Nutrition Research and Practice

The Korean Nutrition Society (한국영양학회)
권호 표지
DOI QR코드

DOI QR Code

A review of recent evidence of dietary protein intake and health

  • Park, Yoon Jung (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Chung, Sangwon (Food Functionality Research Division, Korea Food Research Institute) ;
  • Hwang, Jin-Taek (Food Functionality Research Division, Korea Food Research Institute) ;
  • Shon, Jinyoung (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Kim, Eunjung (Department of Food Science and Nutrition, Daegu Catholic University)
  • Received : 2021.11.05
  • Accepted : 2022.03.18
  • Published : 2022.05.20
Download PDF
⟨ Previous Next ⟩

Abstract

The Korea National Health and Nutrition Examination Survey of 2013 to 2017 reported that the average protein consumption of the Korean population is above the current recommended nutrient intake of protein proposed by the Dietary Reference Intakes for Koreans. Some health professionals and the media often advise consuming diets high in protein for promoting metabolic regulation, weight control, and muscle synthesis. However, due to lack of scientific evidence, the validity and safety of high protein consumption are yet to be fully ascertained. The present review assesses recent evidence published in 2014-2020 from human studies, focusing on adequate protein intake and protein sources for the prevention of chronic diseases, particularly metabolic disorders and sarcopenia.

Keywords

Acknowledgement

This research was supported by Policy Research Program for (project No. 20180415A13-00, 25193068200, 25203084501) from the Ministry of Health and Welfare in 2018-2020.

