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dietary protein

Dietary protein is graded by quality as to content of essential amino acids, relative to egg albumin. About 30 g of protein (egg albumin quality) is needed to maintain nitrogen balance inhealthy young adult men. U.S. recommended dietary allowance (RDA) for protein is 0.8 g/kg/day regardless of age or physical function (< ounces for a 70-kg man) [4] Contraindications: - lean body mass in functionally limited older men is unchanged by protein intake beyond recommended daily allowance, with or without testosterone replacement therapy [4] Biochemistry: - dietary protein seems to increase IGF-1 signaling activity [2] Adverse effects: - high animal protein-based diet before age 65 years associated with increased mortality, & 4-fold risk of cancer-related mortality [2] - high protein-diet in persons > 65 years of age associated with decreased mortality & cancer-related mortality but 5-fold increase in risk of diabetes mellitus-related mortality [2] - high animal protein intake is positively associated with cardiovascular mortality [3] - high plant protein intake is inversely associated with all-cause & cardiovascular mortality, especially among individuals with at least 1 lifestyle risk factor* [3,6] - substitution of plant protein for animal protein, especially processed red meat, is associated with lower mortality [3] - consumption of plant-based proteins, including legumes & cereals lowers mortality [4] - higher plant protein intake associated with 8% lower mortality risk - plant protein associated with 12% lower cardiovascular mortality, but not cancer mortality * underscores importance of lifestyle Laboratory: - see ARUP consult [1]

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diet protein

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References

  1. ARUP Consult: Proteins deprecated reference
  2. Levine ME et al Low Protein Intake Is Associated with a Major Reduction in IGF-1, Cancer, and Overall Mortality in the 65 and Younger but Not Older Population. Cell Metabolism, Volume 19, Issue 3, 407-417, 4 March 2014 PMID: 24606898 http://www.cell.com/cell-metabolism/retrieve/pii/S155041311400062X
  3. Song M, Fung TT, Hu FB et al Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. JAMA Intern Med. 2016;176(10):1453-1463. PMID: 27479196 http://archinte.jamanetwork.com/article.aspx?articleid=2540540
  4. Bhasin S, Apovian CM, Travison TG et al. Effect of protein intake on lean body mass in functionally limited older men: A randomized clinical trial. JAMA Intern Med 2018 Mar 12; PMID: 29532075
  5. Budhathoki S, Sawada N, Iwasaki M et al Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. JAMA Intern Med. Published online August 26, 2019 PMID: 31449285 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2748453
  6. Huang J, Liao LM, Weinstein SJ et al Association Between Plant and Animal Protein Intake and Overall and Cause-Specific Mortality. JAMA Intern Med. Published online July 13, 2020 PMID: 32658243 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768358
  7. Naghshi S et al Dietary intake of total, animal, and plant proteins and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies. BMJ 2020;370:m2412 July 22, 2020 PMID: 32699048 https://www.bmj.com/content/370/bmj.m2412