Effects of Protein, Monounsaturated Fat, and Carbohydrate Intake on Blood Pressure and Serum Lipids

Department of Nutrition , Harvard University, Cambridge, Massachusetts, United States
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 11/2005; 294(19):2455-64. DOI: 10.1001/jama.294.19.2455
Source: PubMed


Reduced intake of saturated fat is widely recommended for prevention of cardiovascular disease. The type of macronutrient that should replace saturated fat remains uncertain.
To compare the effects of 3 healthful diets, each with reduced saturated fat intake, on blood pressure and serum lipids.
Randomized, 3-period, crossover feeding study (April 2003 to June 2005) conducted in Baltimore, Md, and Boston, Mass. Participants were 164 adults with prehypertension or stage 1 hypertension. Each feeding period lasted 6 weeks and body weight was kept constant.
A diet rich in carbohydrates; a diet rich in protein, about half from plant sources; and a diet rich in unsaturated fat, predominantly monounsaturated fat.
Systolic blood pressure and low-density lipoprotein cholesterol.
Blood pressure, low-density lipoprotein cholesterol, and estimated coronary heart disease risk were lower on each diet compared with baseline. Compared with the carbohydrate diet, the protein diet further decreased mean systolic blood pressure by 1.4 mm Hg (P = .002) and by 3.5 mm Hg (P = .006) among those with hypertension and decreased low-density lipoprotein cholesterol by 3.3 mg/dL (0.09 mmol/L; P = .01), high-density lipoprotein cholesterol by 1.3 mg/dL (0.03 mmol/L; P = .02), and triglycerides by 15.7 mg/dL (0.18 mmol/L; P<.001). Compared with the carbohydrate diet, the unsaturated fat diet decreased systolic blood pressure by 1.3 mm Hg (P = .005) and by 2.9 mm Hg among those with hypertension (P = .02), had no significant effect on low-density lipoprotein cholesterol, increased high-density lipoprotein cholesterol by 1.1 mg/dL (0.03 mmol/L; P = .03), and lowered triglycerides by 9.6 mg/dL (0.11 mmol/L; P = .02). Compared with the carbohydrate diet, estimated 10-year coronary heart disease risk was lower and similar on the protein and unsaturated fat diets.
In the setting of a healthful diet, partial substitution of carbohydrate with either protein or monounsaturated fat can further lower blood pressure, improve lipid levels, and reduce estimated cardiovascular risk. Clinical Trials Registration Identifier: NCT00051350.