References

  1. World Health Organization/Food and Agriculture Organization of the United Nations/United Nations University (WHO/FAO/UNU). Protein and Amino Acid Requirements in Human Nutrition. Report of a Joint WHO/FAO/UNU Expert Consultation. Geneva: World Health Organization; 2007.
  2. Ministry of Health and Welfare, The Korean Nutrition Society. 2020 Dietary Reference Intakes for Koreans: Energy and Macronutrients. Seoul: Ministry of Health and Welfare, The Korean Nutrition Society; 2020.
  3. Kim JG, Kim JS, Kim JG. Trends of food supply and nutrient intake in South Korea over the past 30 years. Curr Res Nutr Food Sci 2019;7:85-95. https://doi.org/10.12944/CRNFSJ.7.1.09
  4. Yun S, Kim HJ, Oh K. Trends in energy intake among Korean adults, 1998-2015: results from the Korea National Health and Nutrition Examination Survey. Nutr Res Pract 2017;11:147-54. https://doi.org/10.4162/nrp.2017.11.2.147
  5. Collell R, Closa-Monasterolo R, Ferre N, Luque V, Koletzko B, Grote V, Janas R, Verduci E, Escribano J. Higher protein intake increases cardiac function parameters in healthy children: metabolic programming by infant nutrition-secondary analysis from a clinical trial. Pediatr Res 2016;79:880-8. https://doi.org/10.1038/pr.2016.30
  6. Liotto N, Orsi A, Menis C, Piemontese P, Morlacchi L, Condello CC, Gianni ML, Roggero P, Mosca F. Clinical evaluation of two different protein content formulas fed to full-term healthy infants: a randomized controlled trial. BMC Pediatr 2018;18:59. https://doi.org/10.1186/s12887-018-1046-6
  7. Oropeza-Ceja LG, Rosado JL, Ronquillo D, Garcia OP, Caamano MDC, Garcia-Ugalde C, Viveros-Contreras R, Duarte-Vazquez MA. Lower protein intake supports normal growth of full-term infants fed formula: a randomized controlled trial. Nutrients 2018;10:10. https://doi.org/10.3390/nu10010010
  8. Tang M, Krebs NF. High protein intake from meat as complementary food increases growth but not adiposity in breastfed infants: a randomized trial. Am J Clin Nutr 2014;100:1322-8. https://doi.org/10.3945/ajcn.114.088807
  9. Weber M, Grote V, Closa-Monasterolo R, Escribano J, Langhendries JP, Dain E, Giovannini M, Verduci E, Gruszfeld D, Socha P, et al. Lower protein content in infant formula reduces BMI and obesity risk at school age: follow-up of a randomized trial. Am J Clin Nutr 2014;99:1041-51. https://doi.org/10.3945/ajcn.113.064071
  10. Ziegler EE, Fields DA, Chernausek SD, Steenhout P, Grathwohl D, Jeter JM, Nelson SE, Haschke F. Adequacy of infant formula with protein content of 1.6 g/100 kcal for infants between 3 and 12 months. J Pediatr Gastroenterol Nutr 2015;61:596-603. https://doi.org/10.1097/MPG.0000000000000881
  11. Monasta L, Batty GD, Cattaneo A, Lutje V, Ronfani L, Van Lenthe FJ, Brug J. Early-life determinants of overweight and obesity: a review of systematic reviews. Obes Rev 2010;11:695-708. https://doi.org/10.1111/j.1467-789X.2010.00735.x
  12. Koletzko B, von Kries R, Closa R, Escribano J, Scaglioni S, Giovannini M, Beyer J, Demmelmair H, Anton B, Gruszfeld D, et al. Can infant feeding choices modulate later obesity risk? Am J Clin Nutr 2009;89:1502S-1508S. https://doi.org/10.3945/ajcn.2009.27113d
  13. Metges CC, Barth CA. Metabolic consequences of a high dietary-protein intake in adulthood: assessment of the available evidence. J Nutr 2000;130:886-9. https://doi.org/10.1093/jn/130.4.886
  14. Pedersen AN, Kondrup J, Borsheim E. Health effects of protein intake in healthy adults: a systematic literature review. Food Nutr Res 2013;57:23364.
  15. Kim HH, Kim YJ, Lee SY, Jeong DW, Lee JG, Yi YH, Cho YH, Choi EJ, Kim HJ. Interactive effects of an isocaloric high-protein diet and resistance exercise on body composition, ghrelin, and metabolic and hormonal parameters in untrained young men: a randomized clinical trial. J Diabetes Investig 2014;5:242-7. https://doi.org/10.1111/jdi.12148
  16. Gulati S, Misra A, Tiwari R, Sharma M, Pandey RM, Yadav CP. Effect of high-protein meal replacement on weight and cardiometabolic profile in overweight/obese Asian Indians in North India. Br J Nutr 2017;117:1531-40. https://doi.org/10.1017/S0007114517001295
  17. Rietman A, Schwarz J, Blokker BA, Siebelink E, Kok FJ, Afman LA, Tome D, Mensink M. Increasing protein intake modulates lipid metabolism in healthy young men and women consuming a high-fat hypercaloric diet. J Nutr 2014;144:1174-80. https://doi.org/10.3945/jn.114.191072
