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Teunissen-Beekman KFM, Dopheide J, Geleijnse JM, Bakker SJL, Brink EJ, de Leeuw PW, van Baak MA. Protein supplementation lowers blood pressure in overweight adults: effect of dietary proteins on blood pressure (PROPRES), a randomized trial. Am J Clin Nutr 2012; 95:966-71. [PMID: 22357725 DOI: 10.3945/ajcn.111.029116] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Dietary protein intake may help to manage blood pressure (BP) and prevent complications associated with elevated BP. OBJECTIVE The objective of this study was to determine whether 4 wk of increased protein intake (∼25% compared with ∼15% of energy intake that isoenergetically replaces carbohydrate intake) lowers office and daytime BP compared with increased carbohydrate intake. DESIGN A randomized, double-blind, parallel study compared consumption of 3 × 20 g protein/d (20% pea, 20% soy, 30% egg, and 30% milk-protein isolate) with 3 × 20 g maltodextrin/d. Protein or maltodextrin were isoenergetically substituted for a sugar-sweetened drink. Primary outcomes were office and daytime BP. A total of 99 men and women [age range: 20-70 y; BMI (in kg/m²): 25-35] with untreated elevated BP (BP ≥130/85 and <160/100 mm Hg) were randomly assigned. Ninety-four completers (51 subjects in the maltodextrin group, 43 subjects in the protein group) were included in the analyses. RESULTS Office systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 4.9 ± 1.7 mm Hg (P = 0.005) and 2.7 ± 1.3 mm Hg (P = 0.05) lower, respectively, in the protein group. Daytime SBP was 4.6 ± 1.7 mm Hg lower in the protein group (P = 0.006), whereas daytime DBP did not differ between groups (P = 0.37). Urinary sodium excretion was higher in the maltodextrin group (P = 0.004). CONCLUSION Increased protein intake, at the expense of maltodextrin, lowers BP in overweight adults with upper-range prehypertension and grade 1 hypertension. This trial was registered at www.trialregister.nl as NTR 1362.
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Mirmiran P, Hajifaraji M, Bahadoran Z, Sarvghadi F, Azizi F. Dietary protein intake is associated with favorable cardiometabolic risk factors in adults: Tehran Lipid and Glucose Study. Nutr Res 2012; 32:169-76. [DOI: 10.1016/j.nutres.2012.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 12/12/2011] [Accepted: 01/13/2012] [Indexed: 01/16/2023]
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Abstract
Meat protein is associated with an increase in risk of heart disease. Recent data have shown that meat protein appeared to be associated with weight gain over 6.5 years, with 1 kg of weight increase per 125 g of meat per day. In the Nurses' Health Study, diets low in red meat, containing nuts, low-fat dairy, poultry, or fish, were associated with a 13% to 30% lower risk of CHD compared with diets high in meat. Low-carbohydrate diets high in animal protein were associated with a 23% higher total mortality rate whereas low-carbohydrate diets high in vegetable protein were associated with a 20% lower total mortality rate. Recent soy interventions have been assessed by the American Heart Association and found to be associated with only small reductions in LDL cholesterol. Although dairy intake has been associated with a lower weight and lower insulin resistance and metabolic syndrome, the only long-term (6 months) dairy intervention performed so far has shown no effects on these parameters.
