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Clinical Studies and Practice

Dietary protein and urinary nitrogen in relation to 6-year changes in fat mass and fat-free mass

International Journal of Obesity volume 39, pages 162–168 (2015)Cite this article

Subjects

Abstract

Background:

In contrast to the physiological expectation, observational studies show that greater protein intake is associated with subsequent body weight (BW) gain. An increase in fat-free mass (FFM) due to the anabolic effects of protein could explain this.

Objective:

To examine associations between protein intake and subsequent changes in fat mass (FM) and FFM in longitudinal, observational data.

Design:

A health examination, including measures of FM and FFM by bioelectrical impedance at baseline and follow-up 6 years later, was conducted. Diet history interviews (DHI) were performed, and 24-h urinary nitrogen collection at baseline was done. In total, 330 participants with DHI, of whom 227 had validated and complete 24-h urine collection data, were analyzed. Macronutrient energy substitution models were used.

Results:

Mean estimated protein intake was 14.6 E% from DHI and 11.3 E% from urinary nitrogen. Estimated from DHI, FM increased 46 g per year, with every 1 E% protein substituted for fat (95% confidence interval (CI)=13, 79; P=0.006), and FFM increased 15 g per year (1, 30; P=0.046). Results were similar in other substitution models. Estimated from urinary nitrogen, FM increased 53 g per year, with 1 E% protein substituted for other macronutrients (24, 81; P<0.0005), and FFM increased 18 g per year (6, 31; P=0.004).

Conclusion:

Within a habitual range, a greater protein intake was associated with BW gain, mostly in FM. This is in contrast to the expectations based on physiological and clinical trials, and calls for a better understanding of how habitual dietary protein influences long-term energy balance, versus how greater changes in dietary proteins may influence short-term energy balance.

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Acknowledgements

This work is carried out as a part of the research program of Gene-diet interactions in obesity (GENDINOB). GENDINOB is supported by the Danish Council for Strategic Research (Grant 09-067111). We thank Kim Fleischer Michaelsen for discussions about protein intake and growth in infants.

Author Contributions

AA, TIAS conceived the study. BLH designed the data collection on diet intake and body composition. MZA, KG, LÄ, AA, BLH, TIAS planned the analyses. MZA, KG, LÄ conducted the analyses. MZA, KG, LÄ, AA, BLH, TIAS interpreted the results of the analyses. MZA, KG drafted the manuscript. MZA, KG, LÄ, AA, BLH, TIAS revised the manuscript. All authors read and approved the final manuscript.

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Author notes

  1. M Z Ankarfeldt and K Gottliebsen: These authors contributed equally to this work.

Authors and Affiliations

  1. Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark

    M Z Ankarfeldt, K Gottliebsen, L Ängquist, B L Heitmann & T I A Sørensen

  2. Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark

    M Z Ankarfeldt

  3. Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark

    A Astrup

  4. The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, Australia

    B L Heitmann

  5. National Institute of Public Health, University of Southern Denmark, Odense, Denmark

    B L Heitmann

  6. The Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark

    T I A Sørensen

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  1. M Z Ankarfeldt
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Corresponding author

Correspondence to M Z Ankarfeldt.

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Competing interests

AA is currently the member of external scientific advisory boards for Global Dairy Platform and MacDonald’s (both USA), and is PI of research projects funded by the Global Dairy Platform, the Danish Dairy Research Foundation and by the Arla Foods A/S, Denmark. AA has received a sponsorship of congress attendance, and a honorarium for speaking at an industry-sponsored satellite symposia from the National Cattlemen’s Beef Association, USA and Danone Inc, Europe. The remaining authors declare no conflict of interest.

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Ankarfeldt, M., Gottliebsen, K., Ängquist, L. et al. Dietary protein and urinary nitrogen in relation to 6-year changes in fat mass and fat-free mass. Int J Obes 39, 162–168 (2015). https://doi.org/10.1038/ijo.2014.80

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