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| Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids - Results of the OmniHeart randomized trial |
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| Author(s): Appel LJ, Sacks FM, Carey VJ, Obarzanek E, Swain JF, Miller ER, Conlin PR, Erlinger TP, Rosner BA, Laranjo NM, Charleston J, McCarron P, Bishop LM |
| Source: JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Volume: 294 Issue: 19 Pages: 2455-2464 Published: NOV 16 2005 |
| Times Cited: 145 References: 47 |
| Abstract: Context Reduced intake of saturated fat is widely recommended for prevention of cardiovascular disease. The type of macronutrient that should replace saturated fat remains uncertain. Objective To compare the effects of 3 healthful diets, each with reduced saturated fat intake, on blood pressure and serum lipids.
Design, Setting, and Participants 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.
Interventions 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.
Main Outcome Measures Systolic blood pressure and low-density lipoprotein cholesterol.
Results 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.
Conclusion 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 ClinicalTrials.gov Identifier: NCT00051350.
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| Document Type: Article |
| Language: English |
| Reprint Address: Appel, LJ (reprint author), Johns Hopkins Univ, Sch Med, Welch Ctr Prevent Epidemiol & Clin Res, 2024 E Monument St,Suite 2-618, Baltimore, MD 21205 USA |
Addresses:
1. Johns Hopkins Univ, Sch Med, Welch Ctr Prevent Epidemiol & Clin Res, Baltimore, MD 21205 USA
2. Johns Hopkins Univ, Sch Med, Div Gen Internal Med, Baltimore, MD 21205 USA
3. Johns Hopkins Univ, Sch Med, Dept Epidemiol, Baltimore, MD 21205 USA
4. Bloomberg Sch Publ Hlth, Baltimore, MD USA
5. Brigham & Womens Hosp, Channing Lab, Boston, MA 02115 USA
6. Brigham & Womens Hosp, Div Endocrinol Diabet & Hypertens, Boston, MA 02115 USA
7. Brigham & Womens Hosp, Gen Clin Res Ctr, Boston, MA 02115 USA
8. Harvard Univ, Sch Med, Boston, MA USA
9. Harvard Univ, Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA
10. NHLBI, Div Epidemiol & Clin Applicat, Bethesda, MD 20892 USA
11. VA Boston Healthcare Syst, Div Endocrinol, Boston, MA USA |
| Publisher: AMER MEDICAL ASSOC, 515 N STATE ST, CHICAGO, IL 60610-0946 USA |
| Subject Category: Medicine, General & Internal |
| IDS Number: 984BL |
| ISSN: 0098-7484 |
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