Abstract P510: Association of Animal and Plant Protein Intake With Mortality Among US Adults: A Prospective Cohort Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Zhilei Shan ◽  
Danielle E Haslam ◽  
Colin D Rehm ◽  
Mingyang Song ◽  
Frank B Hu ◽  
...  
Keyword(s):  
Heart Disease ◽  
Cancer Mortality ◽  
Protein Intake ◽  
Total Mortality ◽  
Cox Proportional Hazards ◽  
Animal Protein ◽  
Plant Protein ◽  
Food Sources ◽  
Processed Meat ◽  
Disease Mortality

Introduction: Animal protein sources, especially red and processed meat, have been associated with adverse health outcomes. Epidemiological evidence on the isocaloric substitution of plant for animal protein on mortality risk remains limited. Hypothesis: We hypothesized that substituting plant protein for carbohydrates and animal protein would be associated with lower mortality. Method: We included a nationally representative sample of 37 233 US adults ≥20 years with 24-h dietary recall data from eight National Health and Nutrition Examination Survey (NHANES) cycles (1999-2014). Mortality from all causes, heart disease, and cancer were identified through National Death Index linkage (until December 31, 2015). We used Cox proportional hazards regression to estimate the association between plant and animal protein intake and mortality after adjustment for potential confounding factors. Results: During 297 768 person-years of follow-up, 4 866 total deaths occurred, including 849 deaths from heart disease and 1 068 deaths from cancer. After multivariable adjustment, higher intake of total animal protein was not associated with total mortality. Plant protein was associated with lower total mortality; when comparing the lowest with highest quintiles of plant protein intake, the multivariable adjusted HR (95% CIs) of total mortality was 0.73 (0.61, 0.88); P for trend <0.001. The HRs (95% CIs) comparing extreme quintiles were 0.71 (0.48, 1.05) for heart disease mortality, and 0.74 (0.53, 1.04) for cancer mortality. When isocalorically replacing 5% of energy from total animal protein with plant protein, the multivariable HRs were 0.49 (0.32, 0.74) for total mortality, 0.51 (0.28, 0.95) for heart disease mortality, and 0.53 (0.28, 1.00) for cancer mortality. For different food sources of animal protein, isocaloric substitution of 2% of energy from plant protein for protein in unprocessed red meat (0.74, 95% CI: 0.63, 0.87), processed meat (0.68, 95% CI: 0.53, 0.89), total dairy (0.74, 95% CI: 0.58, 0.94), and 1% of energy from plant protein for seafood (0.86, 95% CI: 0.79, 0.93) was each associated with a lower risk of total mortality. Conclusions: Higher plant protein intake was associated with lower total mortality. Isocalorically replacing animal protein with plant protein was associated with lower total mortality.

scholarly journals Total Protein Usual Intake Is Associated With Reduced Risk of All-Cause and Heart Disease Mortality in US Adults

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1079-1079
Author(s):  
Yanni Papanikolaou ◽  
Victor III Fulgoni
Keyword(s):  
Heart Disease ◽  
Mortality Risk ◽  
Total Protein ◽  
Protein Intake ◽  
Animal Protein ◽  
Disease Mortality ◽  
Usual Intake ◽  
Cancer Mortality Risk ◽  
Reduced Risk ◽  
Related Mortality

