Tharrey M, et al. - The link between specific patterns of protein intake with cardiovascular mortality was investigated among men and women from the Adventist Health Study-2. For the ‘Meat’ protein factor and ‘Nuts & Seeds’ protein factor, the hazard ratios (HRs) for cardiovascular mortality were 1.61 and 0.60, respectively. No significant associations were found for the ‘Grains’, ‘Processed Foods’ and ‘Legumes, Fruits & Vegetables’ protein factors. Strong associations were noted between the ‘Meat’ and ‘Nuts & Seeds’ protein factors and cardiovascular outcomes and these links could not be ascribed to other associated nutrients considered to be important for cardiovascular health. Overall, healthy diets, preferentially including low contributions of protein from meat and higher intakes of plant protein from nuts and seeds can be advocated based on protein sources.

• A total of 81,337 men and women were selected from the Adventist Health Study-2.
• Using a validated food frequency questionnaire, diet was assessed between 2002 and 2007.
• Using factor analysis, dietary patterns based on the participants’ protein consumption were derived.
• Multivariate-adjusted hazard ratios (HRs) adjusted for sociodemographic and lifestyle factors and dietary components were estimated via Cox regression analysis.

• A mean follow-up of 9.4 years was carried out, during this time period 2276 cardiovascular deaths were reported.
• For the ‘Meat’ protein factor, the HRs for cardiovascular mortality were 1.61 [98.75% confidence interval (CI), 1.12 2.32; P-trend < 0.001] and 0.60 (98.75% CI, 0.42 0.86; P-trend < 0.001) for the ‘Nuts & Seeds’ protein factor (highest vs lowest quintile of factor scores).
• Findings demonstrated no significant links for the ‘Grains’, ‘Processed Foods’ and ‘Legumes, Fruits & Vegetables’ protein factors.
• Results did not change after additional adjustments for the participants’ vegetarian dietary pattern and nutrients related to cardiovascular disease outcomes.