Full-text preview

Available from:
    • "The carbohydrate intake of our population was below the RDI. Diets with a lower proportion of carbohydrate can improve BP and triglycerides if replaced by protein or monounsaturated fats (Appel et al., 2005), however in our study, carbohydrate appeared to be substituted for saturated fats, potentially contributing to a worse metabolic profile, which is concerning. Saturated fat is directly proportional to LDL-cholesterol levels and the percentage of saturated fat from dietary calories strongly correlates with coronary death rates (Willett, 2012). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To explore the diets of people living with psychotic disorders, and to compare their dietary composition to the general population. Method: 184 people with psychotic disorders in Adelaide, South Australia completed a food frequency questionnaire. Physical information and mental health status were collected. Outcome measures included energy and macronutrient intake; fish, sodium, fruit and vegetable intake; micro-nutrient intake; body mass index; waist circumference; and diagnoses of diabetes and hypertension. The RDI of nutrients was derived from Australian Government publications. Comparison dietary data was obtained from surveys carried out by the Australian Bureau of Statistics. Results: The majority of participants were overweight or obese (78%) and 77.5% met the criteria for at-risk waist circumference; and 58% of participants consumed salt and saturated fat in excess of the RDI. Most did not achieve the RDI for fruits and vegetables (97.8%), fibre (88.6%), fish (61.4%), magnesium (73.4%) or folate (86.4%). Women with psychosis had significantly higher intakes of vitamins and minerals compared to women in the general population. Men and women with psychosis consumed more daily total fat, saturated fat and sodium compared to adults in the Australian population, but lower fibre and vitamin E than their male and female counterparts. Conclusion: People with psychosis, especially women, report poor dietary choices including increased energy and fat intake, heightening their risk for cardiovascular disease. Women with psychosis report higher intake of vitamins and minerals than women in the general population. Whilst dietary intake contributes to obesity in psychosis, other factors including antipsychotic agents, decreased physical activity and smoking add to the cardiovascular risk.
    No preview · Article · Jan 2015 · Schizophrenia Research
  • Source
    • "The main effect of the consumption of probiotic cheese and yoghurt was a decreased diastolic BP, while consuming probiotic cheese was linked to a significant reduction in systolic BP. Usually, both the amount and type of carbohydrate affect BP, and partial substitution of carbohydrate with either protein or monounsaturated fat lowers BP (Appel et al., 2005). A few trials have tested the effects of periodic consumption of sugars, proteins, and fat in different probiotic products. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The blood pressure-lowering effect of dairy products holds the potential to decrease the risk of cardiovascular disease (CVD). An open question is if the successful expression of functional properties of the probiotic strain depends on host biomarkers and/or food matrix properties. The probiotic Lactobacillus plantarum strain TENSIA® (DSM 21380) is a novel microorganism with antimicrobial and antihypertensive functional properties. The aim of this study was to characterise the functional properties of the probiotic L. plantarum TENSIA and compare its effects on host anthropometric, clinical, and blood biomarkers when consumed with cheese or yoghurt. This study involved two double-blinded randomised placebo-controlled exploratory trials (ISRCTN15061552 and ISRCTN79645828) of healthy adults over a three-week period. The three-week consumption of probiotic L. plantarum TENSIA in a daily dose of 1×1010 cfu in probiotic cheese or a daily dose of 6×109 cfu in yoghurt with different content of carbohydrates, proteins, and lipids did not significantly change the body mass index (BMI), plasma glucose and lipid levels, or inflammatory markers in the blood. Reduced lowered systolic and diastolic blood pressure values were detected, regardless of food matrix or baseline values for blood pressure and BMI. In conclusion, our study showed that three-week consumption of the probiotic L. plantarum TENSIA either in cheese or yoghurt lowered diastolic and systolic blood pressure regardless of food matrix and baseline values of blood pressure and BMI, confirming the impact of the functional properties of the probiotic strain in decreasing CVD risk.
    Full-text · Article · Dec 2014 · Beneficial Microbes
  • Source
    • "In particular, adherence to a Mediterranean dietary pattern is of great importance and has been shown to impact mortality [12]. Although there exists dispute regarding the effect of definite micro-and macronutrients on vascular functions, the groundbreaking DASH (Dietary Approaches to Stop Hypertension ) trial demonstrated that certain dietary patterns influence blood pressure [34] [35] [36]. Abundant in our everyday diet and especially in leafy green vegetables is the micronutrient inorganic nitrate. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Aging increases the risk for cardiovascular morbidity and mortality. Chronic low-grade inflammation deteriorates vascular function, increases age-related vascular stiffness, and affects hemodynamics. The proinflammatory cytokine macrophage migration inhibitory factor (MIF) is a major mediator of atherosclerosis. Plasma MIF levels are associated with arterial stiffness, a hallmark of vascular aging. Preclinical studies show that blockade of MIF leads to atherosclerotic plaque regression. Nutritional approaches provide opportunities to counteract age-related inflammation. Following a chronic dietary supplementation with the micronutrient nitrate has been demonstrated to improve vascular stiffness. Whether dietary nitrate affects circulating MIF levels is not known. In a randomized placebo-controlled, double-blinded study, elderly subjects received a dietary nitrate supplementation for 4 weeks. Dietary nitrate led to a decrease in plasma MIF levels in the elderly and to an improvement in vascular functions. This was associated with a reduction in central systolic blood pressure. Our data show that supplementation with dietary nitrate is associated with a reduction of circulating MIF levels along with an improvement in vascular function. This supports the concept of dietary approaches to modulate age-related changes of vascular functions.
    Full-text · Article · Jul 2014 · BioMed Research International
Show more