1. Macronutrient Composition of the Diet and Prospective Weight Change in Participants of the EPIC-PANACEA Study
- Author
-
Göran Hallmans, Tonje Braaten, Anne M. May, Rudolf Kaaks, Françoise Clavel-Chapelon, Androniki Naska, Heinz Freisling, Amalia Mattiello, Marianne Uhre Jakobsen, Florence Perquier, Anne Tjønneland, Emily Sonestedt, Petra H.M. Peeters, Heiner Boeing, Jytte Halkjær, Birgit Teucher, Kay-Tee Khaw, Dora Romaguera, Eiliv Lund, Aurelio Barricarte, Rosario Tumino, Marie-Christine Boutron-Ruault, Anne-Claire Vergnaud, Nadia Slimani, Antonia Trichopoulou, Francesca L. Crowe, Pilar Amiano, Nicholas J. Wareham, Laudina Rodríguez, Kim Overvad, Fulvio Ricceri, María Dolores Chirlaque, Isabel Drake, Franco Berrino, Elio Riboli, Domenico Palli, Esther Molina-Montes, Philippos Orfanos, Guri Skeie, H. Bas Bueno-de-Mesquita, Traci Mouw, Teresa Norat, Daphne L. van der A, Antonio Agudo, Isabelle Romieu, Ingeged Johansson, Brian Buijsse, [Vergnaud,AC, Norat,T, Mouw,T, Romaguera,D, Riboli,E, Peeters,PHM] Department of Epidemiology & Public Health, Imperial College London, London, United Kingdom. [May,AM, Peeters,PHM] Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands. [May,AM, Bueno-de-Mesquita,HB, van der A,HD] National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. [Bueno-de-Mesquita,HB] Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. [Agudo,A] Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology, IDIBELL, Barcelona, Spain. [Wareham,N] Medical Research Council, Epidemiology Unit, Institute of Metabolic Science, Cambridge, United Kingdom. [Khaw,KT] Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. [Romieu,I, Freisling,H, Slimani,N] International Agency for Research on Cancer (IARC-WHO), Lyon, France. [Perquier,F, Boutron-Ruault,MC, Clavel-Chapelon,F] Institut National de la Santé et de la Recherche Médicale (INSERM), Villejuif, France. Institut Gustave Roussy, Villejuif, France. [Palli,D] Molecular and Nutritional Epidemiology Unit, CSPO-Scientific Institute of Tuscany, Florence, Italy. [Berrino,F] Epidemiology and Prevention Unit, IRCCS Foundation, National Cancer Institute, Milan, Italy. [Mattiello,A] Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, ‘‘Civile M.p.Arezzo’’ Hospital, Ragusa, Italy. [Ricceri,F] Human Genetics Foundation, HuGeF, Turin, Italy. [Rodríguez,L] Public Health and Participation Directorate, Health and Health Care Services Council, Asturias, Spain. [Molina-Montes,E] Andalusian School of Public Health, Granada, Spain. [Amiano,P] Public Health Department of Gipuzkoa, Basque Regional Health Department, San Sebastian, Spain and Biodonostia [sic]. [Barricarte,A] Navarre Public Health Institute, Pamplona, Spain. [Molina-Montes,E, Amiano,P, Barricarte,A, Chirlaque,MD] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Spain. [Chirlaque,MD] Department of Epidemiology, Regional Health Authority, Murcia, Spain. [Crowe,FL] Cancer Epidemiology Unit Nuffield Department of Clinical Medicine University of Oxford, Oxford, United Kingdom. [Orfanos,P, Naska,A, Trichopoulou,A] WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. Hellenic Health Foundation, Athens, Greece. [Teucher,B, Kaaks,R] Division of Clinical Epidemiology, German Cancer Research Center, Heidelberg, Germany. [Boeing,H, Buijsse,B] Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany. [Johansson,I] Department of Odontology, Umea University, Umea, Sweden. [Hallmans,G] Department of Public Health and Clinical Medicine, Nutritional Research, Umea University, Umea, Sweden. [Drake,I, Sonestedt,E] Department of Clinical Sciences in Malmö, Nutrition Epidemiology, Lund University, Malmö, Sweden. [Jakobsen, MU, Overvad,K] Department of Epidemiology School of Public Health Aarhus University, Aarhus, Denmark. [Overvad,K] Department of Cardiology Center for Cardiovascular Research Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark. [Tjønneland,A, Halkjær,J] Danish Cancer Society Research Center, Copenhagen, Denmark. [Skeie,G, Braaten,T, Lund,E] Institute of Community Medicine, University of Tromsø, Tromsø, Norway., This publication arises from the project PANACEA, which has received funding from the European Union, in the framework of the Public Health Programme (project number: 2005328). The work was further financially supported by the European Commission: Public Health and Consumer Protection Directorate 1993–2004, Research Directorate-General 2005-.’’, Ligue contre le Cancer, Societe´ 3M, Mutuelle Ge´ne´ rale de l9Education Nationale, Institut National de la Sante´ et de la Recherche Me´dicale (INSERM) (France), German Cancer Aid, German Cancer Research Center, Federal Ministry of Education and Research (Germany), Danish Cancer Society (Denmark), Health Research Fund (FIS) of the Spanish Ministry of Health, The participating regional governments and institutions (Spain), Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, the Wellcome Trust (United Kingdom), Greek Ministry of Health and Social Solidarity, Hellenic Health Foundation and Stavros Niarchos Foundation (Greece), Italian Association for Research on Cancer, National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports, Dutch Ministry of Health, Dutch Prevention Funds, LK Research Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF) (The Netherlands), Swedish Cancer Society, Swedish Scientific Council, Regional Government of Skane and Va¨sterbotten (Sweden), and Norwegian Research Council (Norway).
