scholarly journals The long-term association of different dietary protein sources with metabolic syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Parisa Hajihashemi ◽  
Razieh Hassannejad ◽  
Fahimeh Haghighatdoost ◽  
Noushin Mohammadifard ◽  
Masoumeh Sadeghi ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Dietary Protein ◽  
Total Protein ◽  
Randomized Clinical Trials ◽  
Dietary Guidelines ◽  
Plant Protein ◽  
Processed Meat ◽  
Inverse Association ◽  
Dietary Intakes ◽  
Total Protein Intake

AbstractDue to scarce epidemiologic data linking dietary protein intakes and metabolic syndrome (MetS), we aim to determine the longitudinal association of different types of dietary protein with the incidence of MetS among Iranians adults. The study was conducted in the framework of the Isfahan Cohort Study (ICS) on 6504 adults, aged ≥ 35 years, and free of MetS at baseline. A validated food frequency questionnaire was used for assessing usual dietary intakes. MetS was defined according to the Joint Scientific Statement. Mixed-effects logistic regression was applied to examine the associations between changes in weekly frequency consumption of protein and MetS status. After a median follow-up of 11.25 years, in multivariate-adjusted model, each additional frequency consumption of total protein intake (OR 0.83; 95% CI 0.81–0.85), animal protein (OR 0.80; 95% CI 0.77–0.83), plant protein (OR 0.70; 95% CI 0.64–0.76), red meat (OR 0.74; 95% CI 0.70–0.78), poultry (OR 0.73; 95% CI 0.68–0.78), egg (OR 0.79; 95% CI 0.72–0.88) and nuts and seeds (OR 0.77; 95% CI 0.71–0.84) was associated with reduced risk of MetS. No significant association was found for processed meat (OR 0.96; 95% CI 0.87–1.01) and legumes and soy (OR 0.96; 95% CI 0.86–1.07) with MetS. Our results suggest an independent inverse association between total protein, animal and plant protein and the risk of MetS. These associations did not differ by sex. Although our results can be considered to be a strategy to reduce MetS risk by dietary guidelines, randomized clinical trials are required to confirm our findings.

scholarly journals Estimated Protein Intake From Animal and Plant Foods by U.S. Adults, What We Eat in America, NHANES, 2015–2016

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 133-133
Author(s):  
Kathy Hoy ◽  
John Clemens ◽  
Alanna Moshfegh
Keyword(s):  
Protein Intake ◽  
Animal Protein ◽  
Dietary Guidelines ◽  
Plant Protein ◽  
Dietary Intakes ◽  
Food Ingredients ◽  
Plant Foods ◽  
Cured Meats ◽  
Total Protein Intake ◽  
Plant Sources

Abstract Objectives The 2020–2025 Dietary Guidelines for Americans encourage varying protein intake to include both animal foods and plant foods for the range of nutrients provided. The objective of this study is to estimate proportions of adults’ protein intake from animal and plant sources and the contribution of foods to each. Methods One day dietary intake data of adults 20+ years (N = 5017) in What We Eat in America (WWEIA), NHANES 2015–2016 were used. Proportions of protein intake from animal and plant sources were estimated from the ingredients for the foods in the Food and Nutrient Database for Dietary Studies (FNDDS) 2015–2016. Single ingredient foods such as chicken or beans were classified as 100% animal or plant, respectively. Proportions from multi-ingredient foods were determined from the amounts of animal and plant food ingredients in each item. If ingredients were not specified, the proportions from a similar food were applied. The proportions were applied to the dietary intakes to determine the population intake of protein from animal and plant sources. The WWEIA food categories were used to describe contribution of foods to animal and plant protein intake. Results Animal and plant foods accounted for 67% and 33% of total protein intake, respectively. Excluding mixed dishes, animal protein intake was contributed by dairy products (14%); meats (12%); poultry (16%); seafood (6%); cured meats (8%); and eggs (6%). Mixed dishes contributed 31% of animal protein intake. Protein from plant foods, excluding mixed dishes, was contributed by grains (24%); plant-based protein foods including legumes (4%), nuts and seeds (7%) soy products (1%); vegetables (9%); and fruit (2%). Mixed dishes accounted for 30% of plant protein intake; snacks and sweets contributed 14%. Conclusions Although protein intake from animal sources is relatively diverse, encouraging greater variety of protein intake from plant-based protein foods appears warranted. Funding Sources ARS-USDA.

