Dietary Protein Sources and Muscle Mass over the Life Course: The Lifelines Cohort Study

The influence of dietary protein intake on muscle mass in adults remains unclear. Our objective was to investigate the association between protein intake and muscle mass in 31,278 men and 45,355 women from the Lifelines Cohort. Protein intake was estimated by food frequency questionnaire and muscle mass was estimated from 24 h urinary creatinine excretion. The age range was 18–91 years and mean total protein intake was 1.0 ± 0.3 g/kg/day. Across increasing quartiles of total protein intake, animal protein intake, and fish/meat/egg protein intake, creatinine excretion significantly increased in both men (+4% for total and +6% for fish/meat/egg protein intake, p < 0.001) and women (+3% for total and +6% for fish/meat/egg protein intake, p < 0.001). The associations were not systematically stronger or weaker with increasing age, but associations were strongest for young men (26–45 years) and older women (>75 years). The association between total protein intake and muscle mass was dependent on physical activity in women (p interaction < 0.001). This study suggests that total protein intake, animal protein intake, and in particular fish/meat/egg protein intake may be important for building and preserving muscle mass. Dietary protein sources should be further studied for their potential to build and preserve muscle mass.

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Association between dietary protein intake and the risk of depressive symptoms in adults

British Journal Of Nutrition ◽

10.1017/s0007114520000562 ◽

2020 ◽

Vol 123 (11) ◽

pp. 1290-1301 ◽

Cited By ~ 3

Author(s):

Yan Li ◽

Caixia Zhang ◽

Suyun Li ◽

Dongfeng Zhang

Keyword(s):

Depressive Symptoms ◽

Dietary Protein ◽

Total Protein ◽

Protein Intake ◽

Public Health Problem ◽

Response Analysis ◽

Dietary Protein Intake ◽

Milk Products ◽

Protein Sources ◽

Total Protein Intake

AbstractDepression is an important public health problem. The aim of the study is to explore the associations of total protein intake and protein sources with the risk of depressive symptoms. This cross-sectional study used data from the National Health and Nutrition Examination Survey for the years 2007–2014. Dietary protein intake was obtained from two 24-h dietary recall interviews. Depressive symptoms were assessed by a nine-item Patient Health Questionnaire. Logistic regression models and restricted cubic spline models were used to estimate the associations of total protein intake (g/kg per d) and protein sources with the risk of depressive symptoms. A total of 17 845 individuals aged 18 years and older were included in this study. Total protein intake was inversely associated with the risk of depressive symptoms. The full-adjusted OR of depressive symptoms was 0·34 (95 % CI 0·17, 0·68) for quartile (Q) 4 v. Q1 of total protein intake. For protein intake from milk and milk products, the association with depressive symptoms was significant both for Q2 v. Q1 (OR 0·61; 95 % CI 0·41, 0·93) and Q3 v. Q1 (OR 0·37; 95 % CI 0·24, 0·59) in the full-adjusted model. In the dose–response analysis, the shape of the associations of total protein intake and protein intake from milk and milk products with the risk of depressive symptoms was approximately L-shaped and U-shaped, respectively. The present study demonstrated that total protein intake and protein intake from milk and milk products might reduce the risk of depressive symptoms in US adults.

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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 ◽

10.3390/nu13041062 ◽

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.

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The Relationships between Total Protein Intake, Protein Sources, Physical Activity, and Lean Mass in a Representative Sample of the US Adults

Nutrients ◽

10.3390/nu12103151 ◽

2020 ◽

Vol 12 (10) ◽

pp. 3151

Author(s):

Furong Xu ◽

Jacob E. Earp ◽

Maya Vadiveloo ◽

Alessandra Adami ◽

Matthew J. Delmonico ◽

...

Keyword(s):

Physical Activity ◽

Lean Mass ◽

Total Protein ◽

Representative Sample ◽

Protein Intake ◽

Large Scale ◽

Weight Status ◽

Protein Sources ◽

Total Protein Intake ◽

Study Results

Background: Although dietary protein and physical activity play essential roles in developing and preserving lean mass, studies exploring these relationships are inconsistent, and large-scale studies on sources of protein and lean mass are lacking. Accordingly, the present study examined the relationship between total protein intake, protein sources, physical activity, and lean mass in a representative sample of US adults. Methods: This cross-sectional study analyzed data from 2011–2016 US National Health and Nutrition Examination Survey and corresponding Food Patterns Equivalents Database (n = 7547). Multiple linear regression models were performed to examine the sex-specific associations between total protein intake, protein sources (Dairy, Total Protein Foods, Seafood, and Plant Proteins), physical activity, and lean mass adjusting for demographics, weight status, and total daily energy intake. Results: Total protein intake was inversely related to lean mass in females only (Lean mass index: β= −0.84, 95%CI: −1.06–−0.62; Appendicular lean mass index: β= −0.35, 95%CI: −0.48–−0.22). However, protein sources and physical activity was positively associated with lean mass in males and/or females (p < 0.05). Conclusion. Study results suggest that consuming more protein daily had a detrimental influence on lean mass in females whereas eating high-quality sources of proteins and being physically active are important for lean mass for men and women. However, the importance of specific protein sources appears to differ by sex and warrants further investigation.

