Dietary Protein Intake and Coronary Heart Disease in a Large Community Based Cohort: Results from the Atherosclerosis Risk in Communities (ARIC) Study
Open accessAbstract
BACKGROUND: Prospective data examining the relationship between dietary protein intake and incident coronary heart disease (CHD) are inconclusive. Most evidence is derived from homogenous populations such as health professionals. Large community-based analyses in more diverse samples are lacking. METHODS: We studied the association of protein type and major dietary protein sources and risk for incident CHD in 12,066 middle-aged adults (aged 45-64 at baseline, 1987-1989) from four U.S. communities enrolled in the Atherosclerosis Risk in Communities (ARIC) Study who were free of diabetes mellitus and cardiovascular disease at baseline. Dietary protein intake was assessed at baseline and after 6 years of follow-up by food frequency questionnaire. Our primary outcome was adjudicated coronary heart disease events or deaths with following up through December 31, 2010. Cox proportional hazard models with multivariable adjustment were used for statistical analyses. RESULTS: During a median follow-up of 22 years, there were 1,147 CHD events. In multivariable analyses total, animal and vegetable protein were not associated with an increased risk for CHD before or after adjustment. In food group analyses of major dietary protein sources, protein intake from red and processed meat, dairy products, fish, nuts, eggs, and legumes were not significantly associated with CHD risk. The hazard ratios [with 95% confidence intervals] for risk of CHD across quintiles of protein from poultry were 1.00 [ref], 0.83 [0.70-0.99], 0.93 [0.75-1.15], 0.88 [0.73-1.06], 0.79 [0.64-0.98], P for trend = 0.16). Replacement analyses evaluating the association of substituting one source of dietary protein for another or of decreasing protein intake at the expense of carbohydrates or total fats did not show any statistically significant association with CHD risk. CONCLUSION: Based on a large community cohort we found no overall relationship between protein type and major dietary protein sources and risk for CHD.
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In several large studies, poultry is not significantly associated with CVD events; in other cohorts, poultry is associated with modestly lower risk of CVD, with smaller observed benefits than seen for fish, nuts, or legumes.
“In several large studies, poultry is not significantly associated with CVD events;174, 186-189 and in other cohorts, with modestly lower risk of CVD, with smaller observed benefits than seen for fish, nuts, or legumes.52, 53”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [189]
Few longitudinal studies have reported on total protein intake and CHD events, with generally null results.
“Few longitudinal studies have reported on total protein intake and CHD events, with generally null results.189, 386”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [189]
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“…10), 15 for red meat (Amiano et al. 2016b; Ashaye et al. 2011; Bernstein et al. 2012b; Bernstein et al. 2010; Del Gobbo et al. 2015; Fraser et al. 1992; Haring et al. 2014; Haring et al. 2015; Kaluza et al. 2014, 2015; Larsson et al. 2011b, 2011c; Nettle-ton et al. 2008; Wurtz et al. 2016;…”
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- Authors
- Haring, B., Gronroos, N., Nettleton, J. A., Wyler von Ballmoos, M. C., Selvin, E., & Alonso, A.
- Affiliations
- University of Würzburg (DE)
- University of Minnesota (US)
- The University of Texas Health Science Center at Houston (US)
- Johns Hopkins University (US)
- Corresponding author
- Haring, Bernhard
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-10-10
- Volume
- 9
- Issue
- 10
- Pages
- e109552
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4193805
- OpenAlex
- W2027771898
- Cited by
- 82
- References
- 42
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 3 · 2023: 7 · 2022: 6 · 2021: 10 · 2020: 11 · 2019: 9 · 2018: 8 · 2017: 7 · 2016: 10 · 2015: 1 · 2014: 1
- FWCI
- 6.28
- Type
- journal article
- Language
- en
- Update notices
- correction (2014-11-20)
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Online Publication Service of Würzburg University (Würzburg University) (submittedVersion, cc-by)
- Funders
- Deutsche Forschungsgemeinschaft
- National Heart, Lung, and Blood Institute (HHSN268201 100012C, HHSN268201100007I, HHSN268201100007C, HHSN2682 01100008C, HH-SN-268201100006C, HHSN268201100011C, HHSN2682011-00005I, HHSN2682011-00009I, HHSN268201100005C, HHSN268201100005G, HHSN268201100010C, HHSN268201100011I, HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C, HHSN26820 1100009C, HHSN2682011-00008I)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Keywords
- protein intake, coronary artery disease, animal protein, plant proteins, red and processed meat, dairy products, fish, nuts, eggs, Fabaceae, poultry, protein replacement, middle-aged adults, Atherosclerosis Risk in Communities Study
- MeSH terms
- Coronary Disease, Dietary Proteins, Female, Humans, Male, Middle Aged, Nutrition Surveys, Prospective Studies, Risk, United States, Cohort Studies, Incidence
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