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Optimal intakes of protein in the human diet

Published online by Cambridge University Press:  28 February 2007

D. Joe Millward
D. Joe Millward*
Affiliation:
Centre for Nutrition and Food Safety, School of Biological Sciences, University of Surrey, Guildford GU2 5XH, UK
*
Corresponding author: Professor Joe Millward, fax +44 (0)1483 259297, email [email protected]
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Abstract

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For protein, progress is slow in defining quantifiable indicators of adequacy other than balance and growth. As far as current requirements are concerned, only in the case of infants and children is there any case for revision, and this change is to lower values. Such intakes would appear to be safe when consumed as milk formula. In pregnancy, notwithstanding the concern that deficiency may influence programming of disease in later life, there is little evidence of any increased need, and some evidence that increased intakes would pose a risk. For the elderly there is no evidence of an increased requirement or of benefit from increased intakes, except possibly for bone health. For adults, while we now know much more about metabolic adaptation to varying intakes, there would appear to be no case for a change in current recommendations. As far as risks and benefits of high intakes are concerned, there is now only a weak case for risk for renal function. For bone health the established views of risk of high protein intakes are not supported by newly emerging data, with benefit indicated in the elderly. There is also circumstantial evidence for benefit on blood pressure and stroke mortality. With athletes there is little evidence of benefit of increased intakes in terms of performance, with older literature suggesting an adverse influence. Thus, given that a safe upper limit is currently defined as twice the reference nutrient intake, and that for individuals with high energy requirements this value (1.5 g/kg per d) is easily exceeded, there is a case for revising the definition of a safe upper limit.

Keywords

Protein requirementsPregnancyBone healthRenal functionBlood pressure
Type
‘Optimal nutrition’
Information
Proceedings of the Nutrition Society , Volume 58 , Issue 2 , May 1999 , pp. 403 - 413
Copyright
Copyright © The Nutrition Society 1999

