Associations between Dietary Animal and Plant Protein Intake and Cardiometabolic Risk Factors—A Cross-Sectional Study in China Health and Nutrition Survey

Abstract

Available data investigating the associations between dietary animal and plant protein intakes and cardiometabolic risk factors (CMRFs) among populations with habitual plant-based diets are heterogenous and limited in scope. The current study was to assess the associations between dietary animal and plant protein intakes and CMRFs, including lipid and lipoprotein profiles, glucose homeostasis biomarkers, low-grade chronic inflammatory biomarker and uric acid in Chinese adults. Data of 7886 apparently healthy adults were extracted from the China Health and Nutrition Survey 2009. Dietary protein (total, animal and plant) intakes were assessed with three consecutive 24 h dietary recalls, and CMRFs were measured with standard laboratory methods. Substituting 5% of energy intake from animal protein for carbohydrates was positively associated with total cholesterol, low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C) and uric acid (all p < 0.05). Substituting 5% of energy intake from plant protein for carbohydrates was inversely associated with non-HDL-C and LDL-C:HDL-C ratio, and positively associated with HDL-C and glycated hemoglobin (all p < 0.05). Some of these associations varied in subgroup analyses by BMI, sex, age or region. There were no significant associations between animal or plant protein intakes and high-sensitivity C-reactive protein. The public health implication of these findings requires further investigation.

Geographic Variations in Dietary Patterns and Their Associations with Overweight/Obesity and Hypertension in China: Findings from China Nutrition and Health Surveillance (2015–2017)

“…A randomized controlled trial in the European population with habitual high intake of protein and animal protein indicated a lower weight regain in high protein intake groups after weight loss, while another trial in the US population with habitual high intake of protein and animal protein indicated no difference in weight maintenance among groups with isocaloric protein (animal or plant sources) or maltodextrin supplements [ 75 , 78 ]. Similar inconsistency presented in observational studies [ 76 , 79 ]. This issue warrants further investigation in China and other transitional countries with habitual low intake of animal foods.…”

The association between low carbohydrate diet scores and cardiometabolic risk factors in Chinese adults

“…This study explains that higher consumption of an animal-based diet leads to higher TC levels. A prospective study also shown that animal protein substitution of carbohydrates was positively associated with LDL-cholesterol or TC (51) . However, the notion that animal-based LCD may have a deleterious effect on blood lipids remains speculative.…”

Protein Intake Is Associated with Blood Pressure and Cholesterol Levels in Italian Older Adults: A Cross-Sectional Study

“…However, HbA1C was not measured in our study. Fifth, specific patterns of associations have been observed between protein sources and cardiometabolic parameters [ 62 , 63 ]. This aspect was not investigated in the present study.…”