Abstract Objectives Studies have linked animal protein intake with an increased risk in mortality from all-causes and certain chronic diseases, including cancer and heart disease. The objective of the current analysis was to examine associations between usual intake of total and animal protein from various sources and all-cause, cancer, and heart disease-related mortality risk. Methods Data for adults (≥19 y; N = 54,830) from the Third National Health and Nutrition Examination Survey (NHANES) and NHANES 1999–2014 were linked with mortality data through 2015. Individual protein usual intakes were estimated using the National Cancer Institute method. Hazard ratio (HR) models were fit for mortality types (all cause, cancer, heart disease) and measures of total and animal protein usual intake. Multivariable analysis further adjusted for age, gender, ethnicity, waist circumference, smoking status, education level, chronic condition status (i.e., based on cancer, myocardial infarct, and diabetes/diabetes medication reported), weight loss attempts, and % kcal from total fat. Results Total protein usual intake was associated with 10% and 13% lowered risk of mortality from all-causes [HR = 0.90; CI: 0.82–0.99; P = 0.003] and heart disease [HR = 0.87; CI: 0.72–1.05; P = 0.05], respectively. No associations were observed between total protein intake and cancer mortality risk [HR = 0.98; CI: 0.80–1.21; P = 0.84]. No associations were seen between animal protein intake and mortality risk from all-causes [Quartile trend HR = 0.97; confidence intervals (CI): 0.91–1.04; P = 0.32], cancer [HR = 1.08; CI: 0.95–1.23; P = 0.13] and heart disease [HR = 0.98; CI: 0.85–1.13; P = 0.73]. No associations were seen between total dairy protein intake and all-cause and cancer mortality risk, however, there was an 11% reduced risk in heart disease mortality [HR = 0.89; CI: 0.80–1.00; P = 0.008]. No significant associations were seen between total red meat (beef, pork, lamb) protein usual intake and all-cause, cancer, and heart disease-related mortality risk. Conclusions These results contradict previous findings that have linked animal protein intake to increased mortality risk from all-causes, cancer and heart disease. Further, total protein consumption may help lower all-cause and heart disease-related mortality risk in adults. Funding Sources Funded by the Beef Checkoff.

scholarly journals Association of Hearing Loss With Total and Cause-specific Mortality in US Adults

2021 ◽  
Author(s):  
Xiaobing Feng ◽  
Wenzhen Li ◽  
Man Cheng ◽  
Weihong Qiu ◽  
Ruyi Liang ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Heart Disease ◽  
Proportional Hazards ◽  
Total Mortality ◽  
Study Data ◽  
Cox Proportional Hazards ◽  
Risk Of Death ◽  
Disease Mortality ◽  
Hearing Thresholds ◽  
Specific Mortality

Abstract ObjectivesWe expected to explore the associations of hearing loss and hearing thresholds at different frequencies with total and cause-specific mortality.Methods11,732 individuals derived from the National Health and Nutrition Examination Survey (NHANES) 1999-2012 were included in this study. Data of death was extracted from the NHANES Public-Use Linked Mortality File through December 31, 2015. Cox proportional hazards models were used to explore the associations between hearing loss, hearing thresholds at different frequencies and total or cause-specific mortality. ResultsA total of 1,253 deaths occurred with a median follow-up of 12.15 years. A significant positive dose-response relationship between hearing loss in speech frequency and total mortality was observed, and the HRs and 95% CIs were 1.16 (0.91, 1.47), 1.54 (1.19, 2.00) and 1.85 (1.36, 2.50), respectively for mild, moderate and severe speech-frequency hearing loss (SFHL) with a P trend of 0.0003. In addition, moderate (HR: 1.90, 95%CI: 1.20-3.00) and greater (3.50, 1.38-8.86) SFHL significantly elevated risk of heart disease mortality. Moreover, hearing thresholds of >25 dB at 500, 1000, or 2000 Hz were significantly associated with elevated mortality from all causes (1.40, 1.17-1.68; 1.44, 1.20-1.73; and 1.33, 1.10-1.62, respectively) and heart disease (1.89, 1.08-3.34; 1.95, 1.21-3.16; and 1.89, 1.16-3.09, respectively). ConclusionHearing loss is associated with increased risks of total mortality and heart disease mortality, especially for hearing loss at speech frequency. Preventing or inhibiting the pathogenic factors of hearing loss is important for reducing the risk of death.

scholarly journals Animal and Plant Protein Usual Intakes Are Not Associated with Mortality in US Adults (P18-037-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Yanni Papanikolaou ◽  
Victor Fulgoni
Keyword(s):  
Older Adults ◽  
Chronic Diseases ◽  
Protein Intake ◽  
Animal Protein ◽  
Plant Protein ◽  
Food Sources ◽  
Mortality Data ◽  
Current Analysis ◽  
Increased Risk ◽  
Cvd Mortality

