Dietary Protein Sources and Muscle Mass over the Life Course: The Lifelines Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Estimation of Muscle Mass
2.3. Dietary Assessment
2.4. Demographics, Lifestyle Factors, and Blood Biomarkers
2.5. Statistical Analyses
3. Results
3.1. Subject Characteristics
3.2. Associations between Protein Intake and Creatinine Excretion
3.3. Age Groups
3.4. Physical Activity
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
ANCOVA | Analysis of covariance |
ANOVA | Analysis of variance |
BMI | Body mass index |
BSA | Body surface area |
CI | Confidence interval |
COPD | Chronic obstructive pulmonary disease |
DIAAS | Digestible Indispensable Amino Acid Score |
FAO | Food and Agriculture Organization |
FFQ | Food frequency questionnaire |
MET | Metabolic equivalent |
MVPA | Moderate-intensity and vigorous-intensity physical activity |
Q | Quartile |
RDA | Recommended dietary allowance |
SD | Standard deviation |
SQUASH | Short questionnaire to assess health-enhancing physical activity |
UMCG | University Medical Center Groningen |
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Characteristic | Total (n = 76,633) | Q1 (n = 19,158) | Q2 (n = 19,158) | Q3 (n = 19,160) | Q4 (n = 19,157) | p |
---|---|---|---|---|---|---|
Age (years) | 44.9 ± 12.8 | 41.5 ± 12.8 | 44.5 ± 12.7 | 45.9 ± 12.5 | 47.7 ± 12.1 | <0.001 |
Female (%) | 59.2 | 59.2 | 59.2 | 59.2 | 59.2 | 0.99 |
White (%) | 98.3 | 97.7 | 98.3 | 98.5 | 98.7 | <0.001 |
Education (%) | ||||||
-Low | 60.8 | 63.3 | 59.1 | 59.4 | 61.3 | <0.001 |
-Medium | 8.9 | 9.6 | 9.0 | 8.6 | 8.3 | <0.001 |
-High | 30.3 | 27.1 | 31.9 | 32.0 | 30.4 | <0.001 |
Smoking (%) | ||||||
-Never | 45.0 | 45.5 | 46.0 | 45.2 | 43.1 | <0.001 |
-Former | 36.2 | 30.7 | 35.8 | 37.5 | 40.7 | <0.001 |
-Current | 18.9 | 23.8 | 18.3 | 17.2 | 16.2 | <0.001 |
Alcohol intake (%) | ||||||
-0 g/day | 14.5 | 16.3 | 14.4 | 13.1 | 14.1 | <0.001 |
->0–<10 g/day | 60.0 | 56.9 | 59.9 | 61.7 | 61.4 | <0.001 |
-≥10–<20g/day | 18.4 | 17.3 | 18.5 | 19.0 | 18.7 | <0.001 |
-≥20 g/day | 7.2 | 9.5 | 7.2 | 6.2 | 5.9 | <0.001 |
Prevalent health conditions (%) | ||||||
-Diabetes | 2.4 | 1.4 | 1.9 | 2.6 | 3.7 | <0.001 |
-Ischemic heart disease | 0.3 | 0.2 | 0.3 | 0.3 | 0.3 | 0.008 |
-Congestive heart failure | 0.7 | 0.5 | 0.7 | 0.8 | 1.0 | <0.001 |
-Hypertension | 22.0 | 17.6 | 20.8 | 22.9 | 26.7 | <0.001 |
-Cerebrovascular accident | 0.7 | 0.7 | 0.6 | 0.7 | 0.9 | 0.003 |
-Chronic obstructive pulmonary disease | 5.3 | 5.4 | 5.0 | 5.2 | 5.5 | 0.059 |
-Cancer | 4.6 | 3.9 | 4.3 | 4.7 | 5.4 | <0.001 |
Physical activity | ||||||
