Protein intake is more stable than carbohydrate or fat intake across various US demographic groups and international populations

Background: The optimal macronutrient composition of the diet is controversial and many adults attempt to regulate the intake of specific macronutrients for various health-related reasons. Objective: The objective was to compare stability and ranges of intakes of different macronutrients across diverse adult populations in the USA and globally. Methods: US dietary intake data from NHANES 2009-2014 were used to determine macronutrient intake as a percentage of total energy intake. Variability in macronutrient intake was estimated by calculating the difference between 75th and 25th percentile (Q3-Q1) IQRs of macronutrient intake distributions. In addition, intake data from 13 other countries with per capita gross domestic product (GDP) over $10,000 US dollars (USD) were used to assess variability of intake internationally since there are large differences in types of foods consumed in different countries. Results: Protein, carbohydrate, and fat intake (NHANES 20092014) was 15.7 +/- 0.1, 48.1 +/- 0.1, and 32.9 +/- 0.1% kcal, respectively, in US adults. The IQR of protein intake distribution (3.73 +/- 0.11% kcal) was 41% of carbohydrate intake distribution (9.18 +/- 0.20% kcal) and 58% of fat intake distribution (6.40 +/- 0.14% kcal). The IQRs of carbohydrate and fat intake distributions were significantly (P <0.01) influenced by age and race; however, the IQR of protein intake was not associated with demographic and lifestyle factors including sex, race, income, physical activity, and body weight. International mean protein intake was 16.3 +/- 0.2% kcal, similar to US intake, and there was less variation in protein than carbohydrate or fat intake. Conclusion: Protein intake of the US population and multiple international populations, regardless of demographic and lifestyle factors, was consistently similar to 16% of total energy, suggesting biological control mechanism(s) tightly regulate protein intake and, consequently, influence intake of other macronutrients and food constituents. Substantial differences in intake of the other macronutrients observed in US and international populations had little influence on protein intake. This trial was registered at the ISRCTN registry as ISRCTN46157745 (https://www.isrctn.com/ISRCTN4615774).