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Sources of dietary protein in relation to blood pressure in a general Dutch population. PLoS One 2012; 7:e30582. [PMID: 22347387 PMCID: PMC3274530 DOI: 10.1371/journal.pone.0030582] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 12/19/2011] [Indexed: 02/07/2023] Open
Abstract
Background Little is known about the relation of different dietary protein types with blood pressure (BP). We examined whether intake of total, plant, animal, dairy, meat, and grain protein was related to BP in a cross sectional cohort of 20,820 Dutch adults, aged 20–65 y and not using antihypertensive medication. Design Mean BP levels were calculated in quintiles of energy-adjusted protein with adjustment for age, sex, BMI, education, smoking, and intake of energy, alcohol, and other nutrients including protein from other sources. In addition, mean BP difference after substitution of 3 en% carbohydrates or MUFA with protein was calculated. Results Total protein and animal protein were not associated with BP (ptrend = 0.62 and 0.71 respectively), both at the expense of carbohydrates and MUFA. Systolic BP was 1.8 mmHg lower (ptrend<0.01) in the highest (>36 g/d) than in the lowest (<27 g/d) quintile of plant protein. This inverse association was present both at the expense of carbohydrates and MUFA and more pronounced in individuals with untreated hypertension (−3.6 mmHg) than in those with normal (+0.1 mmHg) or prehypertensive BP (−0.3 mmHg; pinteraction<0.01). Meat and grain protein were not related to BP. Dairy protein was directly associated with systolic BP (+1.6 mmHg, ptrend<0.01), but not with diastolic BP (ptrend = 0.24). Conclusions Total protein and animal protein were not associated with BP in this general untreated Dutch population. Plant protein may be beneficial to BP, especially in people with elevated BP. However, because high intake of plant protein may be a marker of a healthy diet and lifestyle in general, confirmation from randomized controlled trials is warranted.
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Lee IT, Lee WJ, Tsai CM, Su IJ, Yen HT, Sheu WHH. Combined extractives of red yeast rice, bitter gourd, chlorella, soy protein, and licorice improve total cholesterol, low-density lipoprotein cholesterol, and triglyceride in subjects with metabolic syndrome. Nutr Res 2012; 32:85-92. [PMID: 22348456 DOI: 10.1016/j.nutres.2011.12.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 12/12/2011] [Accepted: 12/24/2011] [Indexed: 01/30/2023]
Abstract
In this study, we aimed to examine the effects of a plant-extractive compound on lipid profiles in subjects with metabolic syndrome. We hypothesized that extractives from red yeast rice, bitter gourd, chlorella, soy protein, and licorice have synergistic benefits on cholesterol and metabolic syndrome. In this double-blinded study, adult subjects with metabolic syndrome were randomized to receive a plant-extractive compound or a placebo treatment for 12 weeks. Both total cholesterol (5.4 ± 0.8 to 4.4 ± 0.6 mmol/L, P < .001) and low-density lipoprotein cholesterol (3.4 ± 0.7 to 2.7 ± 0.5 mmol/L, P < .001) were significantly reduced after treatment with the plant extractives, and the magnitudes of reduction were significantly greater than in the placebo group (-1.0 ± 0.6 vs 0.0 ± 0.6mmol/L, P < .001; -0.7 ± 0.6 vs 0.0 ± 0.6 mmol/L, P < .001). The reduction in the fasting triglycerides level was significantly greater in the plant-extractive group than in the placebo group (-0.5 ± 0.8 vs -0.2 ± 1.0 mmol/L, P = .039). There was also a significantly greater reduction in the proportion of subjects with hypertensive criteria in the plant-extractive group than in the placebo group (P = .040). In conclusion, the plant extractives from red yeast rice, bitter gourd, chlorella, soy protein, and licorice were effective in reducing total and low-density lipoprotein cholesterol. The plant extractives also showed potential for reducing triglyceride and normalizing blood pressure.
