title: Diets higher in animal and plant protein are associated with lower adiposity and do not impair kidney function in US adults.
abstract: 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.
  
  
  METHODS
  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.
authors.affiliation: Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA; Oak Ridge Institute for Science and Education, Belcamp, MD; and.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Berryman
authors.affiliation: Oak Ridge Institute for Science and Education, Belcamp, MD; and.
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA;
authors.forename: Harris R
authors.initials: HR
authors.lastname: Lieberman
authors.affiliation: Henry M Jackson Foundation, Bethesda, MD.
authors.forename: Victor L
authors.initials: VL
authors.lastname: Fulgoni
authors.affiliation: Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA; stefan.m.pasiakos.civ@mail.mil.
authors.forename: Stefan M
authors.initials: SM
authors.lastname: Pasiakos
mesh_terms: D050154:Adiposity; D000328:Adult; D000818:Animals; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects* / Q000639:trends; D004044:Dietary Proteins / Q000009:adverse effects*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000502:physiology*; D008297:Male; D008894:Milk Proteins / Q000009:adverse effects; D009124:Muscle Proteins / Q000009:adverse effects; D009749:Nutrition Surveys; D050177:Overweight / Q000453:epidemiology / Q000517:prevention & control*; D014674:Plant Proteins, Dietary / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000453:epidemiology / Q000517:prevention & control*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D004044:Dietary Proteins; D008894:Milk Proteins; D009124:Muscle Proteins; D014674:Plant Proteins, Dietary
keywords: NHANES; cardiometabolic risk; central adiposity; higher-protein diet; kidney function; protein source