title: Dietary protein intake and risk of type 2 diabetes: results from the Melbourne Collaborative Cohort Study and a meta-analysis of prospective studies.
abstract: Reported associations between protein intake from different sources and type 2 diabetes (T2D) have been inconsistent.
  
  
  
  We prospectively examined the relations of total, animal, and plant protein intakes with incident T2D.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Australian Institute for Musculoskeletal Science, Melbourne, Australia; xshang@student.unimelb.edu.au.|Faculty of Medicine, Dentistry and Health Sciences, Melbourne Medical School-Western Campus, and.
authors.forename: Xianwen
authors.identifier: 0000-0002-2362-3222
authors.initials: X
authors.lastname: Shang
authors.affiliation: Australian Institute for Musculoskeletal Science, Melbourne, Australia.|Faculty of Medicine, Dentistry and Health Sciences, Melbourne Medical School-Western Campus, and.|Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia.
authors.forename: David
authors.identifier: 0000-0001-5226-1972
authors.initials: D
authors.lastname: Scott
authors.affiliation: Center for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.|Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia; and.
authors.forename: Allison M
authors.identifier: 0000-0001-5464-2197
authors.initials: AM
authors.lastname: Hodge
authors.affiliation: Center for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.|Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia; and.
authors.forename: Dallas R
authors.initials: DR
authors.lastname: English
authors.affiliation: Center for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.|Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia; and.
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
authors.affiliation: Australian Institute for Musculoskeletal Science, Melbourne, Australia.|Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Ebeling
authors.affiliation: Australian Institute for Musculoskeletal Science, Melbourne, Australia.|Faculty of Medicine, Dentistry and Health Sciences, Melbourne Medical School-Western Campus, and.|Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia.
authors.forename: Kerrie M
authors.identifier: 0000-0002-2718-6592
authors.initials: KM
authors.lastname: Sanders
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D006801:Humans; D015994:Incidence; D009124:Muscle Proteins / Q000008:administration & dosage; D015596:Nutrition Assessment; D010940:Plant Proteins / Q000008:administration & dosage; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D004044:Dietary Proteins; D009124:Muscle Proteins; D010940:Plant Proteins
keywords: animal protein; dietary protein; meta-analysis; plant protein; prospective study; type 2 diabetes