Dietary protein intake and risk of type 2 diabetes: results from the Melbourne Collaborative Cohort Study and a meta-analysis of prospective studies12

https://doi.org/10.3945/ajcn.116.140954Get rights and content
Under an Elsevier user license
open archive

ABSTRACT

Background: Reported associations between protein intake from different sources and type 2 diabetes (T2D) have been inconsistent.

Objective: We prospectively examined the relations of total, animal, and plant protein intakes with incident T2D.

Design: We followed 21,523 participants (women: 61.7%) between 1990 and 2007 from the Melbourne Collaborative Cohort Study who were free of diabetes, cardiovascular disease, cancer, and kidney stones at baseline. We also conducted a meta-analysis that included the results from our cohort and from 10 previous prospective studies.

Results: A total of 929 new cases (4.3%) of T2D were documented during a mean of 11.7 y of follow-up. Multivariate-adjusted ORs for incident T2D in the highest compared with lowest quintiles of total and animal protein intakes as percentages of energy were 1.23 (95% CI: 0.96, 1.56; P-trend = 0.029) and 1.29 (95% CI: 0.99, 1.67; P-trend = 0.014), respectively. These associations appeared to be greater in men and in participants with normal baseline plasma glucose, body mass index, or blood pressure. Plant protein intake was inversely associated with incident T2D in women only (OR; 0.60; 95% CI: 0.37, 0.99). In the meta-analysis of 11 prospective cohort studies with 505,624 participants and 37,918 T2D cases (follow-up range: 5–24 y), pooled RRs for the comparison of the highest with lowest categories of total, animal, and plant protein intakes were 1.09 (95% CI: 1.06, 1.13), 1.19 (95% CI: 1.11, 1.28), and 0.95 (95% CI: 0.89, 1.02), respectively. Associations between animal protein intake and T2D were similar across sex, geographic region, length of follow-up, study quality, and method of expressing protein intake. An inverse association between plant protein intake and T2D was observed in women (RR: 0.93; 95% CI: 0.85, 1.00) and in US populations (RR: 0.91; 95% CI: 0.84, 0.97).

Conclusion: Higher intakes of total and animal protein were both associated with increased risks of T2D, whereas higher plant protein intake tended to be associated with lower risk of T2D.

Keywords

animal protein
dietary protein
meta-analysis
plant protein
prospective study
type 2 diabetes

ABBREVIATIONS

EPIC
European Prospective Investigation into Cancer and Nutrition
FFQ
food-frequency questionnaire
MCCS
Melbourne Collaborative Cohort Study
PG
plasma glucose
SES
socioeconomic status
T2D
type 2 diabetes

Cited by (0)

1

Supported by the VicHealth and Cancer Council Victoria and the Australian National Health and Medical Research Council (grants 209057, 251553, and 504711) and by infrastructure provided by the Cancer Council Victoria.

2

Supplemental Figures 14 and Supplemental Tables 15 are available from the “Online Supporting Material” link in the online posting of the article and from the same link in the online table of contents at http://ajcn.nutrition.org.