Abstract:
Background and aims : To assess the impact of a high versus low protein intake in relation to diabetes risk and safety aspects, we developed a scoring tool, in particular on animal versus vegetable protein. Analyses were based on observational study populations included in the PREVIEW project. Methods : We analyzed cross-sectional data from two Dutch observational studies conducted among general adult populations: NQplus (n=1,048) and Lifelines (n=57,349). Dietary intake data from food-frequency questionnaires were used to develop a protein score, which consisted of two components: percentage of energy from total protein and the ratio of animal to vegetable (A:V) protein. Subjects were divided into 11 strata of total protein intake (en%) and 11 strata of the A:V ratio. A subject could receive a combined score of 0–20 points, where a higher score reflected a higher intake of total protein, and a lower A:V ratio. The associations between the protein score and HbA1c and renal function calculated as eGFR, using the CKD-EPI equation, were examined using multiple linear regression with adjustment for age, sex, education, BMI, prevalent hypertension or hypercholesterolemia, smoking status, alcohol consumption, and physical activity. Results : We found a negative association between the protein score and HbA1c levels in Lifelines (β=−0.037±0.005, p<0.001) but not in NQplus. In both Lifelines (β=0.17±0.02, p<0.001) and NQplus (β=0.44±0.12, p<0.001), there was a positive association between the protein score and eGFR. Conclusion : Our preliminary analyses suggest that a diet rich in protein and with a lower ratio of animal to vegetable (A:V) protein may be associated with a lower risk of diabetes and an increased eGFR.
