Changes in intake of protein foods, carbohydrate amount and quality, and long-term weight change: results from 3 prospective cohorts - PubMed (original) (raw)

Changes in intake of protein foods, carbohydrate amount and quality, and long-term weight change: results from 3 prospective cohorts

Jessica D Smith et al. Am J Clin Nutr. 2015 Jun.

Abstract

Background: Dietary guidelines recommend interchanging protein foods (e.g., chicken for red meat), but they may be exchanged for carbohydrate-rich foods varying in quality [glycemic load (GL)]. Whether such exchanges occur and how they influence long-term weight gain are not established.

Objective: Our objective was to determine how changes in intake of protein foods, GL, and their interrelationship influence long-term weight gain.

Design: We investigated the association between 4-y changes in consumption of protein foods, GL, and their interaction with 4-y weight change over a 16- to 24-y follow-up, adjusted for other lifestyle changes (smoking, physical activity, television watching, sleep duration), body mass index, and all dietary factors simultaneously in 3 prospective US cohorts (Nurses' Health Study, Nurses' Health Study II, and Health Professionals Follow-Up Study) comprising 120,784 men and women free of chronic disease or obesity at baseline.

Results: Protein foods were not interchanged with each other (intercorrelations typically <|0.05|) but with carbohydrate (negative correlation as low as -0.39). Protein foods had different relations with long-term weight gain, with positive associations for meats, chicken with skin, and regular cheese (per increased serving/d, 0.13-1.17 kg; P = 0.02 to P < 0.001); no association for milk, legumes, peanuts, or eggs (P > 0.40 for each); and relative weight loss for yogurt, peanut butter, walnuts, other nuts, chicken without skin, low-fat cheese, and seafood (-0.14 to -0.71 kg; P = 0.01 to P < 0.001). Increases in GL were independently associated with a 0.42-kg greater weight gain per 50-unit increase (P < 0.001). Significant interactions (P-interaction < 0.05) between changes in protein foods and GL were identified; for example, increased cheese intake was associated with weight gain when GL increased, with weight stability when GL did not change, and with weight loss when exchanged for GL (i.e., decrease in GL).

Conclusion: Protein foods were commonly interchanged with carbohydrate, and changes in protein foods and GL interacted to influence long-term weight gain.

Keywords: dietary change; glycemic index; glycemic load; protein; weight change.

© 2015 American Society for Nutrition.

PubMed Disclaimer

Figures

FIGURE 1

FIGURE 1

Pearson correlation between 4-y change in protein foods and 4-y change in percentage of calories from carbohydrates. Pearson correlation between baseline change in protein food intake and change in percentage of calories from carbohydrate, adjusted for age, from 120,784 US men and women from the NHS (baseline 1986–1990), NHS II (baseline 1991–1995), and HPFS (baseline 1986–1990). aBaseline for flavored sweetened yogurt, plain or artificially flavored yogurt, regular cheese, low-fat cheese, and regular hamburger and lean hamburger was 1994–1998 for the NHS and HPFS and 1995–1999 for the NHS II based on the first appearance on the FFQ. bBaseline for beef or lamb as a main dish and pork as a main dish was 1990–1994 for the NHS and HPFS based on the first appearance on the FFQ. cBaseline for walnuts and other nuts was 1998–2002 for the NHS and HPFS and 1999–2003 for the NHS II based on the first appearance on the FFQ. dButter, although not a significant source of protein, was included in the analysis of protein foods for completeness because it may be considered a dairy product and is of animal origin. All correlations had a P value of <0.0001 except for plain or artificially sweetened yogurt for the NHS (P = 0.84) and HPFS (P = 0.02) and low-fat cheese for the NHS (P = 0.02) and HPFS (P = 0.07). FFQ, food-frequency questionnaire; HPFS, Health Professionals Follow-Up Study; NHS, Nurses’ Health Study; NHS II, Nurses’ Health Study II.

