Choi Y, Ryu S, Chang Y, Lee JE, Sung E, Cho J, Rampal S, Zhao D, Zhang Y, Ahn J, Cainzos-Achirica M, Pastor-Barriuso R, Lima JA, Shin H, Guallar E. Animal and vegetable protein intake and coronary artery calcium – the Kangbuk Samsung health study. Poster presented at the American Heart Association and American Stroke Association EPI Lifestyle 2015; March 2015. Baltimore, MD. [abstract] Circulation. 2015 Mar 10; 131(Suppl 1).

INTRODUCTION: Few studies have evaluated the association between type and amount of dietary protein intake and clinically evident cardiovascular disease, with inconsistent findings, and no study has investigated the association between type and amount of dietary protein intake and sub-clinical coronary atherosclerosis.

HYPOTHESIS: We examined the associations of total, animal, and vegetable protein intakes with coronary artery calcium (CAC) in a large population of asymptomatic adults.

METHODS: We performed a cross-sectional study of 29,034 asymptomatic young and middle-aged adults (mean age 41.6 years; males 80.3%) who are free of clinically evident cancer or cardiovascular disease. All participants underwent a health screening examination including cardiac computed tomography for CAC scoring and completed a food frequency questionnaire at the Kangbuk Samsung Hospital Total Healthcare Centers in Seoul and Suwon, South Korea from March, 2011 to April, 2013. Protein intake and other nutrient intake were adjusted for total energy intake using the residual method. Multivariable-adjusted CAC score ratios and 95% confidence intervals (CIs) were estimated by robust Tobit regression models for natural logarithm (CAC score + 1).

The proportion of study participants with detectable CAC (CAC score greater than 0) was 13.4 %. After adjustment for total energy intake, other nutrient intake, and potential confounding factors, we found an increased prevalence of CAC with higher animal protein intake, but not with total and vegetable protein intakes. In multivariable-adjusted models, CAC ratios (95% CIs) comparing the highest with the lowest quintiles were 1.82 (1.09-3.04; P for trend = 0.01) for animal protein intake, 1.25 (0.87-1.81; P for trend = 0.13) for vegetable protein intake, and 1.19 (0.74-1.93; P for trend = 0.59) for total protein intake.

CONCLUSION: High animal protein intake, but not total or vegetable protein, was associated with an increased prevalence of sub-clinical coronary atherosclerosis and with a greater degree of coronary calcification.

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