論文

査読有り 国際誌
2019年11月1日

Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality in a Japanese Cohort.

JAMA internal medicine
  • Sanjeev Budhathoki
  • Norie Sawada
  • Motoki Iwasaki
  • Taiki Yamaji
  • Atsushi Goto
  • Ayaka Kotemori
  • Junko Ishihara
  • Ribeka Takachi
  • Hadrien Charvat
  • Tetsuya Mizoue
  • Hiroyasu Iso
  • Shoichiro Tsugane
  • 全て表示

179
11
開始ページ
1509
終了ページ
1518
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1001/jamainternmed.2019.2806

Importance: Epidemiological evidence regarding the long-term effects of higher dietary protein intake on mortality outcomes in the general population is not clear. Objective: To evaluate the associations between animal and plant protein intake and all-cause and cause-specific mortality. Design, Setting, and Participants: This prospective cohort study included 70 696 participants in the Japan Public Health Center-based Prospective Cohort who were aged 45 to 74 years and had no history of cancer, cerebrovascular disease, or ischemic heart disease at study baseline. Data were collected from January 1, 1995, through December 31, 1999, with follow-up completed December 31, 2016, during which 12 381 total deaths were documented. Dietary intake information was collected through a validated food frequency questionnaire and used to estimate protein intake in all participants. Participants were grouped into quintile categories based on their protein intake, expressed as a percentage of total energy. Data were analyzed from July 18, 2017, through April 10, 2019. Main Outcomes and Measures: Hazard ratios (HRs) and 95% CIs for all-cause and cause-specific mortality were estimated using Cox proportional hazards regression models with adjustment for potential confounding factors. Results: Among the 70 696 participants, 32 201 (45.5%) were men (mean [SD] age, 55.6 [7.6] years) and 38 495 (54.5%) were women (mean [SD] age, 55.8 [7.7] years). Intake of animal protein showed no clear association with total or cause-specific mortality. In contrast, intake of plant protein was associated with lower total mortality, with multivariable-adjusted HRs of 0.89 (95% CI, 0.83-0.95) for quintile 2; 0.88 (95% CI, 0.82-0.95) for quintile 3; 0.84 (95% CI, 0.77-0.92) for quintile 4; and 0.87 (95% CI, 0.78-0.96) for quintile 5, with quintile 1 as the reference category (P = .01 for trend). For cause-specific mortality, this association with plant protein intake was evident for cardiovascular disease (CVD)-related mortality (HRs, 0.84 [95% CI, 0.73-0.96] to 0.70 [95% CI, 0.59-0.83]; P = .002 for trend). Isocaloric substitution of 3% energy from plant protein for red meat protein was associated with lower total (HR, 0.66; 95% CI, 0.55-0.80), cancer-related (HR, 0.61; 95% CI, 0.45-0.82), and CVD-related (HR, 0.58; 95% CI, 0.39-0.86) mortality; substitution for processed meat protein was associated with lower total (HR, 0.54; 95% CI, 0.38-0.75) and cancer-related (HR, 0.50; 95% CI, 0.30-0.85) mortality. Conclusions and Relevance: In this large prospective study, higher plant protein intake was associated with lower total and CVD-related mortality. Although animal protein intake was not associated with mortality outcomes, replacement of red meat protein or processed meat protein with plant protein was associated with lower total, cancer-related, and CVD-related mortality.

リンク情報
DOI
https://doi.org/10.1001/jamainternmed.2019.2806
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31682257
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714005
ID情報
  • DOI : 10.1001/jamainternmed.2019.2806
  • ISSN : 2168-6106
  • PubMed ID : 31682257
  • PubMed Central 記事ID : PMC6714005

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