Low Protein Intake Irrespective of Source is Associated with Higher Mortality Among Older Community-Dwelling Men

Osteoporotic Fractures in Men (MrOS) Research Group

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Objectives: Our aim was to determine the association between protein intake (overall and by source) and all-cause and cause-specific mortality among older men. Design: Prospective cohort study. Setting: 5790 ambulatory community-dwelling older men from multicenter Osteoporotic Fractures in Men (MrOS) study. Measurements: Total energy and protein intake, and protein intake by source (dairy, non-dairy animal, plant) were assessed using a 69-item food frequency questionnaire. We included up to 10-year follow-up with adjudicated cardiovascular, cancer and other mortality outcomes. We used time-to-event analysis with protein exposures, mortality outcome, and adjusted for possible confounders including age, center, education, race, smoking, alcohol use, physical activity, weight, total energy intake (TEI), and comorbidities. Hazard ratios were expressed per each unit=2.9% TEI decrement for all protein intake variables. Results: The mean (SD) baseline age of 5790 men was 73.6 (5.8) y. There were 1611 deaths and 211 drop-outs prior to 10 years, and 3868 men who were alive at the 10-year follow-up. The mean (SD) total protein intake was 64.7 (25.8) g/d, while the mean (SD) intake expressed as percent of total energy intake (%TEI) was 16.1 (2.9) %TEI. Lower protein intake was associated with an increased risk of death, with unadjusted HR=1.11 (95% CI: 1.06, 1.17) and adjusted HR=1.09 (95% CI: 1.04, 1.14) and the associations for protein intake by source were similar. The adjusted HR for cancer mortality was HR=1.13 (95% CI: 1.03, 1.25) while the association for CVD mortality was HR=1.08 (95% CI: 0.99, 1.18). Conclusions: Low protein intake, irrespective of source, was associated with a modest increase in risk of all-cause and cause-specific mortality among older men. Special consideration should be given to level of protein intake among older adults.

Original languageEnglish (US)
Pages (from-to)900-905
Number of pages6
JournalJournal of Nutrition, Health and Aging
Issue number8
StatePublished - Aug 1 2020

Bibliographical note

Funding Information:
The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute on Aging (NLA), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Center for Advancing Translational Sciences (NCATS), and NTH Roadmap for Medical Research under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG04214S, U01 AG042168, U01 AR066160, and UL1 TR000128. Additional funding for this study was provided by Abbott Nutrition. This manuscript is the result of work supported with resources and use of facilities of the Minneapolis VA Health Care System. Analysis funded by Abbott through an institutional research grant supporting L.L., P.M.C. and S.H. L.L. and P.M.C. designed the study: S.H. analyzed the data; all authors interpreted the findings: L.L. drafted the manuscript; and L.L. and P.M.C. have primary responsibility for the final content. All authors read and approved the final manuscript.

Funding Information:
Analysis funded by Abbott Nutrition through an institutional research grant supporting L.L., P.M.C. and S.H. S.J. and S.L.P are employed by Abbott Nutrition. In addition L.L. has an institutional research grant from Merck and P.M.C has institutional research grants from Nestle and is a consultant to BioAge. The other authors have no disclosures.

Publisher Copyright:
© 2020, Serdi and Springer-Verlag International SAS, part of Springer Nature.


  • Protein intake
  • all-cause mortality
  • cause-specific mortality
  • older men


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