Dietary Intake of Total, Animal, and Vegetable Protein and Risk of Type 2 Diabetes in the EPIC-NL Study

Abstract

Objective- Dietary recommendations are mainly focused on relative dietary fat and carbohydrate content in relation to diabetes risk. Meanwhile, high protein diets may contribute to disturbance of glucose metabolism, but evidence from prospective studies is scarce. We examined the association between dietary total, vegetable, and animal protein intake and diabetes incidence and whether consuming 5 energy% from protein at the expense of 5 energy% from either carbohydrates or fat was associated with diabetes risk.

Research Design and Methods- A prospective cohort study was conducted among 38,094 participants of the EPIC-NL study. Dietary protein intake was measured with a validated food-frequency questionnaire. Incident diabetes was verified against medical records.

Results- During 10 years follow-up, 918 incident diabetes cases were documented. Diabetes risk increased with higher total protein (HR (95%CI) highest vs. lowest quartile: 2.15 (1.77-2.60)) and animal protein (2.18 (1.80-2.63)) intake. Adjustment for confounders did not materially change these results. Further adjustment for adiposity measures attenuated the associations. Vegetable protein was not related to diabetes. Consuming 5 energy% from total or animal protein at the expense of 5 energy% from carbohydrates or fat increased diabetes risk.

Conclusions- Diets high in animal protein are associated with an increased diabetes risk. Our findings also suggest a similar association for total protein itself instead of only animal sources. Consumption of energy from protein at the expense of energy from either carbohydrates or fat may similarly increase diabetes risk. This indicates that accounting for protein content in dietary recommendations for diabetes prevention may be useful.