References

Barker, DJ (1998) In utero programming of chronic disease. Clinical Science 95, 115–128.CrossRefGoogle ScholarPubMed
Beaton, GH & Cheery, A (1988) Protein requirements of infants: a re-examination of concepts and approaches. American Journal of Clinical Nutrition 48, 1403–1412.CrossRefGoogle Scholar
Brandle, E, Sieberth, HG & Hautmann, RE (1996) Effect of chronic dietary protein intake on the renal function in healthy subjects. European Journal of Clinical Nutrition 50, 734–740.Google ScholarPubMed
Brenner, BM, Meyer, TW & Hostetter, TH (1982) Dietary protein intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal disease. New England Journal of Medicine 307, 652–659.Google ScholarPubMed
Bunker, VW, Lawson, MS, Stanfield, ME & Clayton, BE (1987) Nitrogen balance studies in apparently healthy elderly people and those who are housebound. British Journal of Nutrition 47, 211–221.CrossRefGoogle Scholar
Campbell, DM, Hall, MH, Barker, DJ, Cross, J, Shiell, AW & Godfrey, KM (1996) Diet in pregnancy and the offspring's blood pressure 40 years later. British Journal of Obstetrics and Gynaecology 103, 273–280.Google Scholar
Chittenden, RH (1907) The Nutrition of Man. London: Heinemann.Google Scholar
Cohen, RJ, Brown, KH, Canahuati, J, Rivera, LL & Dewey, KG (1995) Determinants of growth from birth to 12 months among breast-fed Honduran infants in relation to age of introduction of complementary foods. Pediatrics 96, 504–510.Google Scholar
Cooper, C, Atkinson, EJ, Hensrud, DD, Wahner, HW, O'Fallon, WM, Riggs, BL & Melton, LJ (1996) Dietary protein intake and bone mass in women. Calcified Tissue International 58, 320–325.CrossRefGoogle ScholarPubMed
Department of Health (1991) Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects no. 41. London: H.M. Stationery Office.Google Scholar
Dewey, KG (1997) Energy and protein requirements during lactation. Annual Reviews of Nutrition 17, 19–36.CrossRefGoogle ScholarPubMed
Dewey, KG, Beaton, G, Fjeld, C, Lonnerdal, B & Reeds, P (1996 a) Protein requirements of infants and children. European Journal of Clinical Nutrition 50, Suppl. 1, S119–S147.Google ScholarPubMed
Dewey, KG, Cohen, RJ, Rivera, LL, Canahuati, J & Brown, KH (1996 b) Do exclusively breast-fed infants require extra protein? Pediatric Research 39, 303–307.Google Scholar
Dewey, KG, Heinig, MJ, Nommsen, LA, Peerson, JM & Lonnerdal, B (1992) Growth of breast-fed and formula-fed infants from 0 to 18 months: the DARLING Study. Pediatrics 89, 1035–1041.CrossRefGoogle Scholar
Dewey, KG, Heinig, MJ, Nommsen, LA, Peerson, JM & Lonnerdal, B (1993) Breast-fed infants are leaner than formula-fed infants at 1 y of age: the DARLING study. American Journal of Clinical Nutrition 57, 140–145.Google Scholar
Dewey, KG, Heinig, MJ & Nommsen Rivers, LA (1995) Differences in morbidity between breast-fed and formula-fed infants. Journal of Pediatrics 126, 696–702.CrossRefGoogle ScholarPubMed
Ellis, FR, Holesh, FRC & Ellis, JW (1972) Incidence of osteoporosis in vegetarians and omnivores. American Journal of Clinical Nutrition 25, 555–558.Google Scholar
Food and Agriculture Organization/World Health Organization/United Nations University (1985) Energy and Protein Requirements. Report of a Joint Expert Consultation. WHO Technical Report Series no. 724. Geneva: WHO.Google Scholar
Fereday, A, Gibson, NR, Cox, M, Pacy, PJ & Millward, DJ (1997) Protein requirements and ageing: metabolic demand and efficiency of utilization. British Journal of Nutrition 77, 685–702.Google Scholar
Fomon, SJ (1991) Requirements and recommended dietary intakes of protein during infancy. Pediatric Research 30, 391–395.Google Scholar
Fomon, SJ, Ziegler, EE, Nelson, SE & Franz, JA (1995) What is the safe protein-energy ratio for infant formulas? American Journal of Clinical Nutrition 62, 358–363.CrossRefGoogle ScholarPubMed
Garn, SM & Kangas, J (1988) Protein intake, bone mass and bone loss. In Osteoporosis: Recent Advances in Pathogenesis and Treatment, pp. 212–230 [De Luca, HF, editor]. Baltimore, MD: University Park Press.Google Scholar
