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Session: Dietary Patterns for Human Health (Poster Theater Flash Session 12)

(PTFS12-05-24) Dietary Plant to Animal Protein Ratio and Total and Cause-Specific Mortality in Two Prospective Cohort Studies

Monday, July 1, 2024
8:12 AM – 8:16 AM CT
Location:  Hall F1 (The Hub) - Poster Theater

    Presenting Author(s)

  • Andrea J. Glenn, PhD, RD (she/her/hers)

    Postdoctoral Research Fellow
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

    Disclosure(s): British Nutrition Society: Speaker/Speaker's Bureau (Terminated, February 27, 2024)

    • Co-Author(s)

  • Anne-Julie Tessier, RD, PhD (she/her/hers)

    Postdoctoral Fellow
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

  • FW

    Fenglei Wang, PhD (he/him/his)

    Research Fellow
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

  • JoAnn E. Manson, MD, DrPH

    Chief, Division of Preventive Medicine
    Brigham and Women's Hospital
    Boston, Massachusetts, United States

  • Jorge E. Chavarro, MD, PhD

    Associate Professor of Medicine, Harvard Medical School
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

  • QS

    Qi Sun, PhD

    Associate Professor
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

  • WW

    Walter c. Willett, DrPH, MPH, MD

    Professor
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

  • MS

    Meir J. Stampfer, MD, PhD

    Professor
    Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School
    Boston, Massachusetts, United States

  • DJ

    David J. Jenkins

    Professor
    Department of Nutritional Sciences and Medicine, Temerty, Faculty of Medicine, University of Toronto, Toronto, Canada 5 Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada 6 Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Canada 7 Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada
    Toronto, Ontario, Canada

  • MG

    Marta Guasch-Ferre, PhD

    University of Copenhagen
    Boston, Massachusetts, United States

  • Frank B. Hu, MD, PhD

    Professor
    Harvard University
    Boston, Massachusetts, United States

Objectives: Dietary guidelines recommend increasing plant protein intake, however, the optimal ratio of plant to animal protein in the diet remains uncertain. We therefore examined plant to animal protein ratios in two large cohorts and assessed associations with total and cause-specific mortality.

Methods: Participants included 69,394 women in the Nurses’ Health Study (NHS) (1984-2020) and 42,875 men from the Health Professionals Follow-up Study (HPFS) (1986-2020) without cardiovascular disease, diabetes, or cancer at baseline. Plant to animal protein ratios were calculated based on the percent energy from plant and animal protein and assessed using validated food frequency questionnaires every four years. Cox proportional hazard regressions were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Restricted cubic spline plots were used to explore the shape of the association with total mortality.

Results: During up to 36 years of follow-up, 50,060 deaths occurred in the two cohorts. After multivariable adjustment for lifestyle factors and diet quality, participants in the highest vs lowest decile (median ratio of 0.24 vs. 0.73) had a lower risk of total mortality (pooled HR: 0.71; 95% CI: 0.69-0.74, P trend < 0.001), cardiovascular mortality (pooled HR: 0.65; 95% CI: 0.60-0.70, P trend < 0.001), cancer mortality (pooled HR: 0.74; 95% CI: 0.69-0.80, P trend < 0.001), neurodegenerative disease mortality (pooled HR: 0.80; 95% CI: 0.73-0.89, P trend < 0.001), and respiratory disease mortality (pooled HR: 0.69; 95% CI: 0.61-0.79, P trend < 0.001). In the dose-response analysis of total mortality, with increasing ratios, the risk initially declined sharply and then more gradually at a ratio of ~0.50 (P curvature < 0.001; P linearity < 0.001).

Conclusions: Higher plant to animal protein ratios were associated with a lower risk of total and cause-specific mortality. These findings suggest that replacing some animal protein with plant protein would benefit more than half of the US population to lower overall mortality risk.

Funding Sources: The NHS and HPFS cohorts are supported by NIH grants. AJG is supported by a Canadian Institutes of Health Research Postdoctoral Fellowship.