-MVPA score | 4806 ± 4952 | 4546 ± 4792 | 4662 ± 4881 | 4770 ± 4950 | 5246 ± 5150 | <0.001 |
Body composition | ||||||
-Creatinine excretion (mmoL/24 h) | 13.3 ± 4.1 | 13.0 ± 4.2 | 13.2 ± 4.0 | 13.4 ± 4.1 | 13.6 ± 4.3 | <0.001 |
-Waist circumference (cm) | 90.3 ± 12.4 | 88.2 ± 12.3 | 89.7 ± 12.1 | 91.0 ± 12.1 | 92.4 ± 12.5 | <0.001 |
-Height (cm) | 174.7 ± 9.4 | 174.8 ± 9.3 | 174.6 ± 9.2 | 174.7 ± 9.4 | 174.7 ± 9.5 | 0.271 |
-Weight (kg) | 79.8 ± 15.2 | 77.3 ± 15.1 | 79.1 ± 14.8 | 80.5 ± 15.0 | 82.2 ± 15.6 | <0.001 |
-BMI (kg/m2) | 26.1 ± 4.3 | 25.2± 4.2 | 25.9 ± 4.2 | 26.3 ± 4.2 | 26.9 ± 4.4 | <0.001 |
-BSA (m2) | 1.95 ± 0.2 | 1.92 ± 0.2 | 1.94 ± 0.2 | 1.95 ± 0.2 | 1.97 ± 0.2 | <0.001 |
Blood biomarkers | ||||||
-Hemoglobin (mmoL/L) | 8.7 ± 0.8 | 8.7 ± 0.8 | 8.7 ± 0.8 | 8.7 ± 0.8 | 8.8 ± 0.8 | <0.001 |
-Lymphocyte (%) | 34.2 ± 7.7 | 34.1 ± 7.8 | 34.1 ± 7.6 | 34.2 ± 7.7 | 34.3 ± 7.6 | 0.028 |
-Cholesterol (mmoL/L) | 5.1 ± 1.0 | 5.0 ± 1.0 | 5.1 ± 1.0 | 5.1 ± 1.0 | 5.1 ± 1.0 | <0.001 |
-Glucose (mmoL/L) | 5.0 ± 0.8 | 4.9 ± 0.7 | 5.0 ± 0.8 | 5.0 ± 0.8 | 5.1 ± 0.9 | <0.001 |
Dietary intake | ||||||
-Total energy (kcal/day) | 1978 ± 517 | 2034 ± 624 | 1911 ± 544 | 1926 ± 527 | 2042 ± 573 | <0.001 |
-Fat (% of energy) | 34.6 | 34.2 | 34.4 | 34.6 | 35.0 | <0.001 |
-Carbohydrates (% of energy) | 46.8 | 50.0 | 47.4 | 46.0 | 44.0 | <0.001 |
-Protein (% of energy) | 15.4 | 12.3 | 14.8 | 16.1 | 17.9 | <0.001 |
-Protein (g·kg−1·day−1) | 1.0 ± 0.3 | 0.8 ± 0.2 | 0.9 ± 0.2 | 1.0 ± 0.2 | 1.1 ± 0.3 | <0.001 |
-Protein (g/day) | 74.7 ± 19.8 | 64.0 ± 17.6 | 69.4 ± 16.1 | 75.9 ± 15.7 | 89.5 ± 19.7 | <0.001 |
-Animal protein (g/day) | 44.6 ± 14.1 | 33.8 ± 10.8 | 40.0 ± 9.4 | 46.1 ± 9.1 | 58.4 ± 13.4 | <0.001 |
-Dairy protein (g/day) | 19.5 ± 10.0 | 13.6 ± 6.8 | 16.7 ± 7.0 | 20.0 ± 7.7 | 27.7 ± 11.5 | <0.001 |
-Fish/meat/egg protein (g/day) | 25.1 ± 9.2 | 20.2 ± 8.4 | 23.3 ± 7.7 | 26.1 ± 7.6 | 30.7 ± 9.6 | <0.001 |
-Plant protein (g/day) | 30.2 ± 9.7 | 30.1 ± 9.9 | 29.4 ± 9.2 | 29.9 ± 9.3 | 31.2 ± 10.3 | <0.001 |
-Alcohol (g/day) | 7.0 ± 8.7 | 7.6 ± 10.3 | 7.0 ± 8.4 | 6.9 ± 7.9 | 6.7 ± 7.8 | <0.001 |
Quartiles of Protein Intake | |||||
---|---|---|---|---|---|
Model 12 | |||||
Q1 | Q2 | Q3 | Q4 | p-trend | |
Men | |||||
Total protein | 16.38 (16.31–16.45) | 16.60 (16.52–16.67) * | 16.75 (16.67–16.82) * | 16.98 (16.91–17.05) * | <0.001 |
Animal protein | 16.37 (16.29–16.44) | 16.59 (16.51–16.66) * | 16.77 (16.70–16.84) * | 16.98 (16.91–17.06) * | <0.001 |
-Dairy protein | 16.72 (16.65–16.79) | 16.66 (16.59–16.73) | 16.64 (16.57–16.71) | 16.68 (16.61–16.76) | 0.442 |
-Fish/meat/egg protein | 16.19 (16.11–16.26) | 16.54 (16.47–16.61) * | 16.78 (16.71–16.86) * | 17.20 (17.13–17.27) * | <0.001 |