scholarly journals Dietary Intake, Nutritional Adequacy, and Food Sources of Protein and Relationships with Personal and Family Factors in Spanish Children Aged One to < 10 Years: Findings of the EsNuPI Study

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1062
Author(s):  
Casandra Madrigal ◽  
María José Soto-Méndez ◽  
Ángela Hernández-Ruiz ◽  
Teresa Valero ◽  
Federico Lara Villoslada ◽  
...  
Keyword(s):  
Dietary Protein ◽  
Total Protein ◽  
Dairy Products ◽  
Protein Intake ◽  
Meat Products ◽  
Food Sources ◽  
Animal Origin ◽  
Total Protein Intake ◽  
Fish And Shellfish ◽  
Milk And Dairy Products

Diet in the first years of life is an important factor in growth and development. Dietary protein is a critical macronutrient that provides both essential and nonessential amino acids required for sustaining all body functions and procedures, providing the structural basis to maintain life and healthy development and growth in children. In this study, our aim was to describe the total protein intake, type and food sources of protein, the adequacy to the Population Reference Intake (PRI) for protein by the European Food Safety Authority (EFSA), and the Recommended Dietary Allowance (RDA) by the Institute of Medicine (IoM). Furthermore, we analyzed whether the consumption of dairy products (including regular milk, dairy products, or adapted milk formulas) is associated with nutrient adequacy and the contribution of protein to diet and whole dietary profile in the two cohorts of the EsNuPI (in English, Nutritional Study in the Spanish Pediatric Population) study; one cohort was representative of the Spanish population from one to < 10 years old (n = 707) (Spanish reference cohort, SRS) who reported consuming all kinds of milk and one was a cohort of the same age who reported consuming adapted milk over the last year (including follow-on formula, growing up milk, toddler’s milk, and enriched and fortified milks) (n = 741) (adapted milk consumers cohort, AMS). The children of both cohorts had a high contribution from protein to total energy intake (16.79% SRS and 15.63% AMS) and a high total protein intake (60.89 g/day SRS and 53.43 g/day AMS). We observed that protein intake in Spanish children aged one to < 10 years old was above the European and international recommendations, as well as the recommended percentages for energy intakes. The main protein sources were milk and dairy products (28% SRS and 29% AMS) and meat and meat products (27% SRS and 26% AMS), followed by cereals (16% SRS and 15% AMS), fish and shellfish (8% in both cohorts), eggs (5% SRS and 6% AMS), and legumes (4% in both cohorts). In our study population, protein intake was mainly from an animal origin (meat and meat products, milk and dairy products, fish and shellfish, and eggs) rather than from a plant origin (cereals and legumes). Future studies should investigate the long-term effect of dietary protein in early childhood on growth and body composition, and whether high protein intake affects health later in life.

scholarly journals Comparison of two exploratory dietary patterns in association with the metabolic syndrome in a Northern German population

2014 ◽  
Vol 112 (8) ◽  
pp. 1364-1372 ◽  
Author(s):  
Janett Barbaresko ◽  
Sabine Siegert ◽  
Manja Koch ◽  
Imke Aits ◽  
Wolfgang Lieb ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Dietary Guidelines ◽  
Processed Meat ◽  
German Population ◽  
Food Groups ◽  
Reduced Rank Regression ◽  
Cross Sectional ◽  
The Metabolic Syndrome