Godfrey, KM, Barker, DJ, Robinson, S & Osmond, C (1997) Maternal birthweight and diet in pregnancy in relation to the infant's thinness at birth. British Journal of Obstetrics and Gynaecology 104, 663–667.CrossRefGoogle Scholar
Godfrey, KM, Forrester, T, Barker, DJ, Jackson, AA, Landman, JP, Hall, JS, Cox, V & Osmond, C (1994) Maternal nutritional status in pregnancy and blood pressure in childhood. British Journal of Obstetrics and Gynaecology 101, 398–403.Google Scholar
Godfrey, K, Robinson, S, Barker, DJ, Osmond, C & Cox, V (1996) Maternal nutrition in early and late pregnancy in relation to placental and fetal growth. British Medical Journal 312, 410–414.CrossRefGoogle ScholarPubMed
Heaney, RP (1993) Protein intake and the calcium economy. Journal of the American Dietetic Association 93, 1259–1260.CrossRefGoogle ScholarPubMed
Hegsted, DM (1976) Balance studies. Journal of Nutrition 106, 307–311.CrossRefGoogle Scholar
Hegsted, DM, Schuette, SA, Zemel, MB & Linkswiler, HM (1981) Urinary calcium and calcium balance in young men as affected by the level of protein and phosphorus intake. Journal of Nutrition 111, 553–562.CrossRefGoogle ScholarPubMed
Heinig, MJ, Nommsen, LA, Peerson, JM, Lonnerdal, B & Dewey, KG (1993) Energy and protein intakes of breast-fed and formula-fed infants during the first year of life and their association with growth velocity: the DARLING Study. American Journal of Clinical Nutrition 58, 152–161.CrossRefGoogle ScholarPubMed
Jackson, AA & Margetts, BM (1993) Protein intakes in the adult population of the UK. International Journal of Food Sciences and Nutrition 44, 95–104.Google Scholar
Kimmel, PL, Lew, SQ & Bosch, JP (1996) Nutrition, ageing and GFR: is age-associated decline inevitable? Nephrology Dialysis and Transplantation 11, Suppl. 9, 85–88.Google Scholar
Klag, MJ & Whelton, PK (1993) The decline in stroke mortality. An epidemiologic perspective. Annals of Epidemiology 3, 571–575.Google Scholar
Langley, SC & Jackson, AA (1994) Increased systolic blood pressure in adult rats induced by fetal exposure to maternal low protein diets. Clinical Science 86, 217–222.Google Scholar
Lemon, PW (1996) Is increased dietary protein necessary or beneficial for individuals with a physically active lifestyle? Nutrition Reviews 54, S169–S175.CrossRefGoogle ScholarPubMed
Lemon, PW, Tarnopolsky, MA, Macdougall, JD & Atkinson, SA (1992) Protein requirements and muscle mass/strength changes during intensive training in novice bodybuilders. Journal of Applied Physiology 73, 767–775.CrossRefGoogle ScholarPubMed
Millward, DJ (1995) A protein-stat mechanism for the regulation of growth and maintenance of the lean-body mass. Nutrition Research Reviews 8, 93–120.Google Scholar
Millward, DJ (1999 a) The nutritional value of plant-based diets in relation to human amino acid and protein requirements. Proceedings of the Nutrition Society 58, 249–260.Google Scholar
Millward, DJ (1999 b) Metabolic demands for amino acids and the human dietary requirement: Millward and Rivers (1988) revisited. Journal of Nutrition (In the Press).Google Scholar
Millward, DJ, Bowtell, JL, Pacy, P & Rennie, MJ (1994) Physical activity, protein metabolism and protein requirements. Proceedings of the Nutrition Society 53, 223–240.Google Scholar
Millward, DJ, Fereday, A, Gibson, NR & Pacy, PJ (1997) Ageing, protein requirements and protein turnover. American Journal of Clinical Nutrition 66, 774–786.Google Scholar
Millward, DJ & Rivers, JP (1989) The need for indispensable amino acids: the concept of the anabolic drive. Diabetes Metabolism Reviews 5, 191–211.Google Scholar
Millward, DJ & Roberts, SR (1996) Protein requirement of older individuals. Nutrition Research Reviews 9, 67–88.Google Scholar
Mitch, WE & Maroni, BJ (1998) Nutritional considerations and the indications for dialysis. American Journal of Kidney Diseases 31, 185–189.Google Scholar
Munro, HN, McGandy, RB, Hartz, SC, Russell, RM, Jacob, RA & Otradovec, MA (1987) Protein nutriture of a group of free-living elderly. American Journal of Clinical Nutrition 46, 586–592.CrossRefGoogle ScholarPubMed
Obarzanek, E, Velletri, PA & Cutler, JA (1996) Dietary protein and blood pressure. Journal of the American Medical Association 275, 1598–1603.Google Scholar
