Associations of higher protein intake with diet quality and diabetes-related metabolic health indicators in Korean adults without diabetes: analysis of Korean National Health and Nutrition Examination Survey (KNHANES) 2019–2021

초록

BACKGROUND/OBJECTIVES: Rising pre-diabetes in Korean adults is an emerging concern, with notable increases observed even among younger adults. The interest in high-protein diets is also increasing in Korea, while concerns about excess intake remain. This study examined the associations of protein intake, diet quality, and diabetes-related metabolic indicators in Korean adults. SUBJECTS/METHODS: This study analyzed 8,254 adults aged 19–64 yrs without diabetes from the Korean National Health and Nutrition Examination Survey 2019–2021, stratified by sex and pre-diabetic status. The protein intake was assessed using a 24-h recall, expressed as a percentage of the total energy intake, and divided into quintiles. The diet quality was examined using the Korean Healthy Eating Index. The diabetes-related metabolic indicators were waist circumference, triglyceride, high-density lipoprotein cholesterol (HDL-C), blood pressure, homeostasis model assessment of insulin resistance, and triglyceride-glucose index. The associations were analyzed using complex sample general linear models and logistic regression, adjusting for sociodemographic factors, lifestyle, and total energy intake. RESULTS: The protein intake was positively associated with the diet quality, peaking at Q4, then declining. Pre-diabetic men showed a decreasing trend in the elevated triglyceride risk with higher protein intake (Q4: odds ratio [OR], 0.697 [0.489–0.995]; P for trend = 0.041). In women, higher protein intake was significantly associated with an increased risk of low HDL-C in the non-diabetic group (Q5: OR, 1.544 [1.141–2.088]; P for trend = 0.020) and with the pre-diabetic group showing a lower risk of elevated blood pressure (Q5: OR, 0.657 [0.458–0.944]; P for trend = 0.012). CONCLUSION: These findings suggest that in Korean adults without diabetes, maintaining an appropriate, balanced protein intake rather than simply increasing consumption may help manage the metabolic alterations associated with diabetes.

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