  18. Campos-Nonato I, Hernandez L, Barquera S. Effect of a high-protein diet versus standard-protein diet on weight loss and biomarkers of metabolic syndrome: a randomized clinical trial. Obes Facts 2017;10:238-51. https://doi.org/10.1159/000471485
  19. Preis SR, Stampfer MJ, Spiegelman D, Willett WC, Rimm EB. Dietary protein and risk of ischemic heart disease in middle-aged men. Am J Clin Nutr 2010;92:1265-72. https://doi.org/10.3945/ajcn.2010.29626
  20. Prentice RL, Huang Y, Kuller LH, Tinker LF, Horn LV, Stefanick ML, Sarto G, Ockene J, Johnson KC. Biomarker-calibrated energy and protein consumption and cardiovascular disease risk among postmenopausal women. Epidemiology 2011;22:170-9. https://doi.org/10.1097/EDE.0b013e31820839bc
  21. Halton TL, Willett WC, Liu S, Manson JE, Albert CM, Rexrode K, Hu FB. Low-carbohydrate-diet score and the risk of coronary heart disease in women. N Engl J Med 2006;355:1991-2002. https://doi.org/10.1056/NEJMoa055317
  22. Assmann KE, Joslowski G, Buyken AE, Cheng G, Remer T, Kroke A, Gunther AL. Prospective association of protein intake during puberty with body composition in young adulthood. Obesity (Silver Spring) 2013;21:E782-9. https://doi.org/10.1002/oby.20516
  23. Liu R, Dang S, Yan H, Wang D, Zhao Y, Li Q, Liu X. Association between dietary protein intake and the risk of hypertension: a cross-sectional study from rural western China. Hypertens Res 2013;36:972-9. https://doi.org/10.1038/hr.2013.71
  24. Oh C, No JK. Appropriate protein intake is one strategy in the management of metabolic syndrome in Korean elderly to mitigate changes in body composition. Nutr Res 2018;51:21-8. https://doi.org/10.1016/j.nutres.2017.12.008
  25. Friedman M. Nutritional value of proteins from different food sources. J Agric Food Chem 1996;44:6-29. https://doi.org/10.1021/jf9400167
  26. Altorf-van der Kuil W, Engberink MF, Vedder MM, Boer JM, Verschuren WM, Geleijnse JM. Sources of dietary protein in relation to blood pressure in a general Dutch population. PLoS One 2012;7:e30582. https://doi.org/10.1371/journal.pone.0030582
  27. Wang YF, Yancy WS Jr, Yu D, Champagne C, Appel LJ, Lin PH. The relationship between dietary protein intake and blood pressure: results from the PREMIER study. J Hum Hypertens 2008;22:745-54. https://doi.org/10.1038/jhh.2008.64
  28. Umesawa M, Sato S, Imano H, Kitamura A, Shimamoto T, Yamagishi K, Tanigawa T, Iso H. Relations between protein intake and blood pressure in Japanese men and women: the Circulatory Risk in Communities Study (CIRCS). Am J Clin Nutr 2009;90:377-84. https://doi.org/10.3945/ajcn.2008.27109
  29. van Nielen M, Feskens EJ, Rietman A, Siebelink E, Mensink M. Partly replacing meat protein with soy protein alters insulin resistance and blood lipids in postmenopausal women with abdominal obesity. J Nutr 2014;144:1423-9. https://doi.org/10.3945/jn.114.193706
  30. Tielemans SM, Kromhout D, Altorf-van der Kuil W, Geleijnse JM. Associations of plant and animal protein intake with 5-year changes in blood pressure: the Zutphen Elderly Study. Nutr Metab Cardiovasc Dis 2014;24:1228-33. https://doi.org/10.1016/j.numecd.2014.05.013
  31. Chung S, Chung MY, Choi HK, Park JH, Hwang JT, Joung H. Animal protein intake is positively associated with metabolic syndrome risk factors in middle-aged Korean men. Nutrients 2020;12:3415. https://doi.org/10.3390/nu12113415
  32. Roubenoff R. Sarcopenia: a major modifiable cause of frailty in the elderly. J Nutr Health Aging 2000;4:140-2.
  33. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146-56. https://doi.org/10.1093/gerona/56.3.M146
  34. Dennison EM, Sayer AA, Cooper C. Epidemiology of sarcopenia and insight into possible therapeutic targets. Nat Rev Rheumatol 2017;13:340-7. https://doi.org/10.1038/nrrheum.2017.60
  35. Rolland Y, Abellan van Kan G, Benetos A, Blain H, Bonnefoy M, Chassagne P, Jeandel C, Laroche M, Nourhashemi F, Orcel P, et al. Frailty, osteoporosis and hip fracture: causes, consequences and therapeutic perspectives. J Nutr Health Aging 2008;12:335-46.
  36. Houston DK, Tooze JA, Garcia K, Visser M, Rubin S, Harris TB, Newman AB, Kritchevsky SB; Health ABC Study. Protein intake and mobility limitation in community-dwelling older adults: the health ABC study. J Am Geriatr Soc 2017;65:1705-11. https://doi.org/10.1111/jgs.14856