Oddoye, LA & Margen, S (1979) Nitrogen balance studies in humans: long-term effect of high nitrogen intake on nitrogen accretion. Journal of Nutrition 109, 363–377.Google Scholar
Orwoll, ES, Weigel, RM, Oviatt, SK, Meier, DE & McClung, MR (1987) Serum protein concentrations and bone mineral content in aging normal men. American Journal of Clinical Nutrition 46, 614–621.Google Scholar
Pacy, PJ, Price, GM, Halliday, D, Quevedo, MR & Millward, DJ (1994) Nitrogen homeostasis in man: the diurnal responses of protein synthesis and degradation and amino acid oxidation to diets with increasing protein intakes. Clinical Science 86, 103–116.CrossRefGoogle ScholarPubMed
Pannemans, DLE, Schaafsma, G & Westerterp, KR (1997) Calcium excretion, apparent calcium absorption and calcium balance in young and elderly subjects: influence of protein intake. British Journal of Nutrition 77, 721–729.Google Scholar
Pellett, PL (1996) World essential amino acid supply with special attention to South-East Asia. Food and Nutrition Bulletin 17, 204–234.Google Scholar
Prescott, SL, Jenner, DA, Beilin, LJ, Margetts, BM & Vandongen, R (1988) A randomized controlled trial of the effect on blood pressure of dietary non-meat protein versus meat protein in normotensive omnivores. Clinical Science 74, 665–672.CrossRefGoogle ScholarPubMed
Price, GM, Halliday, D, Pacy, PJ, Quevedo, MR & Millward, DJ (1994) Nitrogen homeostasis in man: 1. Influence of protein intake on the amplitude of diurnal cycling of body nitrogen. Clinical Science 86, 91–102.CrossRefGoogle ScholarPubMed
Quevedo, MR, Cox, M, Coward, WA, Jones, D, Pacy, P, Smeaton, I, Thorpe, D & Millward, DJ (1992) Energy intake and expenditure in bodybuilders. Proceedings of the Nutrition Society 50, 238A.Google Scholar
Quevedo, MR, Price, GM, Halliday, D, Pacy, PJ & Millward, DJ (1994) Nitrogen homeostasis in man: 3. Diurnal changes in nitrogen excretion, leucine oxidation and whole body leucine kinetics during a reduction from a high to a moderate protein intake. Clinical Science 86, 185–193.Google Scholar
Reeds, PJ & Becket, PR (1996) Protein and amino acids. In Present Knowledge in Nutrition, 7th ed., pp. 67–86 [Ziegler, EE and Filer, LJ, editors]. Washington, DC: ILSI Press.Google Scholar
Robertson, JD & Maughen, RJ (1992) Acid–base status of premenopausal vegetarian and omnivorous women. Proceedings of the Nutrition Society 51, 32A.Google Scholar
Rudman, D (1988) Kidney senescence; a model for aging. Nutrition Reviews 46, 209–214.Google Scholar
Rush, D (1989) Effects of changes in maternal energy and protein intake during pregnancy, with special reference to fetal growth. In Fetal Growth, pp. 98–105 [Sharp, F, Fraser, RB and Milner, RDG, editors]. London: Springer Verlag.Google Scholar
Shapses, SA, Robins, SP, Schwartz, EI & Chowdhury, H (1995) Short-term changes in calcium but not protein intake alter the rate of bone resorption in healthy subjects as assessed by urinary pyridinium cross-link excretion. Journal of Nutrition 125, 2814–2821.Google Scholar
Stamler, J, Caggiula, A, Grandits, GA, Kjelsberg, M & Cutler, JA (1996 a) Relationship to blood pressure of combinations of dietary macronutrients. Findings of the Multiple Risk Factor Intervention Trial (MRFIT). Circulation 94, 2417–2423.Google Scholar
Stamler, J, Elliott, P, Kesteloot, H, Nichols, R, Claeys, G, Dyer, AR & Stamler, R (1996 b) Inverse relation of dietary protein markers with blood pressure. Findings for 10,020 men and women in the INTERSALT Study. INTERSALT Cooperative Research Group. INTERnational study of SALT and blood pressure. Circulation 94, 1629–1634.Google Scholar
Tapp, DC, Kobayashi, S, Femandes, G & Venkatachalam, MA (1989) Calorie, not protein restriction prevents renal injury in the remnant kidney after nephrectomy in the rat. Seminars in Nephrology 9, 43–353.Google Scholar
Walser, M (1992) The relationship of dietary protein to kidney disease. In Dietary Proteins in Health and Disease, pp. 168–178 [Liepa, GU, editor]. Washington, DC: American Oil Chemists Society.Google Scholar
Wiseman, MJ, Hunt, R, Goodwin, A, Gross, JL, Keen, H & Viberti, GC (1987) Dietary composition and renal function in healthy subjects. Nephron 46, 37–42.Google Scholar