Macronutrient Composition of the Diet and Prospective Weight Change in Participants of the EPIC-PANACEA Study

Anne-Claire Vergnaud, Teresa Norat, Traci Mouw, Dora Romaguera, Anne M. May, H. Bas Bueno-de-Mesquita, A. van der Daphne, Antonio Agudo, Nicholas Wareham, Kay-Tee Khaw, Isabelle Romieu, Heinz Freisling, Nadia Slimani, Florence Perquier, Marie-Christine Boutron-Ruault, Francoise Clavel-Chapelon, Domenico Palli, Franco Berrino, Amalia Mattiello, Rosario TuminoFulvio Ricceri, Laudina Rodriguez, Esther Molina-Montes, Pilar Amiano, Aurelio Barricarte, Maria-Dolores Chirlaque, Francesca L. Crowe, Philippos Orfanos, Androniki Naska, Antonia Trichopoulou, Birgit Teucher, Rudolf Kaaks, Heiner Boeing, Brian Buijsse, Ingeged Johansson, Goran Hallmans, Isabel Drake, Emily Sonestedt, Marianne Uhre Jakobsen, Kim Overvad, Anne Tjonneland, Jytte Halkjaer, Guri Skeie, Tonje Braaten, Eiliv Lund, Elio Riboli, Petra H. M. Peeters, Michael Müller

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Abstract

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.
Original languageEnglish
Article numbere57300
JournalP L o S One
Volume8
Issue number3
Number of pages11
ISSN1932-6203
DOIs
Publication statusPublished - 2013
Externally publishedYes

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