Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, Shaanxi, People's Republic of China.
Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, UK.
Eur J Nutr. 2019 Aug;58(5):1981-1990. doi: 10.1007/s00394-018-1751-9. Epub 2018 Jun 13.
High-protein diets were popular in weight control. However, the role of protein intake in adiposity and related metabolic conditions among general populations is not clear. We aimed to evaluate the associations of protein intake with adiposity and glycaemic control among adult Chinese in a nationwide population-based survey.
The data were from China Health and Nutrition Survey 2009. A total of 9360 men and women aged 18 years or older were included. Body fat percentage was calculated using validated Chinese-specific equations. Dietary intake levels of macronutrients were evaluated by food-weighing approach combined with a 3-day food intake recall.
Averagely, our participants have 12.5% energy intake from dietary protein. With multivariate adjustment including total energy intake, the odds ratios (95% CIs) of excessive adiposity (body fat percentage ≥ 20/30% for men/women), and central obesity (waist circumference ≥ 90/80 cm for men/women) were 1.51 (1.30, 1.75) and 1.40 (1.21, 1.62), respectively, comparing extreme quintiles of relative protein intake, while fat and carbohydrate were not associated with adiposity indices. Moreover, higher relative protein intake was associated with elevated concentration of fasting glucose (β ± SE: 1.233 ± 0.583), fasting insulin (23.211 ± 9.191), glycated hemoglobin (1.057 ± 0.369), and insulin resistance indicated by homeostasis model assessment of insulin resistance (7.558 ± 2.928) (all P < 0.05). Further adjusting for body mass index attenuated the associations.
In Chinese adults, higher habitual protein consumption may be associated with higher adiposity and worse glycaemic control, independent of total energy intake.
高蛋白饮食在体重控制中很受欢迎。然而，一般人群中蛋白质摄入量与肥胖和相关代谢状况的关系尚不清楚。我们旨在评估蛋白质摄入量与中国成年人全国人群调查中肥胖和血糖控制的相关性。
数据来自 2009 年中国健康与营养调查。共纳入 9360 名年龄在 18 岁及以上的男性和女性。体脂百分比采用经过验证的中国特定方程计算。通过食物称重法结合 3 天食物摄入回忆评估宏量营养素的饮食摄入水平。
平均而言，我们的参与者从饮食中摄入的蛋白质占总能量的 12.5%。经过包括总能量摄入在内的多变量调整，相对蛋白质摄入量最高五分位组与最低五分位组相比，肥胖（男性体脂百分比≥20%/女性体脂百分比≥30%）和中心性肥胖（男性腰围≥90cm/女性腰围≥80cm）的比值比（95%置信区间）分别为 1.51（1.30，1.75）和 1.40（1.21，1.62），而脂肪和碳水化合物与肥胖指数无关。此外，较高的相对蛋白质摄入与空腹血糖（β±SE：1.233±0.583）、空腹胰岛素（23.211±9.191）、糖化血红蛋白（1.057±0.369）和胰岛素抵抗（由稳态模型评估的胰岛素抵抗表示）（7.558±2.928）的浓度升高相关（均 P<0.05）。进一步调整体重指数会减弱这些关联。
在中国成年人中，较高的习惯性蛋白质摄入可能与更高的肥胖和更差的血糖控制有关，而与总能量摄入无关。