- Subjects
PROTEIN-INTAKE ,Non-Clinical Medicine ,Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight::Body Weight Changes::Weight Gain [Medical Subject Headings] ,Obesidad ,Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings] ,Weight Gain ,Social and Behavioral Sciences ,Proteínas en la Dieta ,Ingestión de Energía ,Body Mass Index ,VDP::Medical disciplines: 700::Health sciences: 800::Nutrition: 811 ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,Morbid obesity ,0302 clinical medicine ,Surveys and Questionnaires ,Aumento de Peso ,Medicine ,Poisson Distribution ,Prospective Studies ,Cuestionarios ,lcsh:Science ,Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight::Overweight [Medical Subject Headings] ,LOW-FAT DIET ,0303 health sciences ,Anthropometry ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Questionnaires [Medical Subject Headings] ,Geographicals::Geographic Locations::Europe [Medical Subject Headings] ,LOW-CARBOHYDRATE ,Humanos ,3. Good health ,Näringslära ,Carbohidratos en la Dieta ,Cohort ,Science & Technology - Other Topics ,Dieta ,Dietary Proteins ,Factores de riesgo ,Anciano ,Chemicals and Drugs::Carbohydrates::Dietary Carbohydrates [Medical Subject Headings] ,Obesitat mòrbida ,CONTROLLED-TRIAL ,VDP::Medisinske Fag: 700::Helsefag: 800::Ernæring: 811 ,03 medical and health sciences ,Dietary Carbohydrates ,Named Groups::Persons::Age Groups::Adult [Medical Subject Headings] ,Humans ,Aged ,Survey Research ,Science & Technology ,MULTIDISCIPLINARY SCIENCES ,lcsh:R ,Weight change ,medicine.disease ,Obesity ,Diseases::Nutritional and Metabolic Diseases::Nutrition Disorders::Overnutrition::Obesity [Medical Subject Headings] ,ENERGY-INTAKE ,Anthropology ,Linear Models ,RISK-FACTORS ,lcsh:Q ,Physiological Processes ,Body mass index ,EUROPEAN COUNTRIES ,Demography ,Índice de Masa Corporal ,Gerontology ,Anatomy and Physiology ,030309 nutrition & dietetics ,lcsh:Medicine ,Overweight ,Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Dietary Proteins [Medical Subject Headings] ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings] ,Cohort Studies ,Mediana Edad ,Risk Factors ,030212 general & internal medicine ,Prospective cohort study ,2. Zero hunger ,Nutrition and Dietetics ,Multidisciplinary ,Adulto ,Estudios Prospectivos ,Middle Aged ,Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet::Energy Intake [Medical Subject Headings] ,Europe ,Glycemic index ,Distribución de Poisson ,medicine.symptom ,Europa ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Statistical Distributions::Poisson Distribution [Medical Subject Headings] ,GLYCEMIC-INDEX ,Research Article ,Adult ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings] ,Clinical Research Design ,Modelos Lineales ,UNITED-STATES ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Body Constitution::Body Weights and Measures::Body Mass Index [Medical Subject Headings] ,Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings] ,Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings] ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Linear Models [Medical Subject Headings] ,Nutrition ,Health Care Policy ,business.industry ,Health Risk Analysis ,Diet ,PHYSICAL-ACTIVITY ,Sobrepeso ,Energy Intake ,Energy Metabolism ,business ,Weight gain - Abstract
Journal Article; Research Support, Non-U.S. Gov't; BACKGROUND The effect of the macronutrient composition of the usual diet on long term weight maintenance remains controversial. METHODS 373,803 subjects aged 25-70 years were recruited in 10 European countries (1992-2000) in the PANACEA project of the EPIC cohort. Diet was assessed at baseline using country-specific validated questionnaires and weight and height were measured at baseline and self-reported at follow-up in most centers. The association between weight change after 5 years of follow-up and the iso-energetic replacement of 5% of energy from one macronutrient by 5% of energy from another macronutrient was assessed using multivariate linear mixed-models. The risk of becoming overweight or obese after 5 years was investigated using multivariate Poisson regressions stratified according to initial Body Mass Index. RESULTS A higher proportion of energy from fat at the expense of carbohydrates was not significantly associated with weight change after 5 years. However, a higher proportion of energy from protein at the expense of fat was positively associated with weight gain. A higher proportion of energy from protein at the expense of carbohydrates was also positively associated with weight gain, especially when carbohydrates were rich in fibre. The association between percentage of energy from protein and weight change was slightly stronger in overweight participants, former smokers, participants ≥60 years old, participants underreporting their energy intake and participants with a prudent dietary pattern. Compared to diets with no more than 14% of energy from protein, diets with more than 22% of energy from protein were associated with a 23-24% higher risk of becoming overweight or obese in normal weight and overweight subjects at baseline. CONCLUSION Our results show that participants consuming an amount of protein above the protein intake recommended by the American Diabetes Association may experience a higher risk of becoming overweight or obese during adult life. Yes
- Published
- 2013