Berryman Claire E, Agarwal Sanjiv, Lieberman Harris R, Fulgoni Victor L, Pasiakos Stefan M
Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA; Oak Ridge Institute for Science and Education, Belcamp, MD; and.
Oak Ridge Institute for Science and Education, Belcamp, MD; and.
Am J Clin Nutr. 2016 Sep;104(3):743-9. doi: 10.3945/ajcn.116.133819. Epub 2016 Jul 27.
Higher-protein diets are associated with decreased adiposity and greater HDL cholesterol than lower protein diets. Whether these benefits can be attributed to a specific protein source (i.e., nondairy animal, dairy, or plant) is unknown, and concerns remain regarding the impact of higher-protein diets on kidney function.
The objective of this study was to evaluate trends of protein source on markers of cardiometabolic disease risk and kidney function in US adults.
Total, nondairy animal, dairy, and plant protein intake were estimated with the use of 24-h recall data from NHANES 2007-2010 (n = 11,111; ≥19 y). Associations between source-specific protein intake and health outcomes were determined with the use of models that adjusted for sex, race and ethnicity, age, physical activity, poverty-to-income ratio, individual intake (grams per kilogram) for each of the other 2 protein sources, body mass index (BMI) (except for weight-related variables), and macronutrient (carbohydrate, fiber, and total and saturated fat) intake.
Mean ± SE total protein intake was 82.3 ± 0.8 g/d (animal: 37.4 ± 0.5 g/d; plant: 24.7 ± 0.3 g/d; and dairy: 13.4 ± 0.3 g/d). Both BMI and waist circumference were inversely associated [regression coefficient (95% CI)] with animal [-0.199 (-0.265, -0.134), P < 0.0001; -0.505 (-0.641, -0.370), P < 0.0001] and plant [-0.346 (-0.455, -0.237), P < 0.0001; -0.826 (-1.114, -0.538), P < 0.0001] protein intake. Blood urea nitrogen concentrations increased across deciles for animal [0.313 (0.248, 0.379), P < 0.0001; decile 1-10: 11.6 ± 0.2 to 14.9 ± 0.3 mg/dL] and dairy [0.195 (0.139, 0.251), P < 0.0001; decile 1-10: 12.7 ± 0.2 to 13.9 ± 0.2 mg/dL] but not plant protein intake. Glomerular filtration rate and blood creatinine were not associated with intake of any protein source.
Diets higher in plant and animal protein, independent of other dietary factors, are associated with cardiometabolic benefits, particularly improved central adiposity, with no apparent impairment of kidney function.
与低蛋白饮食相比，高蛋白饮食与肥胖程度降低及高密度脂蛋白胆固醇升高有关。这些益处是否可归因于特定的蛋白质来源（即非乳类动物蛋白、乳类蛋白或植物蛋白）尚不清楚，而且高蛋白饮食对肾功能的影响仍存在担忧。
本研究的目的是评估美国成年人蛋白质来源对心血管代谢疾病风险标志物和肾功能的影响趋势。
使用2007 - 2010年美国国家健康与营养检查调查（NHANES）的24小时回忆数据（n = 11,111；≥19岁）估算总蛋白、非乳类动物蛋白、乳类蛋白和植物蛋白的摄入量。通过调整性别、种族和民族、年龄、身体活动、贫困与收入比率、其他两种蛋白质来源各自的个体摄入量（克/千克）、体重指数（BMI）（体重相关变量除外）以及常量营养素（碳水化合物、纤维、总脂肪和饱和脂肪）摄入量的模型，确定特定来源蛋白质摄入量与健康结果之间的关联。
平均±标准误总蛋白摄入量为82.3±0.8克/天（动物蛋白：37.4±0.5克/天；植物蛋白：24.7±0.3克/天；乳类蛋白：13.4±0.3克/天）。体重指数和腰围均与动物蛋白[-0.199（-0.265，-0.134），P < 0.0001；-0.505（-0.641，-0.370），P < 0.0001]和植物蛋白[-0.346（-0.455，-0.237），P < 0.0001；-0.826（-1.114，-0.538），P < 0.0001]摄入量呈负相关。动物蛋白[0.313（0.248，0.379），P < 0.0001；第1 - 10分位数：11.6±0.2至14.9±0.3毫克/分升]和乳类蛋白[0.195（0.139，0.251），P < 0.0001；第1 - 10分位数：12.7±0.2至13.9±0.2毫克/分升]的血尿素氮浓度随十分位数增加，而植物蛋白摄入量则不然。肾小球滤过率和血肌酐与任何蛋白质来源的摄入量均无关联。
与其他饮食因素无关，植物蛋白和动物蛋白含量较高的饮食与心血管代谢益处相关，尤其是改善中心性肥胖且对肾功能无明显损害。