FIGURE 2

FIGURE 2

Association between 4-y changes in servings of protein foods with long-term weight change. Data are based on 16–24 y of follow-up for 46,994 women in the NHS, 47,928 women in the NHS II, and 25,862 men in the HPFS. The 4-y weight changes are reported for each 1-serving/d increase in protein foods. Decreased protein food intake would be associated with the inverse weight changes. To convert kilograms to pounds, multiply by 2.2. All weight changes were adjusted for age, baseline (of each 4-y period) BMI, sleep duration, and change in smoking status, physical activity, television watching, alcohol consumption, fruit intake, vegetable intake, glycemic load, and the shown dietary factors. Because of their first appearance on the food-frequency questionnaire, data were available from a1994–2010 for the NHS and HPFS and 1995–2007 for the NHS II, b1990–2010 for the NHS and HPFS for the indicated foods, and c1998–2010 for the NHS and HPFS and 1999–2007 for the NHS II. Only subcategories of protein foods (e.g., lean hamburger and regular hamburger, not total unprocessed red meat) are shown, and protein foods have been ordered according to descending effect size. dButter, although not a significant source of protein, was included in the analysis of protein foods for completeness because it may be considered a dairy product and is of animal origin. HPFS, Health Professionals Follow-Up Study; NHS, Nurses’ Health Study; NHS II, Nurses’ Health Study II.

FIGURE 3

FIGURE 3

Interaction between change in protein foods and change in GL in association with long-term weight change. Data are based on pooled results from 120,784 US men and women from 3 prospective cohorts with 16–24 y of follow-up. The 4-y weight gain across follow-up is shown for a 1-serving/d increase in protein food adjusted for age; baseline (of each 4-y period) BMI; sleep duration; change in smoking status, physical activity, television watching, alcohol consumption, and the shown dietary factors; change in fruit, vegetable, and trans fat intake; and indicator variables for GL change, protein change, and their interaction. The GL indicator categories included 1) no change in GL, 2) minimal change, 3) increase, and 4) decrease. For comparison, a 10-unit change in GL represents about one-third of an SD of GL change in our cohorts or one slice (30 g) of white bread (10). No significant interactions between protein food change and GL change were seen when protein food intake decreased (data not shown). Butter, although not a significant source of protein, was included in the analysis of protein foods for completeness because it may be considered a dairy product and is of animal origin. *_P_-trend ≤ 0.01 tested in a separate model as the multiplicative interaction term between the ordinal change in carbohydrate and the continuous change in protein food. To convert kilograms to pounds, multiply by 2.2. GL, glycemic load.

Similar articles

Cited by

References

    1. US Department of Agriculture, US Department of Health and Human Services. Dietary guidelines for Americans, 2010. 7th ed. Washington (DC): Government Printing Office, 2010. - PubMed
    1. Department of Health and Human Services, Food and Drug Administration. Food Labeling: Revision of the Nutrition and Supplement Facts Label; Proposed Rule. Federal Register March 3 2014, volume 79, number 41. [cited 2015 Mar 30.] Available from: https://www.federalregister.gov/articles/2014/03/03/2014-04387/food-labe....
    1. Department of Health and Human Services, Food and Drug Administration. Food Labeling: Nutrition Labeling of Standard Menu Items in Restaurants and Similar Retail Establishments; Calorie Labeling of Articles of Food in Vending Machines; Final Rule. Federal Register December 1 2014, volume 79, number 230. [cited 2015 Mar 30]. Available from: https://www.federalregister.gov/articles/2014/12/01/2014-27833/food-labe.... - PubMed
    1. Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011;364:2392–404. - PMC - PubMed
    1. Ebbeling CB, Swain JF, Feldman HA, Wong WW, Hachey DL, Garcia-Lago E, Ludwig DS. Effects of dietary composition on energy expenditure during weight-loss maintenance. JAMA 2012;307:2627–34. - PMC - PubMed

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources