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Diets higher in animal and plant protein are associated with lower adiposity and do not impair kidney function in US adults

Berryman, Claire E, Agarwal, Sanjiv, Lieberman, Harris R, Fulgoni, Victor L, Pasiakos, Stefan M
TheAmerican journal of clinical nutrition 2016 v.104 no.3 pp. 743-749
National Health and Nutrition Examination Survey, adiposity, adults, animal proteins, animal source protein, blood, body mass index, carbohydrates, creatinine, dairy animals, glomerular filtration rate, high density lipoprotein cholesterol, high protein diet, models, nationalities and ethnic groups, nutrition risk assessment, physical activity, plant proteins, protein content, protein intake, protein sources, regression analysis, saturated fats, urea nitrogen, waist circumference, United States
Background: 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. Objective: The objective of this study was to evaluate trends of protein source on markers of cardiometabolic disease risk and kidney function in US adults. Design: 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. Results: 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. Conclusions: 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.