Abstract Objectives Previous findings have linked higher animal protein intake with an increase in overall mortality and increased risk of chronic diseases, including cancer and cardiovascular disease (CVD), in older adults, while some data suggest that plant protein food sources may confer health benefits. The objective of the current analysis was to examine associations between all animal protein and plant protein sources with mortality from all-causes, cancer, and CVD, using data from NHANES III. Methods Data in all adults (19–99 years-old (yrs-old); N = 17,199) and older adults (66–99 yrs-old) was linked with mortality data (Mortality N for 19–99 yrs-old = 4280; Mortality N for 66–99 yrs-old = 505), through 2006. Individual usual intakes for protein intake were estimated using the National Cancer Institute method. Results Hazard ratios (HR) models were fit for mortality types (all cause, cancer, CVD) with measures of protein intake. No associations were seen between animal protein intake and all-cause [HR = 1.01; confidence intervals (CI): 0.99–1.02; P = 0.25], cancer [HR = 1.00; CI: 0.98–1.03; P = 0.78], and CVD [HR = 1.01; CI: 0.99–1.02; P = 0.15] mortality. No associations were seen between plant protein intake and all-cause [HR = 0.99; CI: 0.97–1.01; P = 0.17], cancer [HR = 1.01 CI: 0.97–1.05; P = 0.43], and CVD [HR = 1.00; CI: 0.97–1.02; P = 0.69] mortality. Similarly, no associations were seen between animal protein intake and all-cause mortality [HR = 1.00; CI: 0.98–1.01; P = 0.38], and CVD mortality [HR = 1.00; CI: 0.99–1.02; P = 0.51] in older adults, however, a 3% reduction in cancer mortality was linked to animal protein intake [HR = 0.97; CI: 0.94–1.01; P = 0.025]. No associations were seen between plant protein intake and all-cause [HR = 1.00; CI: 0.98–1.03; P = 0.70], cancer [HR = 1.03; CI: 0.97–1.10; P = 0.22] and CVD mortality [HR = 1.01; CI: 0.97–1.04; P = 0.74] in older adults. Conclusions The current results contradict previous findings that have linked animal protein intake to various chronic diseases. Similarly, the current analysis did not link beneficial mortality outcomes with plant protein consumption. A small, but significant beneficial association was seen with animal protein intake in older US adults. Funding Sources Supported by The Beef Checkoff, through the National Cattlemen's Beef Association.

scholarly journals Association of plasma vitamin C concentration to total and cause-specific mortality: a 16-year prospective study in China

2018 ◽  
Vol 72 (12) ◽  
pp. 1076-1082 ◽  
Author(s):  
Shao-Ming Wang ◽  
Jin-Hu Fan ◽  
Philip R Taylor ◽  
Tram Kim Lam ◽  
Sanford M Dawsey ◽  
...  
Keyword(s):  
Heart Disease ◽  
Vitamin C ◽  
Low Income ◽  
Heart Diseases ◽  
Total Mortality ◽  
Cox Proportional Hazards ◽  
Plasma Vitamin ◽  
Sample Collection ◽  
Disease Mortality ◽  
Chinese Cohort

BackgroundVitamin C insufficiency occurs across many countries and has been hypothesised to increase risk of various diseases. Few prospective studies with measured circulating vitamin C have related deficiency to disease mortality, particularly in low-income and middle-income countries.MethodsWe randomly selected 948 subjects (473 males and 475 females) aged 53–84 years from a Chinese cohort and measured meta-phosphoric acid-preserved vitamin C concentrations in plasma samples collected in 1999–2000. A total of 551 deaths were accrued from sample collection through 2016, including 141 from cancer, 170 from stroke and 174 from heart diseases. Vitamin C was analysed using season-specific quartiles, as a continuous variable and as a dichotomous variable based on sufficiency status (normal >28 µmol/L vs low ≤28 µmol/L). HRs and 95% CIs were estimated using Cox proportional hazards models.ResultsWe found significant inverse associations between higher plasma vitamin C concentrations and total mortality in quartile (HRQ4 vs Q10.75, 95% CI 0.59 to 0.95), continuous (HRq20umol/L0.90, 95% CI 0.82 to 0.99) and dichotomous analyses (HRnormal-vs-low0.77, 95% CI 0.63 to 0.95). We observed significant lower risks of heart disease (ptrend-by-quantile=0.03) and cancer deaths (pglobal-across-quantile=0.04) for higher vitamin C, whereas the association was attenuated for stroke in adjusted models. Similar inverse associations were found when comparing normal versus low vitamin C for heart disease (HRnormal-vs-low0.62, 95% CI 0.42 to 0.89).ConclusionIn this long-term prospective Chinese cohort study, higher plasma vitamin C concentration was associated with lower total mortality, heart disease mortality and cancer mortality. Our results corroborate the importance of adequate vitamin C to human health.

