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Association of dietary sulfur amino acid intake with mortality from diabetes and other causes

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Abstract

Purpose

Sulfur amino acid (SAA) consumption in Western countries is far greater than recommended levels. In preclinical studies, reduced SAA intake enhanced longevity and reduced risk for numerous chronic diseases. The current objective was to examine for associations between the intake of total SAA, including methionine (Met) and cysteine (Cys), and all-cause and disease-specific mortality US adults.

Methods

This prospective analysis included 15,083 US adult participants (mean age = 46.7 years) from the Third National Examination and Nutritional Health Survey (NHANES III, 1988–1994) with available mortality status (National Death Registry, 1988–2011). Dietary SAA intake was obtained from 24-h recall data. Associations between quintile (Q) of SAA intake (expressed as absolute intake or protein density) and mortality were assessed using Cox proportional hazard models and expressed as hazard ratio (HR).

Results

During follow-up (mean = 16.9 years), 4636 deaths occurred. After multivariable adjustment (including demographics and traditional risk factors, such as fat and other micronutrients intake), diabetes-caused mortality rates were nearly threefold higher in the highest compared to lowest SAA intake quintiles [HRQ5–Q1 total SAA, 2.68 (1.46–4.90); HRQ5–Q1 methionine, 2.45 (1.37–4.38); HRQ5–Q1 cysteine, 2.91 (1.57–5.37)] (P < 0.01)]. Higher total SAA protein density was also associated with diabetes-caused mortality [HRQ5–Q1 1.75 (1.31–2.35)]. Associations between SAA intake and all-cause mortality, and mortality caused by other major diseases were not detected.

Conclusion

Results suggest that high-SAA diets are associated with increased risk for diabetes mortality and that lowering intake towards to Recommended Dietary Allowance levels could lead to reductions in lifetime risk.

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Availability of data and material

Detailed NHANES survey descriptions, methodology, sampling procedures, laboratory test procedures, and data tables are publicly available (www.cdc.gov.nchs/nhanes/).

Code availability

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Acknowledgements

The authors’ responsibilities were as follows: ZD, XG and JPR designed the research, ZD conducted the research and drafted the paper, ZD and VMC analyzed the data and drafted the paper, ZD, XG, JM, RS, RW, and JPR contributed to analysis and manuscript development; and all authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Public Health Sciences, Penn State Cancer Institute, The Pennsylvania State University College of Medicine, 500 University Drive, Mail Code CH69, Hershey, PA, 17033, USA

    Zhen Dong, Vernon M. Chinchilli, Joshua Muscat, Renate Winkels & John P. Richie Jr

  2. Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA

    Xiang Gao

  3. Department of Biochemistry and Molecular Biology, The Pennsylvania State University College of Medicine, Hershey, PA, USA

    Raghu Sinha

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  1. Zhen Dong
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Correspondence to John P. Richie Jr.

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The authors declare that they have no conflict of interest.

Ethics approval

The NHANES study has been approved by its institutional review board (17) and all procedures have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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All persons gave their informed consent prior to their inclusion in the study as approved by the NHANES institutional review board (17).

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Dong, Z., Gao, X., Chinchilli, V.M. et al. Association of dietary sulfur amino acid intake with mortality from diabetes and other causes. Eur J Nutr 61, 289–298 (2022). https://doi.org/10.1007/s00394-021-02641-w

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