Animal and Plant Protein vs risk of TD2 - Ischaemic Heart Disease Risk Factor Study

[TomBAvoider]

The long and short of it was that after adjusting for confounders animal sources of protein were not associted with TD2 risk, and meat association must be down to some other factors in the meat (preparation?). However, of interest: plant protein and EGG protein were both associated with lower risk - quick, someone call Dr. Greger so he can start scarfing down the beneficial eggs! Here:

 

Intake of different dietary proteins and risk of type 2 diabetes in men: the Kuopio Ischaemic Heart Disease Risk Factor Study

 

The roles of different dietary proteins in the aetiology of type 2 diabetes (T2D) remain unclear. We investigated the associations of dietary proteins with the risk of incident T2D in Finnish men from the prospective Kuopio Ischaemic Heart Disease Risk Factor Study. The study included 2332 men aged 42–60 years at the baseline examinations in 1984–1989. Protein intakes were calculated from 4-d dietary records. Incident T2D was determined by self-administered questionnaires, fasting blood glucose measurements, 2-h oral glucose tolerance tests, and with national registers. The multivariable-adjusted risk of T2D on the basis of protein intakes was compared by the Cox proportional hazard ratios (HR). During the mean follow-up of 19·3 years, 432 incident T2D cases were identified. Total, animal, meat or dairy product protein intakes were not associated with risk of T2D when the potential confounders were accounted for. Plant (multivariable-adjusted extreme-quartile HR 0·65; 95 % CI 0·42, 1·00; P trend 0·04) and egg (HR 0·67; 95 % CI 0·44, 1·00; P trend 0·03) protein intakes were associated with a decreased risk of T2D. Adjustments for BMI, plasma glucose and serum insulin slightly attenuated associations. Replacing 1 % energy from carbohydrates with energy from protein was associated with a 5 % (95 % CI 0, 11) increased risk of T2D, but adjustment for fibre intake attenuated the association. Replacing 1 % of energy from animal protein with energy from plant protein was associated with 18 % (95 % CI 0, 32) decreased risk of T2D. This association remained after adjusting for BMI. In conclusion, favouring plant and egg proteins appeared to be beneficial in preventing T2D.[emph. mine - T]

[Todd Allen]

This seems to correlate well with insulin index data https://en.wikipedia.org/wiki/Insulin_index

Eggs score low probably due to their fat content and lack of carbohydrate.

 

I don't think the relative importance of the various scores in the insulin index data has been established and in absence of that I think a reasonable formula for ranking foods would be (glucose score * insulin score) / satiety score.  Though it is of limited use because relatively few foods have been scored.  And it is not a comprehensive measure of risk.  Alcohol for instance probably has greater risk than it would appear if scored by this system because of its effects on the liver.  Likewise a purely fructose sweetened flavored water beverage would have very small scores for glucose and insulin but could still be devastating in promoting fatty liver disease which appears to be a significant factor in trashing the insulin sensitivity of the liver.  And there is a fair amount of evidence that insulin insensitivity is a defining element of metabolic syndrome which may be the first stage of T2D and cardiovascular disease.

 

Curiously fats have not been extensively looked at with respect to insulin index.  They were demonized with respect to diabetes although I believe mistakenly.  Even the ADA has been slowly backing away from that and now approves a LCHF diet as a viable therapeutic approach.  My belief is that fats are primarily a problem when insulin is elevated but as fats are not significantly insulinogenic on their own they are fine as long as carbs and protein are moderate.

[mccoy]

This is what I grasped so far:

 

• According to the Low Carb doctors like Fung and Rosedale, fats are neutral as fat as insuline resistance is concerned
• According to the vegan cardiologist Neil Barnard, fats cause insulin resistance because of intra myocellular lipids 'numbing' the receptors
• According to Sthepan Guyenet.... either fats and carbs in excess (excess energy) cause insulin resistance

[mccoy]

Plant proteins vs animal proteins.

 

I still do not understand whether the health-related difference is caused by simple EAAs relative quantities (less Meth, Leu, Trypt in plant foods) or  there is something else, like some other excess amminos in meat, or carnitine or other.

 

Sure enough, it's very easy to take Leu, Meth and Trypt over the roof by eating meat, fish and cheese. Whereas very modest amounts of these foods would place said amminos below the safety threshold

[Gordo]

"Replacing 1 % of energy from animal protein with energy from plant protein was associated with 18 % (95 % CI 0, 32) decreased risk of T2D. This association remained after adjusting for BMI."

 

The above was the most remarkable thing from that study.

[mccoy]

 

 

Replacing 1 % of energy from animal protein with energy from plant protein was associated with 18 % (95 % CI 0, 32) decreased risk of T2D

 

It is not clear what that means in practice

 

If it refers to total caloric intake, an average 2000 kCAL→ 1%→20 kCal = 5 grams protein.

 

Has a replacement of just 5 grams of protein all that effect? Sounds little plausible...

[mccoy]

Also, CI 95% = 0%-32% means that zero improvement in mortality rate is still a statistically plausible explanation, likewise, an hypothetical 32% improvement is plausible as well.

 

Bottom line, we really don't know for sure if that tiny replacement in animal-to plant base protein has brought about a benefit...