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Affiliation(s)
- I-Te Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
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Abstract
Evidence suggests a small beneficial effect of dietary protein on blood pressure (BP), especially for plant protein. We examined the relationship between several types of dietary protein (total, plant, animal, dairy, meat and grain) and the risk of hypertension in a general population of 3588 Dutch adults, aged 26–65 years, who were free of hypertension at baseline. Measurements were done at baseline and after 5 and 10 years of follow-up. Hazard ratios (HR), with 95 % CI, for incident hypertension were obtained in tertiles of energy-adjusted protein, using time-dependent Cox regression models. Models were adjusted for age, sex, BMI, education, smoking, baseline systolic BP, dietary confounders and protein from other sources (if applicable). Mean BP was 118/76 mmHg at baseline. Protein intake was 85 (sd 22) g/d (approximately 15 % of energy) with 62 % originating from animal sources. The main sources of protein were dairy products (28 %), meat (24 %) and grain (19 %). During the follow-up, 1568 new cases of hypertension were identified (44 % of the participants). Energy-adjusted intake of total protein, plant protein and animal protein was not significantly associated with hypertension risk (all HR approximately 1·00, P>0·60). Protein from grain showed a significant inverse association with incident hypertension, with a HR of 0·85 (95 % CI 0·73, 1·00, Ptrend = 0·04) for the upper tertile ( ≥ 18 g/d) v. the lower tertile ( < 14 g/d), whereas dairy protein and meat protein were not associated with incident hypertension. In conclusion, higher intake of grain protein may contribute to the prevention of hypertension, which warrants confirmation in other population-based studies and randomised controlled trials.
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Wang D, He Y, Li Y, Luan D, Yang X, Zhai F, Ma G. Dietary patterns and hypertension among Chinese adults: a nationally representative cross-sectional study. BMC Public Health 2011; 11:925. [PMID: 22168909 PMCID: PMC3299712 DOI: 10.1186/1471-2458-11-925] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Accepted: 12/14/2011] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Several healthful dietary patterns appear to be effective at lowering blood pressure and preventing hypertension. However, the relationship between dietary patterns and hypertension among a representative Chinese population sample is unclear. METHODS A nationally representative sample of 23 671 participants aged 18-59 years were recruited by the 2002 China National Nutrition and Health Survey. All participants had their blood pressure measured with standardized mercury sphygmomanometers. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. We conducted factor analysis using dietary information from a validated food frequency questionnaire to derive dietary patterns. Information of participants on physical activities, education level, annual household income, smoking status and family history of hypertension was collected by interviewer-administrated questionnaires. RESULTS Three major dietary patterns, defined as 'Western', 'traditional northern', and 'traditional southern', were identified. Participants with the highest quartile for the score of the Western pattern had significantly higher blood pressure comparing with counterparts in the lowest quartile. In contrast, participants in the top quartile for the score of the traditional southern pattern presented significantly lower blood pressure comparing with counterparts in the lowest quartile. In multivariate analyses the traditional northern pattern score was associated with an odds ratio (OR) of 1.30 (95% confidence interval (CI) 1.11-1.53, P for trend = 0.0001) comparing with the lowest quartile. The OR for the top quartile of score for the traditional southern pattern was 0.73 (95% CI, 0.59-0.89, P for trend = 0.0040) compared with the lowest quartile of traditional southern pattern score. However, the significant association between the traditional northern pattern and prevalence of hypertension disappeared after further adjusting for body mass index (BMI) (P for trend = 0.3), whereas the association between the traditional southern pattern and prevalence of hypertension persisted after further adjusting for BMI (P for trend = 0.01). CONCLUSIONS We observed a positive relationship between the traditional northern pattern and hypertension that was mediated through differences in BMI. In addition, the traditional southern pattern was significantly associated with lower odds of presenting with hypertension.