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The Relationship Between Healthy Eating Motivation and Protein Intake in Community-Dwelling Older Adults With Varying Functional Status

Nutrients ◽

10.3390/nu12030662 ◽

2020 ◽

Vol 12 (3) ◽

pp. 662

Author(s):

Hanna M. Rempe ◽

Gudrun Sproesser ◽

Anne Hannink ◽

Thomas Skurk ◽

Beate Brandl ◽

...

Keyword(s):

Older Adults ◽

Functional Status ◽

Healthy Eating ◽

Total Protein ◽

Protein Intake ◽

Community Dwelling ◽

Cross Sectional ◽

Protein Sources ◽

Total Protein Intake ◽

The Relationship

In older adults, the relationship between healthy eating motivation (HEM) and protein intake as key component of a healthy diet is poorly understood. Therefore, we investigate the association of HEM with (1) total protein intake and (2) intake of different protein sources in older adults with varying functional status. In this cross-sectional study including 250 adults (≥70 years), we assessed HEM with “The Eating Motivation Survey” and protein intake by 7-day food records. In addition, gender, age, Body Mass Index (BMI), energy intake and functional status were considered. Regression analyses revealed that HEM was neither related to total (β = −0.02; p = 0.723) nor to relative protein intake (β = 0.04; p = 0.370). Notwithstanding this, participants with stronger HEM showed lower intake of protein from meat and meat products (β = −0.14; p = 0.018), higher intake of overall plant-based protein (β = 0.11; p = 0.032), protein from fruit and vegetables (β = 0.20; p = 0.002) and from pulses, nuts an seeds (β = 0.16; p = 0.016). Our findings suggest HEM as a valuable indicator for intake of distinct protein sources. However, since HEM is not related to total protein intake, the importance of sufficient protein consumption should be emphasized by promoting healthy eating, regardless of self-perceived HEM.

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Protein intake per day and at each daily meal and skeletal muscle mass declines among older community dwellers in Japan

Public Health Nutrition ◽

10.1017/s1368980019002921 ◽

2019 ◽

Vol 23 (6) ◽

pp. 1090-1097 ◽

Cited By ~ 8

Author(s):

Rei Otsuka ◽

Yuki Kato ◽

Chikako Tange ◽

Yukiko Nishita ◽

Makiko Tomida ◽

...

Keyword(s):

Skeletal Muscle ◽

Muscle Mass ◽

Total Protein ◽

Protein Intake ◽

Skeletal Muscle Mass ◽

Total Protein Intake ◽

Dietary Records ◽

Logistic Modelling ◽

Community Dwellers

AbstractObjective:To examine associations between protein intake per day and at different meals and skeletal muscle mass declines.Design:Two-year prospective cohort study among older community dwellers.Setting:National Institute for Longevity Sciences–Longitudinal Study of Aging (NILS-LSA) in Japan.Participants:Older men (n 292) and women (n 363) aged 60–87 years who participated in the baseline (2006–2008) and follow-up studies (2008–2010) of NILS-LSA and did not exhibit low skeletal muscle mass at baseline. Muscle mass was assessed using dual-energy X-ray absorptiometry at baseline and follow-up. Low muscle mass was defined as skeletal muscle mass index <7·0 kg/m2 for men and <5·4 kg/m2 for women at follow-up. Daily protein intake and protein intake at each meal were calculated from 3 d dietary records at baseline and sex-stratified tertiles were determined.Results:Mean (sd) protein intake at breakfast, lunch and dinner was 22·7 (7·8), 26·7 (9·3) and 37·4 (10·5) g for men and 19·3 (6·3), 23·2 (7·3) and 28·5 (7·0) g for women, respectively. After adjusting for age, baseline skeletal muscle mass and other confounders in logistic modelling, greater total protein intake was associated with lower prevalence of skeletal muscle mass decline among men at follow-up (P = 0·024). Particularly, the OR (95 % CI) for high lunchtime protein intake was low (0·11 (0·02, 0·61); P = 0·01). No significant association between total protein intake and prevalence of skeletal muscle mass decline was found among women.Conclusions:High total protein intake, particularly at lunchtime, is associated with retention of skeletal muscle mass in men.

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

Proceedings of The Nutrition Society ◽

10.1017/s002966512000066x ◽

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.