Animal protein intake is inversely associated with mortality in older adults: the InCHIANTI study

2021 ◽  
Author(s):  
Tomás Meroño ◽  
Raúl Zamora-Ros ◽  
Nicole Hidalgo-Liberona ◽  
Montserrat Rabassa ◽  
Stefania Bandinelli ◽  
...  
Keyword(s):  
Older Adults ◽  
Total Energy ◽  
Cardiovascular Mortality ◽  
Protein Intake ◽  
Cox Regression ◽  
Clinical Information ◽  
Community Dwelling ◽  
Animal Protein ◽  
Plant Protein

Abstract Background In general, plant protein intake was inversely associated with mortality in studies in middle-aged adults. Our aim was to evaluate the long-term associations of animal and plant protein intake with mortality in older adults. Methods A prospective cohort study including 1,139 community-dwelling older adults (mean age 75 years, 56% women) living in Tuscany, Italy, followed for 20 years (InCHIANTI study) was analyzed. Dietary intake by food frequency questionnaires and clinical information were assessed five times during the follow-up. Protein intakes were expressed as percentages of total energy. Time-dependent Cox regression models adjusted for confounders were used to assess the association between plant and animal protein intake, and mortality. Results During the 20-years of follow up (mean: 12y), 811 deaths occurred (292 of cardiovascular- and 151 of cancer-related causes). Animal protein intake was inversely associated with all-cause (HR per 1% of total energy from protein increase, 95%CI: 0.96, 0.93-0.99) and cardiovascular mortality (HR per 1% of total energy from protein increase, 95%CI: 0.93, 0.87-0.98). Plant protein intake showed no association with any of the mortality outcomes, but an interaction with baseline hypertension was found for all-cause and cardiovascular mortality (p&lt;0.05). Conclusions Animal protein was inversely associated with all-cause and cardiovascular mortality in older adults. Further studies are needed to provide recommendations on dietary protein intake for older adults.

scholarly journals Plant-Protein Diversity Is Critical to Ensuring the Nutritional Adequacy of Diets When Replacing Animal With Plant Protein: Observed and Modeled Diets of French Adults (INCA3)

2019 ◽  
Author(s):  
Marion Salomé ◽  
Erwan de Gavelle ◽  
Ariane Dufour ◽  
Carine Dubuisson ◽  
Jean-Luc Volatier ◽  
...  
Keyword(s):  
Protein Intake ◽  
Dietary Diversity ◽  
Animal Protein ◽  
Plant Protein ◽  
Animal Origin ◽  
National Study ◽  
Higher Plant ◽  
Protein Diversity ◽  
Nutrient Adequacy ◽  
Plant Protein Sources

