Table 3.
Associations of animal protein with all-cause and cause-specific mortality in the Rotterdam Study (n = 7786, comparison is isocaloric substitution for carbohydrate)
| Animal protein | HR (95% CI) per 5 E% increment | Quartile 1 | Quartile 2 | Quartile 3 | Quartile 4 | P trend |
|---|---|---|---|---|---|---|
| n = 7786 | n = 1947 | n = 1946 | n = 1946 | n = 1947 | ||
| Median intake (E%) | 10.2 | 7.2 | 9.3 | 11.1 | 13.9 | |
| All-cause mortality | ||||||
| Number of deaths | n = 3589 | n = 692 | n = 887 | n = 970 | n = 1040 | |
| Model 1 | 1.10 (0.96, 1.25) | 1 (Reference) | 1.07 (0.96, 1.18) | 1.05 (0.95, 1.16) | 1.13 (1.01, 1.26) | 0.04 |
| Model 2 | 1.20 (1.05, 1.37) | 1 (Reference) | 1.06 (0.95, 1.17) | 1.08 (0.97, 1.20) | 1.18 (1.05, 1.31) | 0.003 |
| Cardiovascular mortality | ||||||
| Number of deaths | n = 877 | n = 169 | n = 216 | n = 219 | n = 273 | |
| Model 1 | 1.16 (1.02, 1.32) | 1 (Reference) | 1.08 (0.88, 1.32) | 0.97 (0.79, 1.20) | 1.24 (1.00, 1.54) | 0.08 |
| Model 2 | 1.19 (1.04, 1.37) | 1 (Reference) | 1.07 (0.87, 1.32) | 1.01 (0.82, 1.25) | 1.28 (1.03, 1.60) | 0.03 |
| Non-stroke CVD mortality | ||||||
| Number of deaths | n = 594 | n = 109 | n = 145 | n = 150 | n = 190 | |
| Model 1 | 1.25 (1.07, 1.47) | 1 (Reference) | 1.11 (0.86, 1.43) | 1.05 (0.81, 1.35) | 1.36 (1.04, 1.77) | 0.02 |
| Model 2 | 1.27 (1.08, 1.49) | 1 (Reference) | 1.10 (0.85, 1.42) | 1.06 (0.81, 1.37) | 1.34 (1.03, 1.75) | 0.03 |
| Stroke mortality | ||||||
| Number of deaths | n = 283 | n = 60 | n = 71 | n = 69 | n = 83 | |
| Model 1 | 0.98 (0.78, 1.24) | 1 (Reference) | 1.01 (0.71, 1.43) | 0.84 (0.58, 1.21) | 1.03 (0.71, 1.49) | 0.99 |
| Model 2 | 1.05 (0.83, 1.33) | 1 (Reference) | 1.01 (0.71, 1.44) | 0.90 (0.62, 1.30) | 1.12 (0.76, 1.64) | 0.64 |
| Cancer mortality | ||||||
| Number of deaths | n = 896 | n = 184 | n = 248 | n = 230 | n = 234 | |
| Model 1 | 0.93 (0.82, 1.07) | 1 (Reference) | 1.09 (0.90, 1.32) | 0.94 (0.77, 1.15) | 0.97 (0.78, 1.21) | 0.51 |
| Model 2 | 0.95 (0.82, 1.08) | 1 (Reference) | 1.08 (0.89, 1.32) | 0.94 (0.77, 1.16) | 0.98 (0.78, 1.22) | 0.54 |
| Other mortality | ||||||
| Number of deaths | n = 1289 | n = 240 | n = 301 | n = 364 | n = 384 | |
| Model 1 | 1.02 (0.92, 1.14) | 1 (Reference) | 1.02 (0.86, 1.21) | 1.03 (0.87, 1.22) | 1.09 (0.91,1.31) | 0.22 |
| Model 2 | 1.09 (0.97, 1.22) | 1 (Reference) | 1.03 (0.86, 1.22) | 1.11 (0.93, 1.32) | 1.21 (1.00, 1.46) | 0.07 |
Effect estimates are hazard ratios (HRs) and 95%-confidence intervals (95%CIs) derived from Cox proportional hazards regression models. Estimates are based on pooled results of imputed data
Model 1: age, sex, and RS-cohort (RS-I, -II, and –III), total energy, plant protein (E%), SFA (E%), MUFA (E%), PUFA (E%), TSFA (E%), and alcohol (E%)
Model 2: Model 1 + fiber, overall diet quality score, physical activity (z-score of metabolic equivalents of task-hours/week), education level (primary, lower, intermediate, and high), smoking status (never, ever, current), and BMI
SFA saturated fat acids, MUFA monounsaturated fat acids, PUFA polyunsaturated fat acids, TSF trans fat acids, BMI body mass index