Diet is related to many chronic disease conditions such as the metabolic syndrome (MetS). We set out to compare behaviour-related with disease-related patterns and their association with the MetS in a German cross-sectional study. A total of 905 participants of a Northern German cohort (aged 25–82 years) completed a FFQ, underwent anthropometric assessments and provided a blood sample. Dietary patterns were derived by principal component analysis (PCA) and reduced-rank regression (RRR) from forty-two food groups. Components of the MetS were used as response variables for the RRR analysis. Simplified patterns comprising ten food groups were generated. Logistic regression analysis was performed to evaluate the likelihood of having the MetS across the quartiles of simplified pattern scores. We identified two similar dietary patterns derived by PCA and RRR characterised by high intakes of potatoes, various vegetables, red and processed meat, fats, sauce and bouillon. Comparing simplified patterns, an increased RRR pattern score was associated with a higher OR (2·18, 95 % CI 1·25, 3·81) of having the MetS than an increased PCA pattern score (OR 1·92, 95 % CI 1·21, 3·03). Comparing concordant food groups by both dietary pattern methods, a diet high in legumes, beef, processed meat and bouillon was also positively associated with the prevalence of the MetS after adjustment for potential confounders (OR 1·71, 95 % CI 1·04, 2·79). We identified a behaviour-related pattern that was positively associated with the MetS. The application of both dietary pattern methods may be advantageous to obtain information for designing and realising dietary guidelines. Prospective studies are needed to confirm the results.

scholarly journals Sources of dietary protein and risk of hypertension in a general Dutch population

2012 ◽  
Vol 108 (10) ◽  
pp. 1897-1903 ◽  
Author(s):  
Wieke Altorf-van der Kuil ◽  
Mariëlle F. Engberink ◽  
Johanna M. Geleijnse ◽  
Jolanda M. A. Boer ◽  
W. M. Monique Verschuren
Keyword(s):  
Dietary Protein ◽  
Cox Regression ◽  
Population Based ◽  
Plant Protein ◽  
Inverse Association ◽  
Incident Hypertension ◽  
Lower Tertile ◽  
Prevention Of Hypertension ◽  
Randomised Controlled

Evidence suggests a small beneficial effect of dietary protein on blood pressure (BP), especially for plant protein. We examined the relationship between several types of dietary protein (total, plant, animal, dairy, meat and grain) and the risk of hypertension in a general population of 3588 Dutch adults, aged 26–65 years, who were free of hypertension at baseline. Measurements were done at baseline and after 5 and 10 years of follow-up. Hazard ratios (HR), with 95 % CI, for incident hypertension were obtained in tertiles of energy-adjusted protein, using time-dependent Cox regression models. Models were adjusted for age, sex, BMI, education, smoking, baseline systolic BP, dietary confounders and protein from other sources (if applicable). Mean BP was 118/76 mmHg at baseline. Protein intake was 85 (sd 22) g/d (approximately 15 % of energy) with 62 % originating from animal sources. The main sources of protein were dairy products (28 %), meat (24 %) and grain (19 %). During the follow-up, 1568 new cases of hypertension were identified (44 % of the participants). Energy-adjusted intake of total protein, plant protein and animal protein was not significantly associated with hypertension risk (all HR approximately 1·00, P>0·60). Protein from grain showed a significant inverse association with incident hypertension, with a HR of 0·85 (95 % CI 0·73, 1·00, Ptrend = 0·04) for the upper tertile ( ≥ 18 g/d) v. the lower tertile ( < 14 g/d), whereas dairy protein and meat protein were not associated with incident hypertension. In conclusion, higher intake of grain protein may contribute to the prevention of hypertension, which warrants confirmation in other population-based studies and randomised controlled trials.

scholarly journals Dietary intake of calcium and magnesium and the metabolic syndrome in the National Health and Nutrition Examination (NHANES) 2001–2010 data

2015 ◽  
Vol 114 (6) ◽  
pp. 924-935 ◽  
Author(s):  
Laura Moore-Schiltz ◽  
Jeffrey M. Albert ◽  
Mendel E. Singer ◽  
James Swain ◽  
Nora L. Nock
Keyword(s):  
Metabolic Syndrome ◽  
National Health ◽  
Experimental Studies ◽  
Complete Information ◽  
Epidemiological Studies ◽  
Inverse Association ◽  
Dietary Intakes ◽  
Health And Nutrition ◽  
The Metabolic Syndrome ◽  
Calcium And Magnesium

