Abstract
Background: High intakes of total and animal protein are associated with the risk of type 2 diabetes (T2D). The influence of protein type on insulin resistance, a key precursor of T2D, has not been extensively studied. Objective: The aim of this study was to determine the associations between dietary total, animal, and plant protein intakes as well as the animal-to-plant protein (AP) intake ratio with insulin resistance in middle-aged and older adults. Methods: This was a cross-sectional analysis in 548 participants (mean ± SD age: 66.2 ± 13.7 y) from the calibration substudy of the AHS-2 (Adventist Health Study 2) cohort. Participants consumed diets with a low AP intake ratio. Dietary intakes of total and particular types of protein were calculated from six 24-h dietary recalls. Participants completed a self-administered questionnaire on demographic, lifestyle, health, diet intake, and physical activity characteristics. Anthropometric variables including weight, height, and waist circumference were measured. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated by using fasting serum glucose and insulin. Multiple linear regression models were used to test the relations between total and specific protein intakes with insulin resistance. Results: The ranges of dietary intakes of animal and plant protein and the AP intake ratio were 0.4-87.4 and 14.0-79.2 g/d and 0.02-4.43, respectively. Dietary intakes per 10-g/d increments of total protein (β: 0.11; 95% CI: 0.02, 0.21) and animal protein (β: 0.11; 95% CI: 0.01, 0.20) and the AP intake ratio (β: 1.82; 95% CI: 0.80, 2.84) were positively related to HOMA-IR. Plant protein was not significantly related to insulin resistance. Conclusion: Total and animal protein intakes and the AP intake ratio were positively associated with HOMA-IR in adults with relatively a low intake of animal protein and a high consumption of plant protein.