伊朗德黑兰医科大学Ahmad Esmaillzadeh团队对总蛋白、动物蛋白和植物蛋白的摄入量与全因、心血管疾病和癌症死亡风险的相关性进行了剂量反应荟萃分析。相关论文于2020年7月22日发表在《英国医学杂志》上。

为了研究并量化摄入总蛋白、动物蛋白和植物蛋白与全因、心血管疾病和癌症死亡风险之间的潜在剂量反应关系，研究组在PubMed、Scopus和ISI Web of Science等数据库中检索2019年12月之前的数据，筛选出关于18岁以上成人全因、心血管疾病和癌症死亡风险评估的前瞻性队列研究，并进行系统评价和荟萃分析。

共有32项前瞻性队列研究被纳入系统评价，31项纳入荟萃分析。 在3.5至32年的随访期间，715128名参与者中有113039名死亡，其中心血管疾病死亡16429例，癌症死亡22303例。摄入总蛋白可显著降低全因死亡的风险。摄入植物蛋白可显著降低全因死亡和心血管疾病死亡的风险，但不能降低癌症死亡的风险。摄入总蛋白和动物蛋白均不能降低心血管疾病死亡和癌症死亡的风险。剂量反应分析显示，摄入植物蛋白与全因死亡率之间呈显著的剂量反应负相关。每天从植物蛋白中额外获取3%的能量，全因死亡的风险则降低5%。

总之，总蛋白摄入量越高，全因死亡率越低，植物蛋白摄入量越高，全因和心血管疾病死亡率越低。用植物蛋白代替动物蛋白含量高的食物可能会延长寿命。

附：英文原文

Title: Dietary intake of total, animal, and plant proteins and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies

Author: Sina Naghshi, Omid Sadeghi, Walter C Willett, Ahmad Esmaillzadeh

Issue&Volume: 2020/07/22

Abstract: Objective To examine and quantify the potential dose-response relation between intake of total, animal, and plant protein and the risk of mortality from all causes, cardiovascular disease, and cancer.

Design Systematic review and meta-analysis of prospective cohort studies.

Data sources PubMed, Scopus, and ISI Web of Science until December 2019, and references of retrieved relevant articles.

Study selection Prospective cohort studies that reported the risk estimates for all cause, cardiovascular, and cancer mortality in adults aged 18 or older.

Data synthesis Random effects models were used to calculate pooled effect sizes and 95% confidence intervals for the highest versus lowest categories of protein intake and to incorporate variation between studies. Linear and non-linear dose-response analyses were done to evaluate the dose-response relations between protein intake and mortality.

Results 32 prospective cohort studies were included in the systematic review and 31 in the meta-analysis. During the follow-up period of 3.5 to 32 years, 113039 deaths (16429 from cardiovascular disease and 22303 from cancer) occurred among 715128 participants. Intake of total protein was associated with a lower risk of all cause mortality (pooled effect size 0.94, 95% confidence interval 0.89 to 0.99, I2=58.4%, P<0.001). Intake of plant protein was significantly associated with a lower risk of all cause mortality (pooled effect size 0.92, 95% confidence interval 0.87 to 0.97, I2=57.5%, P=0.003) and cardiovascular disease mortality (pooled hazard ratio 0.88, 95% confidence interval 0.80 to 0.96, I2=63.7%, P=0.001), but not with cancer mortality. Intake of total and animal protein was not significantly associated with risk of cardiovascular disease and cancer mortality. A dose-response analysis showed a significant inverse dose-response association between intake of plant protein and all cause mortality (P=0.05 for non-linearity). An additional 3% energy from plant proteins a day was associated with a 5% lower risk of death from all causes.

Conclusions Higher intake of total protein was associated with a lower risk of all cause mortality, and intake of plant protein was associated with a lower risk of all cause and cardiovascular disease mortality. Replacement of foods high in animal protein with plant protein sources could be associated with longevity.

DOI: 10.1136/bmj.m2412

Source: https://www.bmj.com/content/370/bmj.m2412