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Health effects of protein intake in healthy adults: a systematic literature review
Open accessAbstract
The purpose of this systematic review is to assess the evidence behind the dietary requirement of protein and to assess the health effects of varying protein intake in healthy adults. The literature search covered the years 2000–2011. Prospective cohort, case-control, and intervention studies were included. Out of a total of 5,718 abstracts, 412 full papers were identified as potentially relevant, and after careful scrutiny, 64 papers were quality graded as A (highest), B, or C. The grade of evidence was classified as convincing, probable, suggestive or inconclusive. The evidence is assessed as: probable for an estimated average requirement of 0.66 g good-quality protein/kg body weight (BW)/day based on nitrogen balance studies, suggestive for a relationship between increased all-cause mortality risk and long-term low-carbohydrate–high-protein (LCHP) diets; but inconclusive for a relationship between all-cause mortality risk and protein intake per se; suggestive for an inverse relationship between cardiovascular mortality and vegetable protein intake; inconclusive for relationships between cancer mortality and cancer diseases, respectively, and protein intake; inconclusive for a relationship between cardiovascular diseases and total protein intake; suggestive for an inverse relationship between blood pressure (BP) and vegetable protein; probable to convincing for an inverse relationship between soya protein intake and LDL cholesterol; inconclusive for a relationship between protein intake and bone health, energy intake, BW control, body composition, renal function, and risk of kidney stones, respectively; suggestive for a relationship between increased risk of type 2 diabetes (T2D) and long-term LCHP-high-fat diets; inconclusive for impact of physical training on protein requirement; and suggestive for effect of physical training on whole-body protein retention. In conclusion, the evidence is assessed as probable regarding the estimated requirement based on nitrogen balance studies, and suggestive to inconclusive for protein intake and mortality and morbidity. Vegetable protein intake was associated with decreased risk in many studies. Potentially adverse effects of a protein intake exceeding 20–23 E% remain to be investigated. Keywords: protein requirement; nitrogen balance; animal protein; vegetable protein; mortality; chronic disease; Nordic nutrition recommendations (Published: 30 July 2013) Citation: Food & Nutrition Research 2013. 57: 21245 - http://dx.doi.org/10.3402/fnr.v57i0.21245 Access the supplementary material to this article – see Supplementary files under Article Tools online. Special Issue: This paper is part of the Nordic Nutrition Recommendations - The NNR5 project. More papers from this issue can be found at http://www.foodandnutritionresearch.net
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“Empagliflozin and canagliflozin (the latter given at a higher dose than that approved for use in Japan) are shown to significantly reduce the risk of macroangiopathy in patients at high risk of cardiovascular events 32 , 33 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [32]
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“SGLT2 inhibitors tend to be associated with such adverse effects as an increased frequency of genital infection and fluid loss‐related events 32 , 34 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [32]
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“Intensive insulin therapy has been shown to be effective in preventing the onset of macroangiopathy in type 2 diabetes 9 , 31 , 32 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [32]
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Japanese clinical practice guideline for diabetes 2019
Araki, E., Goto, A., Kondo, T., Noda, M., Noto, H., Origasa, H., Osawa, H., Taguchi, A., Tanizawa, Y., Tobe, K., et al. (2020) · Diabetology International · doi:10.1007/s13340-020-00439-5 · Cited by 545
Nordic Nutrition Recommendations 2023
Blomhoff, R., Andersen, R., Arnesen, E., Christensen, J. J., Eneroth, H., Erkkola, M., Gudanaviciene, I., Halldorsson, T. I., Høyer-Lund, A., Lemming, E. W., et al. (2023) · Nordic Council of Ministers eBooks · doi:10.6027/nord2023-003 · Cited by 455
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Metadata
- Authors
- Pedersen, A. N., Kondrup, J., & Børsheim, E.
- Affiliations
- Technical University of Denmark (DK)
- Copenhagen University Hospital (DK)
- The University of Texas Medical Branch at Galveston (US)
- Corresponding author
- Pedersen, Agnes N.
- ORCID
- Børsheim, Elisabet
- Venue
- Food & Nutrition Research
- Publisher
- SNF Swedish Nutrition Foundation
- Published
- 2013-01
- Volume
- 57
- Issue
- 1
- Pages
- 21245
- ISSN
- 1654-661X (ISSN-L)
- 1654-6628
- PMC
- PMC3730112
- OpenAlex
- W2022177344
- Cited by
- 167
- References
- 89
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 7 · 2023: 13 · 2022: 7 · 2021: 14 · 2020: 19 · 2019: 10 · 2018: 13 · 2017: 19 · 2016: 26 · 2015: 13 · 2014: 11 · 2013: 2
- FWCI
- 1.99
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Food & Nutrition Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Physiology (medical) › Diet and metabolism studies
- Keywords
- protein intake, protein requirements, nitrogen balance, plant proteins, animal protein, all-cause mortality, cardiovascular mortality, cancer mortality, type 2 diabetes, LDL cholesterol, blood pressure, bone health, kidney stones, renal function, body composition, weight management, exercise training, protein retention, high-protein low-carbohydrate diet, Nordic Nutrition Recommendations, healthy adults, energy intake, body weight
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