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Affiliation(s)
- Dong Wang
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, 7 Pan Jia Yuan Nan Li, Chaoyang District, Beijing 100021, China
- Civil Aviation Medicine Center, Civil Aviation Administration of China, Chaoyang District, Beijing, China
| | - Yuna He
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, 7 Pan Jia Yuan Nan Li, Chaoyang District, Beijing 100021, China
| | - Yanping Li
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, 7 Pan Jia Yuan Nan Li, Chaoyang District, Beijing 100021, China
| | - Dechun Luan
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, 7 Pan Jia Yuan Nan Li, Chaoyang District, Beijing 100021, China
- Liaoning Provincial Center for Disease Control and Prevention, Heping District, Shenyang, Liaoning Province, China
| | - Xiaoguang Yang
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, 7 Pan Jia Yuan Nan Li, Chaoyang District, Beijing 100021, China
| | - Fengying Zhai
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, 7 Pan Jia Yuan Nan Li, Chaoyang District, Beijing 100021, China
| | - Guansheng Ma
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, 7 Pan Jia Yuan Nan Li, Chaoyang District, Beijing 100021, China
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Long-term effects of a protein-enriched diet on blood pressure in older women. Br J Nutr 2011; 107:1664-72. [PMID: 21910947 DOI: 10.1017/s0007114511004740] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Short-term randomised, controlled trials have found that dietary protein relative to carbohydrate can reduce blood pressure. Our objective was to investigate the effects on blood pressure of an increase in protein intake from whey over 2 years in women aged over 70 years. From the general population, 219 women aged between 70 and 80 years were recruited to a 2-year randomised, double-blind, placebo-controlled parallel-design trial: 181 women completed the trial to the end of year 2. Participants were randomly assigned to consume a daily whey protein-based beverage (protein) or an energy-matched low-protein high-carbohydrate beverage (control). Blood pressure measurements were performed at baseline, year 1 and year 2. For protein relative to control, the estimated mean net differences in protein and carbohydrate intakes were 18 (95 % CI 13, 23) and -22 (95 % CI -9, -35) g/d at year 1, and 22 (95 % CI 17, 28) and -18 (95 % CI -6, -31) g/d at year 2. Intention-to-treat analysis found no overall differences between groups in blood pressure (P>0·5). Net differences in systolic and diastolic blood pressure were -2·3 (95 % CI -5·3, 0·7) and -1·5 (95 % CI -3·6, 0·6) mmHg at year 1, and 1·6 (95 % CI -1·5, 4·7) and 0·3 (95 % CI -1·9, 2·4) mmHg at year 2. Similar differences in systolic and diastolic blood pressure at years 1 and 2 were observed with per-protocol analysis. Therefore, the present study did not provide evidence that a higher whey protein intake in older women can have prolonged effects on blood pressure.
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He J, Wofford MR, Reynolds K, Chen J, Chen CS, Myers L, Minor DL, Elmer PJ, Jones DW, Whelton PK. Effect of dietary protein supplementation on blood pressure: a randomized, controlled trial. Circulation 2011; 124:589-95. [PMID: 21768541 DOI: 10.1161/circulationaha.110.009159] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Observational studies have reported an inverse association between dietary protein intake and blood pressure (BP). We compared the effect of soy protein, milk protein, and carbohydrate supplementation on BP among healthy adults. METHODS AND RESULTS We conducted a randomized, double-blind crossover trial with 3 intervention phases among 352 adults with prehypertension or stage 1 hypertension in New Orleans, LA, and Jackson, MS, from September 2003 to April 2008. The trial participants were assigned to take 40 g/d soy protein, milk protein, or carbohydrate supplementation each for 8 weeks in a random order. A 3-week washout period was implemented between the interventions. Three BPs were measured at 2 baseline and 2 termination visits during each of 3 intervention phases with a random-zero sphygmomanometer. Compared with carbohydrate controls, soy protein and milk protein supplementations were significantly associated with -2.0 mm Hg (95% confidence interval -3.2 to -0.7 mm Hg, P=0.002) and -2.3 mm Hg (-3.7 to -1.0 mm Hg, P=0.0007) net changes in systolic BP, respectively. Diastolic BP was also reduced, but this change did not reach statistical significance. There was no significant difference in the BP reductions achieved between soy or milk protein supplementation. CONCLUSIONS The results from this randomized, controlled trial indicate that both soy and milk protein intake reduce systolic BP compared with a high-glycemic-index refined carbohydrate among patients with prehypertension and stage 1 hypertension. Furthermore, these findings suggest that partially replacing carbohydrate with soy or milk protein might be an important component of nutrition intervention strategies for the prevention and treatment of hypertension. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00107744.
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Affiliation(s)
- Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
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