Plant protein | 16.68 (16.61–16.75) | 16.69 (16.62–16.76) | 16.65 (16.58–16.72) | 16.68 (16.61–16.75) | 0.893 |
Women | |||||
Total protein | 10.77 (10.73–10.81) | 11.01 (10.97–11.05) * | 11.10 (11.06–11.14) * | 11.17 (11.13–11.21) * | <0.001 |
Animal protein | 10.78 (10.74–10.82) | 11.00 (10.95–11.03) * | 11.10 (11.06–11.14) * | 11.19 (11.14–11.23) * | <0.001 |
-Dairy protein | 11.00 (10.96–11.05) | 11.00 (10.95–11.03) | 11.03 (10.99–11.07) | 11.04 (10.99–11.08) | 0.392 |
-Fish/meat/egg protein | 10.65 (10.61–10.69) | 11.01 (10.97–11.05) * | 11.12 (11.08–11.16) * | 11.27 (11.23–11.31) * | <0.001 |
Plant protein | 11.01 (10.96–11.05) | 11.03 (10.99–11.07) | 10.99 (10.95–11.03) | 11.03 (10.99–11.07) | 0.474 |
Model 23 | |||||
Q1 | Q2 | Q3 | Q4 | p-trend | |
Men | |||||
Total protein | 16.36 (16.29–16.43) | 16.62 (16.55–16.69) * | 16.77 (16.70–16.84) * | 16.95 (16.88–17.02) * | <0.001 |
Animal protein | 16.34 (16.27–16.41) | 16.61 (16.54–16.68) * | 16.79 (16.72-16.87) * | 16.96 (16.89-17.03) * | <0.001 |
-Dairy protein | 16.70 (16.62–16.77) | 16.70 (16.63–16.77) | 16.67 (16.60-16.74) | 16.64 (16.57-16.71) | 0.653 |
-Fish/meat/egg protein | 16.15 (16.08–16.22) | 16.55 (16.47–16.62) * | 16.81 (16.74-16.88) * | 17.20 (17.13-17.28) * | <0.001 |
Plant protein | 16.66 (16.58–16.73) | 16.72 (16.650–16.79) | 16.68 (16.61-16.75) | 16.64 (16.57-16.72) | 0.464 |
Women | |||||
Total protein | 10.77 (10.73–10.81) | 11.03 (10.99–11.07) * | 11.11 (11.07–11.15) * | 11.14 (11.10–11.19) * | <0.001 |
Animal protein | 10.77 (10.73–10.81) | 11.01 (10.97–11.05) * | 11.11 (11.07–11.15) * | 11.17 (11.12–11.21) * | <0.001 |
-Dairy protein | 10.98 (10.94–11.02) | 11.02 (10.98–11.06) | 11.05 (11.01–11.09) | 11.01 (10.97–11.05) | 0.112 |
-Fish/meat/egg protein | 10.66 (10.62–10.70) | 11.00 (10.96–11.04) * | 11.12 (11.08–11.16) * | 11.27 (11.23–11.31) * | <0.001 |
Plant protein | 10.98 (10.94–11.02) | 11.06 (11.02–11.10) * | 11.02 (10.98–11.06) | 11.00 (10.96–11.04) | 0.032 |
Men | Women | |||
---|---|---|---|---|
β (95% CI) | p | β (95% CI) | p | |
Model 12 | ||||
Total protein | 0.022 (0.018–0.025) | <0.001 | 0.015 (0.013–0.017) | <0.001 |
Animal protein | 0.023 (0.019–0.026) | <0.001 | 0.015 (0.013–0.017) | <0.001 |
Dairy protein | 0.001 (–0.003–0.005) | 0.633 | 0.001 (–0.002–0.003) | 0.637 |
Fish/meat/egg protein | 0.051 (0.047–0.055) | <0.001 | 0.033 (0.030–0.036) | <0.001 |
Plant protein | 0.002 (–0.004–0.009) | 0.455 | 0.004 (–0.001–0.009) | 0.091 |
Model 23 | ||||
Total protein | 0.021 (0.018–0.025) | <0.001 | 0.014 (0.012–0.017) | <0.001 |
