Dietary protein is associated with musculoskeletal health independently of dietary pattern: the Framingham Third Generation Study
Dietary protein is associated with musculoskeletal health independently of dietary pattern: the Framingham Third Generation Study
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DOI：
10.3945/ajcn.116.136762
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发表时间：
2017-03-01
影响因子：
7.1
通讯作者：
Hannan, Marian T.
中科院分区：
文献类型：
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作者：
Mangano, Kelsey M.;Sahni, Shivani;Hannan, Marian T.
背景：高于平均水平的膳食蛋白质作为单一营养素，可以改善肌肉骨骼健康。从整体饮食的角度评估膳食蛋白质和肌肉骨骼健康之间的联系非常重要，因为膳食指南重点关注膳食模式。 目的：我们根据弗雷明汉第三代研究，对 2986 名 19-72 岁的男性和女性，研究了新型膳食蛋白食物簇（源自已建立的膳食模式技术）与四肢瘦肉质量 (ALM)、股四头肌力量 (QS) 和骨矿物质密度 (BMD) 的前瞻性关联。 2002-2005年通过食物频率调查问卷估算蛋白质摄入量。聚类分析用于将参与者分为相互排斥的组，这些组是通过食物摄入量占总蛋白质摄入量的百分比来确定的。一般线性模型用于 1) 估计蛋白质摄入量（每天克数）与 BMD、ALM、标准化身高的四肢去脂质量 (ALM/ht(2)) 和 QS (2008-2011) 之间的关联，以及 2) 计算蛋白质四分位数（每天克数）和蛋白质食物簇的调整最小二乘平均结果。 结果：受试者的平均 +/- SD 年龄为 40 +/- 9 岁； 82% 的参与者达到了建议的每日摄入量（0.8 克中心点千克体重(-1) 中心点 d(-1)）。确定了以下 6 个膳食蛋白质食物群：快餐和全脂乳制品、鱼、红肉、鸡肉、低脂牛奶和豆类。 BMD 在蛋白质摄入量四分位数之间没有差异（P 趋势范围 = 0.32-0.82）；但 ALM、ALM/ht(2) (P < 0.001) 和 QS (P = 0.0028) 观察到显着的正趋势。总蛋白质摄入量最低四分位数（四分位数 1）的个体的 ALM、ALM/ht(2) 和 QS 显着低于摄入量较高四分位数（四分位数 2-4）的个体；（P 范围分别 = 0.0001-0.003、0.0007-0.003 和 0.009-0.05）。然而，蛋白质簇与任何蛋白质簇之间没有关联。结论：在富含蛋白质的成年人群体中，膳食蛋白质与 ALM 和 QS 相关，但与 BMD 无关。在这项研究中，膳食蛋白质食物模式无法进一步了解蛋白质对肌肉结果的有益影响。
Background: Above-average dietary protein, as a single nutrient, improves musculoskeletal health. Evaluating the link between dietary protein and musculoskeletal health from a whole-diet perspective is important, as dietary guidelines focus on dietary patterns.Objective: We examined the prospective association of novel dietary protein food clusters (derived from established dietary pattern techniques) with appendicular lean mass (ALM), quadriceps strength (QS), and bone mineral density (BMD) in 2986 men and women, aged 19-72 y, from the Framingham Third Generation Study.Design: Total protein intake was estimated by food-frequency questionnaire in 2002-2005. A cluster analysis was used to classify participants into mutually exclusive groups, which were determined by using the percentage of contribution of food intake to overall protein intake. General linear modeling was used to 1) estimate the association between protein intake (grams per day) and BMD, ALM, appendicular lean mass normalized for height (ALM/ht(2)), and QS (2008-2011) and to 2) calculate adjusted least-squares mean outcomes across quartiles of protein (grams per day) and protein food clusters.Results: The mean +/- SD age of subjects was 40 +/- 9 y; 82% of participants met the Recommended Daily Allowance (0.8 g center dot kg body weight(-1) center dot d(-1)). The following 6 dietary protein food clusters were identified: fast food and full-fat dairy, fish, red meat, chicken, low-fat milk, and legumes. BMD was not different across quartiles of protein intake (P-trend range = 0.32-0.82); but significant positive trends were observed for ALM, ALM/ht(2) (P < 0.001), and QS (P = 0.0028). Individuals in the lowest quartile of total protein intake (quartile 1) had significantly lower ALM, ALM/ht(2), and QS than did those in the higher quartiles of intake (quartiles 2-4; (P ranges = 0.0001-0.003, 0.0007-0.003, and 0.009-0.05, respectively). However, there were no associations between protein clusters and any musculoskeletal outcome in adjusted models.Conclusions: In a protein-replete cohort of adults, dietary protein is associated with ALM and QS but not with BMD. In this study, dietary protein food patterns do not provide further insight into beneficial protein effects on muscle outcomes.