ABSTRACT Background There is a current trend in Western countries toward increasing the intake of plant protein. A higher plant-protein intake has been associated with nutritional and health benefits, but these may depend on the pattern of plant-protein sources. Objective We hypothesized that the diversity of plant foods could be important to nutrient adequacy when increasing plant-protein intake in the diet. Methods Using data on 1341 adults (aged 18–64 y) from a representative French national dietary survey conducted in 2014–2015 (the third Individual and National Study on Food Consumption Survey—INCA3), we studied the links between plant-protein intake, dietary diversity (using various dimensions), and nutrient adequacy [assessed using the PANDiet (Probability of Adequate Nutrient Intake) scoring system, comprising adequacy (AS) and moderation (MS) subscores]. We simulated substituting plant-protein foods for animal-protein foods using different models of plant-protein diversity. Results We found that overall diet quality was weakly associated with total and protein diversity and more strongly with plant-protein diversity. Plant-protein intake was inversely associated with animal-protein intake, and positively with the PANDiet and MS, but not with the AS. Plant-protein intake displayed little diversity, mostly taking the form of grains (61% of plant-protein intake), and this diversity was even less marked under a higher plant-protein intake. Finally, modeled substitutions showed that reducing animal-protein intake increased the MS (by 32%) in a similar manner whichever plant protein was used for substitution, whereas it decreased the AS (by 20%) unless using a highly diversified plant-protein mix. These simulated improvements in overall adequacy included marked decreases in adequacy regarding certain nutrients that are typically of animal origin. Conclusions We conclude that in French adults the current pattern of plant-protein intake is hindering the nutritional benefits of a transition toward more plant protein, indicating that the consumption of plant-protein-based foods other than refined grains should be encouraged.

The Decline in U.S. Cancer Mortality from 1991 to 1995: What's behind the Numbers?

1998 ◽  
Vol 28 (4) ◽  
pp. 747-755 ◽  
Author(s):  
Richard W. Clapp
Keyword(s):  
United States ◽  
Heart Disease ◽  
Racial Disparities ◽  
Cancer Mortality ◽  
Turning Point ◽  
The United States ◽  
Cancer Burden ◽  
News Stories ◽  
Disease Mortality ◽  
The U.S

In 1996, a series of articles and news stories about cancer mortality in the United States proclaimed a “turning point in the 25-year war on cancer.” While these articles and stories pointed to a recent decline in overall cancer mortality, they missed some important points about increases in specific types. They also ignored the politics behind the emphasis on smoking and diet as the main contributors to the cancer rates and the racial disparities in the U.S. data. In addition, recent articles on the decline in cancer mortality fail to note the much sharper decline in heart disease mortality. Continued efforts to reduce carcinogenic exposures at work and in the environment are needed to truly reduce the cancer burden.

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 Levels and Change in Galectin‐3 and Association With Cardiovascular Events: The ARIC Study

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
David Aguilar ◽  
Caroline Sun ◽  
Ron C. Hoogeveen ◽  
Vijay Nambi ◽  
Elizabeth Selvin ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Cardiovascular Events ◽  
Total Mortality ◽  
Cox Proportional Hazards ◽  
Prognostic Information ◽  
Incident Coronary Heart Disease ◽  
Increased Risk ◽  
Galectin 3

Background Circulating galectin‐3 levels provide prognostic information in patients with established heart failure (HF), but the associations between galectin‐3 levels and other incident cardiovascular events in asymptomatic individuals at midlife and when remeasured ≈15 years later are largely uncharacterized. Methods and Results Using multivariable Cox proportional hazards models, we identified associations between plasma galectin‐3 levels (hazard ratio [HR] per 1 SD increase in natural log galectin‐3) and incident coronary heart disease, ischemic stroke, HF hospitalization, and total mortality in ARIC (Atherosclerosis Risk in Communities) participants free of cardiovascular disease at ARIC visit 4 (1996–1998; n=9247) and at ARIC visit 5 (2011–2013; n=4829). Higher galectin‐3 level at visit 4 (median age 62) was independently associated with incident coronary heart disease (adjusted HR, 1.30; 95% CI, 1.06–1.60), ischemic stroke (HR, 1.42; 95% CI, 1.01–2.00), HF (HR, 1.44; 95% CI, 1.17–1.76), and mortality (HR, 1.56; 95% CI, 1.35–1.80). At visit 5 (median age, 74), higher galectin‐3 level was associated with incident HF (HR, 1.93; 95% CI, 1.15–3.24) and total mortality (HR, 1.70; 95% CI, 1.15–2.52), but not coronary heart disease or stoke. Individuals with the greatest increase in galectin‐3 levels from visit 4 to visit 5 were also at increased risk of incident HF and total mortality. Conclusions In a large, biracial community‐based cohort, galectin‐3 measured at midlife and older age was associated with increased risk of cardiovascular events. An increase in galectin‐3 levels over this period was also associated with increased risk.

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