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Estimating the effect of hypothetical dietary protein interventions on changes in body composition of postmenopausal women over 3 years using data from the Women's Health Initiative (WHI) Study: an emulated target trial
Journal article   Open access   Peer reviewed

Estimating the effect of hypothetical dietary protein interventions on changes in body composition of postmenopausal women over 3 years using data from the Women's Health Initiative (WHI) Study: an emulated target trial

Jiarui Li, Luohua Jiang, Nazmus Saquib, Philippe Jean-Luc Gradidge, Simin Liu, Linda Van Horn, Phyllis A Richey, David S Timberlake, Hind A Beydoun, Longjian Liu, …
International journal of obesity (2005)
09 Jan 2026
DOI: https://doi.org/10.1038/s41366-025-01978-0
PMID: 41514045
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1038/s41366-025-01978-0View
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Abstract

Postmenopausal women tend to experience significant changes in body composition, particularly abdominal adipose tissue (AAT) deposition patterns, which are hypothesized to be critical factors influencing future chronic disease risk. The level of protein intake to maintain or achieve a more favorable body composition for health in postmenopausal women is a central, largely unanswered question relating to the appropriateness of current dietary guideline recommendations for sufficient protein intake (set at 0.8 g/kg/day). To estimate the hypothetical effect of a range of protein intake levels on 3-year mean changes in body composition measures in postmenopausal women. We analyzed data from 3789 postmenopausal women aged 50-79 enrolled in the Women's Health Initiative (WHI) to emulate a 3-year target trial of adhering to increasing levels of protein intake: ≥0.8 g/kg/d, ≥1.0 g/kg/d, ≥1.2 g/kg/d, and ≥1.5 g/kg/d. All participants had repeated Dual X-Ray Absorptiometry (DXA) scans with derived abdominal visceral (VAT) and subcutaneous adipose tissue (SAT). The measured differences in average levels of VAT, SAT, and other body composition measures determined at end of follow-up were estimated with the parametric-g formula. Over 3 years, hypothetical interventions of increasing levels of dietary protein intake are estimated to have dose-dependent reductions in abdominal VAT, SAT, and overall body fat, and increases in lean soft tissue, with potential benefits observed at ≥1.2 g/kg/day and the greatest estimated benefit at ≥1.5 g/kg/day of dietary protein. Compared to no intervention, if all participants hypothetically adhered to a total daily protein intake of ≥1.5 g/kg/day over 3 years, they would be estimated to have lower levels of VAT (-13.1 cm , 95% Confidence Interval [CI] -18.9, -7.3), SAT (-25.3 cm , 95% CI -39.7, -11.0), total body fat % (-1.0%, 95% CI -1.7, -0.3), body weight (-2.5 kg, 95% CI -3.7, -1.2) and greater lean soft tissue % (0.9%, 95% CI 0.3, 1.6) over 3 years. This hypothetical emulated intervention suggests that postmenopausal women who maintain a hypothetical total protein intake of at least 1.2 g/kg/day could experience beneficial changes in abdominal VAT, SAT, and overall body composition over three years, with even greater estimated benefits observed at an intake of 1.5 g/kg/day. These findings suggest that protein intake higher than guideline recommendations may better support healthier body composition and lower chronic disease risk in postmenopausal women.

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#5 Gender Equality
#3 Good Health and Well-Being
#2 Zero Hunger

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Endocrinology & Metabolism
Nutrition & Dietetics
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