AbstractHigher dietary intakes of Mg and Ca, individually, have been associated with a decreased risk for the metabolic syndrome (MetSyn). Experimental studies suggest that a higher intra-cellular ratio of Ca:Mg, which may be induced by a diet high in Ca and low in Mg, may lead to hypertension and insulin resistance. However, no previous epidemiological studies have examined the effects of the combined intake of Mg and Ca on MetSyn. Thus, we evaluated the association between dietary intakes of Ca and Mg (using 24-h recalls), independently and in combination, and MetSyn in the National Health and Nutrition Examination Study 2001–2010 data, which included 9148 adults (4549 men and 4599 women), with complete information on relevant nutrient, demographic, anthropometric and biomarker variables. We found an inverse association between the highest (>355 mg/d) v. the lowest (<197 mg/d) quartile of Mg and MetSyn (OR 0·70; 95 % CI 0·57, 0·86). Women who met the RDA for both Mg (310–320 mg/d) and Ca (1000–1200 mg/d) had the greatest reduced odds of MetSyn (OR 0·59; 95 % CI 0·45, 0·76). In men, meeting the RDA for Mg (400–420 mg/d) and Ca (1000–1200 mg/d), individually or in combination, was not associated with MetSyn; however, men with intakes in the highest quartile for Mg (≥386 mg/d) and Ca (≥1224 mg/d) had a lower odds of MetSyn (OR 0·74; 95 % CI 0·59, 0·93). Our results suggest that women who meet the RDA for Mg and Ca have a reduced odds of MetSyn but men may require Ca levels higher than the RDA to be protected against MetSyn.

scholarly journals Associations between plant and animal protein intake and anthropometric indices among school-aged girls in Kabul Afghanistan

2021 ◽  
Author(s):  
Fawzia Zahidi ◽  
Mohammad Ashraf Farahmand ◽  
Mursal Basiry ◽  
Madiha Khalid ◽  
Pamela Surkan ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Dietary Protein ◽  
Protein Intake ◽  
Overweight And Obesity ◽  
Animal Protein ◽  
Plant Protein ◽  
Plant Proteins ◽  
Dietary Protein Intake ◽  
Dietary Intakes ◽  
Anthropometric Indices

Background: Adolescent girls in Afghanistan have high levels of food insecurity, yet little is known about their dietary intakes. Therefore, we aimed to study the association between dietary protein intake and anthropometric indices among adolescent girls in Kabul, Afghanistan. Methods: We conducted a cross-sectional study of 380 adolescent girls at 16 government schools from eight randomly sampled zones in Kabul. In July 2019, we assessed dietary intake, body mass index (BMI), physical activity and socio-demographic variables. Binary logistic regression models were used to estimate the associations between different protein sources (plant protein, animal protein and total protein) and stunting, wasting, overweight and obesity. Results: Participant mean age was 14.8±2 years and mean BMI was 19.8±3.6kg/m2. The mean intakes of carbohydrates from plant proteins, animal proteins and total proteins were approximately 59.4±19.6gr/day, 22.3±7.3gr/day and 81.8±27.1gr/day, respectively. Students with more highly educated fathers consumed more plant proteins (P<0.05). Participants had overall high dietary plant protein intake (mean 34.8±22.0g/day), with 66% from grains, cereals and flour. We did not find an association between dietary protein intake and stunting (OR=0.92; CI: 0.55-1.54), wasting (OR= 0.98; CI: 0.55-1.78), overweight (OR=1.18; CI: 0.62-2.25) or obesity (OR=0.84; CI: 0.19-3.58). Conclusion: While prior research suggests that dietary protein intake is associated with improved nutritional and anthropometric indices, dietary protein intake in this study was not associated with stunting, wasting, overweight and obesity. Further investigation is needed on this topic.

scholarly journals Examination of protein intakes at 2-years and weight status and body composition at 5-years in the Cork BASELINE Birth Cohort

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Áine Hennessy ◽  
Carol ní Chaoimh ◽  
Elaine McCarthy ◽  
Deirdre Murray ◽  
Mairead Kiely
Keyword(s):  
Body Composition ◽  
Birth Cohort ◽  
Fat Mass ◽  
Dietary Protein ◽  
Total Protein ◽  
Protein Intake ◽  
Regression Models ◽  
Fat Free Mass ◽  
Fat Mass Index ◽  
Total Protein Intake