  37. Cuthbertson D, Smith K, Babraj J, Leese G, Waddell T, Atherton P, Wackerhage H, Taylor PM, Rennie MJ. Anabolic signaling deficits underlie amino acid resistance of wasting, aging muscle. FASEB J 2005;19:422-4.
  38. Kumar V, Selby A, Rankin D, Patel R, Atherton P, Hildebrandt W, Williams J, Smith K, Seynnes O, Hiscock N, et al. Age-related differences in the dose-response relationship of muscle protein synthesis to resistance exercise in young and old men. J Physiol 2009;587:211-7. https://doi.org/10.1113/jphysiol.2008.164483
  39. Volpi E, Campbell WW, Dwyer JT, Johnson MA, Jensen GL, Morley JE, Wolfe RR. Is the optimal level of protein intake for older adults greater than the recommended dietary allowance? J Gerontol A Biol Sci Med Sci 2013;68:677-81. https://doi.org/10.1093/gerona/gls229
  40. Kerstetter JE, Bihuniak JD, Brindisi J, Sullivan RR, Mangano KM, Larocque S, Kotler BM, Simpson CA, Cusano AM, Gaffney-Stomberg E, et al. The effect of a whey protein supplement on bone mass in older Caucasian adults. J Clin Endocrinol Metab 2015;100:2214-22. https://doi.org/10.1210/jc.2014-3792
  41. Kim IY, Schutzler S, Schrader A, Spencer H, Kortebein P, Deutz NE, Wolfe RR, Ferrando AA. Quantity of dietary protein intake, but not pattern of intake, affects net protein balance primarily through differences in protein synthesis in older adults. Am J Physiol Endocrinol Metab 2015;308:E21-8. https://doi.org/10.1152/ajpendo.00382.2014
  42. Mitchell CJ, Milan AM, Mitchell SM, Zeng N, Ramzan F, Sharma P, Knowles SO, Roy NC, Sjodin A, Wagner KH, et al. The effects of dietary protein intake on appendicular lean mass and muscle function in elderly men: a 10-wk randomized controlled trial. Am J Clin Nutr 2017;106:1375-83. https://doi.org/10.3945/ajcn.117.160325
  43. Park Y, Choi JE, Hwang HS. Protein supplementation improves muscle mass and physical performance in undernourished prefrail and frail elderly subjects: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 2018;108:1026-33. https://doi.org/10.1093/ajcn/nqy214
  44. Bradlee ML, Mustafa J, Singer MR, Moore LL. High-protein foods and physical activity protect against age-related muscle loss and functional decline. J Gerontol A Biol Sci Med Sci 2017;73:88-94.
  45. Huang RY, Yang KC, Chang HH, Lee LT, Lu CW, Huang KC. The association between total protein and vegetable protein intake and low muscle mass among the community-dwelling elderly population in Northern Taiwan. Nutrients 2016;8:8. https://doi.org/10.3390/nu8010008
  46. Nilsson A, Montiel Rojas D, Kadi F. Impact of meeting different guidelines for protein intake on muscle mass and physical function in physically active older women. Nutrients 2018;10:1156. https://doi.org/10.3390/nu10091156
  47. Mendonca N, Granic A, Hill TR, Siervo M, Mathers JC, Kingston A, Jagger C. Protein intake and disability trajectories in very old adults: the newcastle 85+ study. J Am Geriatr Soc 2019;67:50-6. https://doi.org/10.1111/jgs.15592
  48. Mustafa J, Ellison RC, Singer MR, Bradlee ML, Kalesan B, Holick MF, Moore LL. Dietary protein and preservation of physical functioning among middle-aged and older adults in the Framingham offspring study. Am J Epidemiol 2018;187:1411-9. https://doi.org/10.1093/aje/kwy014
  49. Granic A, Mendonca N, Sayer AA, Hill TR, Davies K, Adamson A, Siervo M, Mathers JC, Jagger C. Low protein intake, muscle strength and physical performance in the very old: the newcastle 85+ study. Clin Nutr 2018;37:2260-70. https://doi.org/10.1016/j.clnu.2017.11.005
  50. McLean RR, Mangano KM, Hannan MT, Kiel DP, Sahni S. Dietary protein intake is protective against loss of grip strength among older adults in the Framingham offspring cohort. J Gerontol A Biol Sci Med Sci 2016;71:356-61. https://doi.org/10.1093/gerona/glv184
  51. Gray-Donald K, St-Arnaud-McKenzie D, Gaudreau P, Morais JA, Shatenstein B, Payette H. Protein intake protects against weight loss in healthy community-dwelling older adults. J Nutr 2014;144:321-6. https://doi.org/10.3945/jn.113.184705
  52. Kobayashi S, Asakura K, Suga H, Sasaki S; Three-generation Study of Women on Diets and Health Study Group. High protein intake is associated with low prevalence of frailty among old Japanese women: a multicenter cross-sectional study. Nutr J 2013;12:164. https://doi.org/10.1186/1475-2891-12-164