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Low Physical Activity in Patients with Complicated Type 2 Diabetes Mellitus Is Associated with Low Muscle Mass and Low Protein Intake

Journal of Clinical Medicine ◽

10.3390/jcm9103104 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3104

Author(s):

Ilse J. M. Hagedoorn ◽

Niala den Braber ◽

Milou M. Oosterwijk ◽

Christina M. Gant ◽

Gerjan Navis ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Muscle Mass ◽

Dietary Protein ◽

Protein Intake ◽

Outcome Variable ◽

Dietary Protein Intake ◽

Cross Sectional ◽

Creatinine Excretion

Objective: In order to promote physical activity (PA) in patients with complicated type 2 diabetes, a better understanding of daily movement is required. We (1) objectively assessed PA in patients with type 2 diabetes, and (2) studied the association between muscle mass, dietary protein intake, and PA. Methods: We performed cross-sectional analyses in all patients included in the Diabetes and Lifestyle Cohort Twente (DIALECT) between November 2016 and November 2018. Patients were divided into four groups: <5000, 5000–6999, 7000–9999, ≥ 10,000 steps/day. We studied the association between muscle mass (24 h urinary creatinine excretion rate, CER) and protein intake (by Maroni formula), and the main outcome variable PA (steps/day, Fitbit Flex device) using multivariate linear regression analyses. Results: In the 217 included patients, the median steps/day were 6118 (4115–8638). Of these patients, 48 patients (22%) took 7000–9999 steps/day, 37 patients (17%) took ≥ 10,000 steps/day, and 78 patients (36%) took <5000 steps/day. Patients with <5000 steps/day had, in comparison to patients who took ≥10,000 steps/day, a higher body mass index (BMI) (33 ± 6 vs. 30 ± 5 kg/m2, p = 0.009), lower CER (11.7 ± 4.8 vs. 14.8 ± 3.8 mmol/24 h, p = 0.001), and lower protein intake (0.84 ± 0.29 vs. 1.08 ± 0.22 g/kg/day, p < 0.001). Both creatinine excretion (β = 0.26, p < 0.001) and dietary protein intake (β = 0.31, p < 0.001) were strongly associated with PA, which remained unchanged after adjustment for potential confounders. Conclusions: Prevalent insufficient protein intake and low muscle mass co-exist in obese patients with low physical activity. Dedicated intervention studies are needed to study the role of sufficient protein intake and physical activity in increasing or maintaining muscle mass in patients with type 2 diabetes.

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

Advances in Nutrition ◽

10.1093/advances/nmz058 ◽

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.

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

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqz025 ◽

2019 ◽

Vol 109 (5) ◽

pp. 1462-1471 ◽

Cited By ~ 26

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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Validation of an FFQ to assess dietary protein intake in type 2 diabetic subjects attending primary health-care services in Mali

Public Health Nutrition ◽

10.1017/s1368980008002620 ◽

2009 ◽

Vol 12 (5) ◽

pp. 644-650 ◽

Cited By ~ 5

Author(s):

A Coulibaly ◽

H Turgeon O’Brien ◽

I Galibois

Keyword(s):

Dietary Protein ◽

Total Protein ◽

Protein Intake ◽

Animal Protein ◽

Plant Protein ◽

Animal Origin ◽

Dietary Protein Intake ◽

Men And Women ◽

Type 2 Diabetic

AbstractObjectiveTo validate a 53-item quantitative FFQ (QFFQ) for the assessment of dietary protein intake in type 2 diabetic outpatients in Bamako, Mali.DesignConsumption of protein-containing foods over the week preceding the interview was measured with a 7d QFFQ and compared with intakes measured with 48-h recalls.SettingCentre National de Lutte contre le Diabète.SubjectsSeventeen male and forty female adults with type 2 diabetes.ResultsCorrelation between protein intakes estimated using the QFFQ and 48h recalls was 0·63 (P< 0·0001). There was no significant difference between the two methods concerning the total protein daily intakes and intakes per kilogram of body weight. The QFFQ indicated that foods of animal origin were a lesser source of protein. Animal protein intake did not differ between men and women but sources did. In men, the main sources were beef (54 % of total animal protein), fish (15 %) and milk powder (8 %). In women, the principal sources were fish (28 %), beef (20 %) and birds (13 %). In contrast, plant protein intake was significantly higher in men than in women (P= 0·01), but the same plant foods contributed in similar proportions for both genders, rice being by far the greatest source (47 % of plant protein in men, 53 % in women).ConclusionThe QFFQ developed in this study is a valid tool to evaluate dietary protein intakes in Malian diabetic subjects. While the total protein intakes were low in both men and women, differences in choices and amounts of protein food sources were shown.

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