AbstractDietary protein is critical for normal growth and development through its contribution of essential amino acids. In high-resource settings, protein intakes are generally adequate. Previous studies have suggested that higher protein intakes in infancy and early childhood are associated with higher body mass index in later childhood.This analysis was performed in a subgroup of 2-year-old children (n = 468) with detailed dietary intake data (2-d weighed food record) participating in an extensively-characterised, prospective birth cohort, the Cork BASELINE Birth Cohort Study (n = 2183). Body weight and height were measured at 2- and 5-years, and indices of body composition (fat mass, fat free mass) were obtained at 5 years in a subgroup of 295 children. Total protein intake was estimated at 2-years and the contribution of animal and plant sources to total protein intake was quantified. Children were split into thirds of protein intake (as % total energy, %TE) and anthropometry and body composition at 5 years was compared across groups. The relationship between protein intake (total and animal sources) and BMI-SDS, fat mass index-SDS and fat free mass index-SDS was explored in multivariate linear regression models, adjusted for common confounders (energy intake, gestational age, duration of breastfeeding, birthweight-SDS, maternal education).Mean (SD) daily protein intake was 41.3 (11.2) g/d, representing 16.1 %TE (girls: 16.2 %TE; boys: 15.9 %TE, P = 0.202) and all children met EFSA average requirement and population reference intake thresholds. Meat (25%), cows’ milk (22%), breads (7%), yoghurt (6%), breakfast cereals (6%) and cheese (5%) were key sources of protein intake in toddlers. The majority of dietary protein intake was from animal sources (69%).Girls with high %TE from protein [mean (SD): 19.7 (2.6) %TE] were significantly heavier and taller at 5 years than their counterparts [low: 13.1 (1.4) %TE; medium: 16.0 (0.7) %TE], and had significantly higher fat free mass, fat free mass index and total body bone area (indicative of body size), but not fat mass. When adjusted for confounders in multivariate regression models, no association was observed between total protein intake and BMI-SDS, fat mass index-SDS or fat free mass index-SDS at 5 years.Children with high animal protein intakes (as %TE) had significantly higher fat free mass than their low and medium group counterparts; however, when adjusted for height and other confounders, no association was observed.Protein intakes in early childhood were associated with larger body size, but not BMI or body composition at 5-years.

THE EFFECT OF THE ESSENTIAL TO NONESSENTIAL AMINO ACID RATIO ON TURKEY PERFORMANCE AND CARCASS COMPOSITION

1988 ◽  
Vol 68 (3) ◽  
pp. 899-906 ◽  
Author(s):  
M. R. BEDFORD ◽  
J. D. SUMMERS
Keyword(s):  
Amino Acids ◽  
Weight Gain ◽  
Feed Intake ◽  
Dietary Protein ◽  
Total Protein ◽  
Protein Level ◽  
Essential Amino Acids ◽  
Carcass Composition ◽  
Feed Conversion ◽  
Total Protein Intake

The effect of altering the proportion of dietary protein supplied as essential amino acids (EAA) on the performance and carcass characteristics of young turkeys (to 3 wk of age) was investigated at three dietary protein levels (22, 26 and 30%) using semipurified diets. Four ratios of EAA to nonessential amino acids (NEAA) were employed (70:30, 60:40, 50:50 and 40:60) at each dietary protein level. Maxima in weight gain, percent and total carcass protein and feed intake were observed when EAA supplied 60% of total protein (i.e., the 60:40 ratio) at each protein level. The differences in weight gain and total carcass protein were largely attributed to differences in feed intake, since feed conversion efficiency was relatively unaffected by altering the EAA: NEAA ratio. More specifically, weight gain was shown to be limited by total protein intake. Since weight gain was maximized at the 60:40 ratio diets (in which all EAA are supplied at 128% of requirement) at least one of the EAA requirement values is incorrect. Key words: Turkeys, essential amino acids, protein requirement

scholarly journals Effects of Dietary Protein Quantity on Bone Quantity following Weight Loss: A Systematic Review and Meta-analysis

2019 ◽  
Vol 10 (6) ◽  
pp. 1089-1107
Author(s):  
Christian S Wright ◽  
Jia Li ◽  
Wayne W Campbell
Keyword(s):  
Weight Loss ◽  
Dietary Protein ◽  
Total Protein ◽  
Protein Intake ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Mean Difference ◽  
Weighted Mean ◽  
Total Protein Intake ◽  
Bone Quantity

