicine and Health Sciences, IISPV (Institut d'Investigació Sanitària Pere Virgili), Universitat Rovira i Virgili, Reus, Spain; CIBER de la Fisiopatología de Obesidad y la Nutrición (ciberobn), Instituto de Salud Carlos III, Spain.
  • 12Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain.
  • 13Primary Health Care Division and Research, Instituto de Investigaciones Biomédicas August Pi i Sunyer-Jordi Gol, Barcelona, Spain.
  • 14Human Nutrition Unit from the Department of Biochemistry and Biotechnology, Hospital Universitari de Sant Joan de Reus, Faculty of Medicine and Health Sciences, IISPV (Institut d'Investigació Sanitària Pere Virgili), Universitat Rovira i Virgili, Reus, Spain; CIBER de la Fisiopatología de Obesidad y la Nutrición (ciberobn), Instituto de Salud Carlos III, Spain. Electronic address: monica.bullo@urv.cat.

Abstract

BACKGROUND & AIMS:

High dietary protein diets are widely used to manage overweight and obesity. However, there is a lack of consensus about their long-term efficacy and safety. Therefore, the aim of this study was to assess the effect of long-term high-protein consumption on body weight changes and death outcomes in subjects at high cardiovascular risk.

METHODS:

A secondary analysis of the PREDIMED trial was conducted. Dietary protein was assessed using a food-frequency questionnaire during the follow-up. Cox proportional hazard models were used to estimate the multivariate-adjusted hazard ratio (HR) and 95% confidence intervals (95%CI) for protein intake in relation to the risk of body weight and waist circumference changes, cardiovascular disease, cardiovascular death, cancer death and total death.

RESULTS:

Higher total protein intake, expressed as percentage of energy, was significantly associated with a greater risk of weight gain when protein replaced carbohydrates (HR: 1.90; 95%CI: 1.05, 3.46) but not when replaced fat (HR: 1.69; 95%CI: 0.94, 3.03). However, no association was found between protein intake and waist circumference. Contrary, higher total protein intake was associated with a greater risk of all-cause death in both carbohydrate and fat substitution models (HR: 1.59; 95%CI: 1.08, 2.35; and HR: 1.66; 95%CI: 1.13, 2.43, respectively). A higher consumption of animal protein was associated with an increased risk of fatal and non-fatal outcomes when protein substituted carbohydrates or fat.

CONCLUSIONS:

Higher dietary protein intake is associated with long-term increased risk of body weight gain and overall death in a Mediterranean population at high cardiovascular risk.

Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

KEYWORDS:

Body weight; Cardiovascular; Death; Protein; Risk

PMID:
25886710
[PubMed - in process]
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