Protein Adequacy in Europe: Adjusting Crude Intakes Using the Protein Adequacy and Quality Score (PAQS).

Background: Because of high overall protein intakes and the substantial proportion of animal-based protein in Europe, protein quality was not considered an issue. However, this may become important when moving toward more sustainable diets that include more plant protein. Objectives: To facilitate the assessment of protein adequacy while considering protein quality, this study aimed to provide an overview of current protein intake and adequacy in European adults, based on crude and utilizable protein. Methods: To assess the prevalence of inadequate protein intake in Europe, the Protein Adequacy and Quality Score (PAQS) was developed and applied to adults (18-64 y) of 25 national dietary surveys obtained from the Comprehensive European Food Consumption Database of the European Food Safety Authority. The PAQS assesses protein adequacy as the ratio of daily utilizable protein intake to requirement, with utilizable protein calculated on a meal basis by considering protein digestibility, indispensable amino acid requirements, and crude protein intake. Results: When accounting for energy misreporting, within-subject variation, and nonnormality of the intake distribution, the prevalence of crude protein inadequacy was <1% in both sexes. Utilizable protein inadequacy ranged from 0% (Spain) to 7% (Austria) in females, except for Germany (17%), and from 0% (Montenegro) to 6% (Germany) in males. Conclusions: These findings suggest no immediate concern for healthy adults regarding utilizable protein intake of current diets. However, diets of females in Germany may warrant closer attention.