ABSTRACT Research supports the hypothesis that higher total protein intake during weight loss promotes retention of lean soft tissue, but the effect of dietary protein quantity on bone mass, a lean hard tissue, is inconsistent. The purpose of this systematic review and meta-analysis was to assess the effect of dietary protein quantity [higher protein (HP): ≥25% of energy from protein or ≥1.0 g · kg body wt–1 · d–1; normal protein (NP): <25% of energy from protein or <1.0 g · kg body wt–1 · d–1] on changes in bone mineral density (BMD) and content (BMC; total body, lumbar spine, total hip, femoral neck) following a prescribed energy restriction. We hypothesized that an HP diet would attenuate the loss of BMD/BMC following weight loss in comparison to an NP diet. Two researchers systematically and independently screened 2366 publications from PubMed, Cochrane, Scopus, CINAHL, and Web of Science Core Collection and extracted data from 34 qualified publications. Inclusion criteria included the following: 1) healthy subjects ≥19 y; 2) a prescribed energy restriction; 3) measurements of total protein intake, BMD, and BMC; and 4) an intervention duration of ≥3 mo. Data from 10 of the 34 publications with 2 groups of different total protein intakes were extracted and used to conduct a random-effects model meta-analysis. A majority of publications (59%) showed a decrease in bone quantity following active weight loss, regardless of total protein intake. Statistically, the loss of total BMD (P = 0.016; weighted mean difference: +0.006 g/cm2; 95% CI: 0, 0.011 g/cm2) and lumbar spine BMD (P = 0.019; weighted mean difference: +0.017 g/cm2; 95% CI: 0.001, 0.033 g/cm2) was attenuated with an HP versus an NP weight-loss diet. However, the clinical significance is questionable given the modest weighted mean difference and study duration. Higher total protein intake does not exacerbate but may attenuate the loss of bone quantity following weight loss.

scholarly journals Dietary proteins and protein sources and risk of death: the Kuopio Ischaemic Heart Disease Risk Factor Study

2019 ◽  
Vol 109 (5) ◽  
pp. 1462-1471 ◽  
Author(s):  
Heli E K Virtanen ◽  
Sari Voutilainen ◽  
Timo T Koskinen ◽  
Jaakko Mursu ◽  
Petra Kokko ◽  
...  
Keyword(s):  
Total Protein ◽  
Protein Intake ◽  
Disease Risk ◽  
Plant Protein ◽  
Disease Risk Factor ◽  
Protein Sources ◽  
Total Protein Intake ◽  
Risk Factor Study ◽  
Factor Study ◽  
Heart Disease Risk

ABSTRACT Background Previous studies investigating protein intake in relation to mortality have provided conflicting results. Objective We investigated the associations of dietary protein and protein sources with risk of disease death in the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Methods The study population consisted of 2641 Finnish men, aged 42–60 y at baseline in 1984–1989. We estimated protein intakes with 4-d dietary records at baseline and collected data on disease deaths from the national Causes of Death Register. Cox proportional hazards regression models were used to estimate HRs and 95% CIs. Results During the average follow-up of 22.3 y, we observed 1225 deaths due to disease. Higher intakes of total protein and animal protein had borderline statistically significant associations with increased mortality risk: multivariable-adjusted HR (95% CI) in the highest compared with the lowest quartile for total protein intake = 1.17 (0.99, 1.39; P-trend across quartiles = 0.07) and for animal protein intake = 1.13 (0.95, 1.35; P-trend = 0.04). Higher animal-to-plant protein ratio (extreme-quartile HR = 1.23; 95% CI: 1.02, 1.49; P-trend = 0.01) and higher meat intake (extreme-quartile HR = 1.23; 95% CI: 1.04, 1.47; P-trend = 0.01) were associated with increased mortality. When evaluated based on disease history at baseline, the association of total protein with mortality appeared more evident among those with a history of type 2 diabetes, cardiovascular disease, or cancer (n = 1094) compared with those without disease history (n = 1547) (P-interaction = 0.05 or 0.07, depending on the model). Intakes of fish, eggs, dairy, or plant protein sources were not associated with mortality. Conclusions Higher ratio of animal to plant protein in diet and higher meat intake were associated with increased mortality risk. Higher total protein intake appeared to be associated with mortality mainly among those with a predisposing disease. This trial was registered at clinicaltrials.gov as NCT03221127.

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