Animal protein | 0.022 (0.019–0.026) | <0.001 | 0.015 (0.012–0.017) | <0.001 |
Dairy protein | –0.001 (–0.005–0.003) | 0.685 | 0.000 (–0.003–0.002 | 0.882 |
Fish/meat/egg protein | 0.052 (0.048–0.057) | <0.001 | 0.033 (0.030–0.036) | <0.001 |
Plant protein | 0.001 (–0.005–0.008) | 0.657 | 0.004 (–0.001–0.009) | 0.158 |
Age Group | |||||||
---|---|---|---|---|---|---|---|
18–25 | 26–35 | 36–45 | 46–55 | 56–65 | 66–75 | >75 | |
Model 12 | |||||||
Men, n | 1591 | 5453 | 8864 | 8610 | 4464 | 1998 | 298 |
Total protein | 0.020 (0.006–0.034) ** | 0.026 (0.019–0.034) * | 0.024 (0.018–0.030)* | 0.017 (0.010–0.023) * | 0.021 (0.013–0.028) * | 0.013 (0.002–0.024) ** | 0.003 (−0.026–0.033) |
Animal protein | 0.022 (0.008–0.037) ** | 0.027 (0.003–0.032) * | 0.026 (0.020–0.032) * | 0.018 (0.011–0.024) * | 0.021 (0.013–0.029) * | 0.013 (0.002–0.024) ** | 0.004 (−0.025–0.034) |
-Dairy protein | −0.007 (−0.025–0.011) | 0.000 (−0.010–0.010) | 0.002 (−0.006–0.009) | −0.001 (−0.009–0.006) | 0.008 (−0.001–0.017) *** | −0.007 (−0.020–0.006) | −0.032 (−0.066–0.003) *** |
-Fish/meat/egg protein | 0.054 (0.035–0.073) * | 0.055 (0.046–0.065) * | 0.057 (0.049–0.066)* | 0.047 (0.038–0.056) * | 0.039 (0.028–0.049) * | 0.041 (0.026–0.055) * | 0.054 (0.014–0.093) ** |
Plant protein | 0.003 (−0.024–0.031) | 0.018 (0.003–0.032) ** | −0.004 (−0.016–0.009) | −0.006 (−0.020–0.007) | −0.008 (−0.024–0.008) | −0.025 (−0.049–0.001) ** | −0.015 (−0.078–0.047) |
Women, n | 3390 | 7570 | 13156 | 12509 | 6151 | 2259 | 320 |
Total protein | 0.015 (0.006–0.024) * | 0.018 (0.013–0.024) * | 0.010 (0.006–0.014) * | 0.015 (0.011–0.019) * | 0.015 (0.010–0.020) * | 0.022 (0.014–0.030) * | 0.029 (0.010–0.048) ** |
Animal protein | 0.016 (0.007–0.025) * | 0.019 (0.013–0.025) * | 0.010 (0.006–0.015) * | 0.015 (0.011–0.019) * | 0.014 (0.009–0.019) * | 0.022 (0.013–0.030) * | 0.028 (0.009–0.047) ** |
-Dairy protein | −0.002 (–0.013–0.010) | 0.004 (−0.003–0.012) | −0.004 (−0.009–0.001) | 0.000 (−0.004–0.005) | 0.003 (−0.003–0.009) | 0.013 (0.002–0.023) ** | 0.017 (−0.008–0.041) |
-Fish/meat/egg protein | 0.034 (0.022–0.045) * | 0.034 (0.026–0.041) * | 0.029 (0.023–0.034) * | 0.036 (0.030–0.041) * | 0.029 (0.023–0.036) * | 0.034 (0.023–0.045) * | 0.039 (0.014–0.064) ** |
Plant protein | 0.005 (−0.015–0.024) | 0.005 (−0.007–0.018) | −0.001 (−0.011–0.008) | 0.008 (−0.001–0.018) *** | −0.007 (−0.020–0.005) | 0.018 (−0.003–0.040) *** | 0.050 (0.003–0.098) ** |
Model 23 | |||||||
Men, n | 1591 | 5453 | 8864 | 8610 | 4464 | 1998 | 298 |
Total protein | 0.020 (0.006–0.034) ** | 0.027 (0.020–0.035) * | 0.024 (0.018–0.031) * | 0.016 (0.010–0.023) * | 0.019 (0.011–0.027) * | 0.013 (0.001–0.024) ** | 0.004 (−0.027–0.035) |
