Division of Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Department of Biomedical Research, University of Bern, Bern, Switzerland.
Eur J Clin Nutr. 2023 Jun;77(6):652-659. doi: 10.1038/s41430-023-01276-w. Epub 2023 Feb 16.
BACKGROUND/OBJECTIVES: The strong regulation of protein intake can lead to overconsumption of total energy on diets with a low proportion of energy from protein, a process referred to as protein leverage. The protein leverage hypothesis posits that protein leverage explains variation in energy intake and potentially obesity in ecological settings. Here, we tested for protein leverage and the protein leverage hypothesis in children and adolescents.
SUBJECTS/METHODS: A population sample of children, mean (SD) age 7.6 (0.4) years (n = 422), followed up at age 9.8 (0.4) years (n = 387) and at age 15.8 (0.4) years (n = 229), participating for the Physical Activity and Nutrition in Children (PANIC) study.
4-day food records-related proportional energy intake of proteins, fats, and carbohydrates.
energy intake, body mass index (BMI) z-score and dual-energy X-ray absorptiometry-related energy expenditure.
Proportional energy intake of proteins was inversely associated with energy intake following power functions at all 3 ages (mean [95%CI] strength of leverage of L = -0.36 [-0.47 to -0.25]; L = -0.26 [-0.37 to -0.15]; L = -0.25 [-0.38 to -0.13]; all P < 0.001). Mixture analysis indicated that variance in energy intake was associated primarily with the proportional intake of energy from proteins, not with either fats or carbohydrates. At all 3 ages, energy intake was not associated with BMI z-score but positively associated with energy expenditure (all P < 0.001).
This study provides evidence consistent with protein leverage in a population sample of children and adolescents. Increased energy intake on diets with lower protein content was counterbalanced by increased energy expenditure and therefore did not translate into increased adiposity.
背景/目的：严格控制蛋白质的摄入量可能会导致在蛋白质提供的能量比例较低的饮食中过度摄入总能量，这一过程被称为蛋白质杠杆作用。蛋白质杠杆作用假说认为，蛋白质杠杆作用可以解释生态环境中能量摄入的变化，以及潜在的肥胖现象。在这里，我们测试了儿童和青少年的蛋白质杠杆作用和蛋白质杠杆作用假说。
受试者/方法：参与者为参加儿童体力活动与营养研究（PANIC）的人群样本，平均（SD）年龄 7.6（0.4）岁（n=422），在 9.8（0.4）岁（n=387）和 15.8（0.4）岁（n=229）时进行随访。通过 4 天的食物记录来记录相关的蛋白质、脂肪和碳水化合物的比例能量摄入。
4 天食物记录相关的蛋白质、脂肪和碳水化合物的比例能量摄入。
在所有 3 个年龄组中，蛋白质的比例能量摄入与能量摄入呈反比关系（L 的平均[95%CI]杠杆强度= -0.36 [-0.47 至 -0.25]；L= -0.26 [-0.37 至 -0.15]；L= -0.25 [-0.38 至 -0.13]；均 P<0.001）。混合分析表明，能量摄入的变异性主要与蛋白质的比例摄入有关，而与脂肪或碳水化合物无关。在所有 3 个年龄组中，能量摄入与 BMI 没有关联，但与能量支出呈正相关（均 P<0.001）。
本研究为儿童和青少年人群样本中存在蛋白质杠杆作用提供了证据。在蛋白质含量较低的饮食中，能量摄入的增加被能量支出的增加所抵消，因此不会导致体脂增加。