Animal protein | 0.022 (0.008–0.036) ** | 0.028 (0.020–0.035) * | 0.026 (0.020–0.033) * | 0.017 (0.011–0.024) * | 0.019 (0.011–0.027) * | 0.012 (0.001–0.024) ** | 0.005 (−0.026–0.036) |
-Dairy protein | −0.006 (−0.025–0.012) | 0.001 (−0.009–0.011) | 0.001 (−0.007–0.008) | −0.004 (−0.011–0.004) | 0.003 (−0.007–0.012) | −0.012 (−0.025–0.002) *** | −0.033 (−0.069–0.003) *** |
-Fish/meat/egg protein | 0.052 (0.033–0.071) * | 0.056 (0.046–0.065) * | 0.059 (0.051–0.068) * | 0.048 (0.039–0.057) * | 0.041 (0.030–0.052) * | 0.042 (0.027–0.057) * | 0.055 (0.015–0.095) ** |
Plant protein | 0.004 (−0.024–0.033) | 0.020 (0.005–0.034) ** | −0.004 (−0.017–0.008) | −0.009 (−0.022–0.005) | −0.015 (−0.031–0.002) *** | −0.025 (−0.050–0.001) *** | −0.013 (−0.080–0.053) |
Women, n | 3390 | 7570 | 13156 | 12509 | 6151 | 2259 | 320 |
Total protein | 0.017 (0.008–0.026) * | 0.019 (0.013–0.025)* | 0.011 (0.007–0.015) * | 0.014 (0.010–0.018) * | 0.013 (0.008–0.017) * | 0.019 (0.010–0.027) * | 0.022 (0.002–0.041) ** |
Animal protein | 0.017 (0.008–0.026) * | 0.020 (0.014–0.026) * | 0.011 (0.007–0.015) * | 0.014 (0.010–0.018) * | 0.011 (0.006–0.016) * | 0.018 (0.010–0.027) * | 0.021 (0.002–0.041) ** |
-Dairy protein | 0.001 (−0.010–0.013) | 0.005 (−0.002–0.013) | −0.004 (−0.009–0.001) | −0.002 (−0.006–0.003) | −0.002 (−0.008–0.004) | 0.007 (−0.003–0.018) | 0.004 (−0.021–0.030) |
-Fish/meat/egg protein | 0.033 (0.022–0.045) * | 0.035 (0.027–0.042) * | 0.030 (0.024–0.035) * | 0.035 (0.030–0.041) * | 0.029 (0.022–0.035) * | 0.032 (0.021–0.044) * | 0.038 (0.013–0.064) ** |
Plant protein | 0.009 (−0.011–0.029) | 0.007 (−0.006–0.019) | −0.001 (−0.011–0.008) | 0.007 (−0.003–0.016) | −0.016 (−0.028–0.003) ** | 0.015 (−0.007–0.037) | 0.030 (−0.021–0.081) |
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Alexandrov, N.V.; Eelderink, C.; Singh-Povel, C.M.; Navis, G.J.; Bakker, S.J.L.; Corpeleijn, E. Dietary Protein Sources and Muscle Mass over the Life Course: The Lifelines Cohort Study. Nutrients 2018, 10, 1471. https://doi.org/10.3390/nu10101471
Alexandrov NV, Eelderink C, Singh-Povel CM, Navis GJ, Bakker SJL, Corpeleijn E. Dietary Protein Sources and Muscle Mass over the Life Course: The Lifelines Cohort Study. Nutrients. 2018; 10(10):1471. https://doi.org/10.3390/nu10101471
Chicago/Turabian StyleAlexandrov, Nikita V., Coby Eelderink, Cécile M. Singh-Povel, Gerjan J. Navis, Stephan J. L. Bakker, and Eva Corpeleijn. 2018. "Dietary Protein Sources and Muscle Mass over the Life Course: The Lifelines Cohort Study" Nutrients 10, no. 10: 1471. https://doi.org/10.3390/nu10101471