Our data do not suggest a major role for glutamic acid, arginine, lysine, tyrosine, or cysteine intake (as % of protein intake) in determining population BP or risk of hypertension.

There is growing evidence from epidemiological studies that dietary protein may beneficially influence blood pressure (BP), but findings are inconclusive. We performed a meta-analysis of 29 observational studies and randomized controlled trials (RCTs) of dietary protein and types of protein in relation to BP or incident hypertension, published until January 2012. The analysis included eight cross-sectional studies (n=48 985), four prospective studies (n=11 761) and 17 RCTs (n=1449). A modest inverse association between total protein intake and BP (-0.20 mm Hg systolic (95% CI: -0.39, -0.01) per 25 g (∼1 s.d.)) was found in cross-sectional studies, but not in prospective studies (relative risk of 0.99 (95% CI: 0.96, 1.02)). For RCTs that used carbohydrate as a control treatment, the pooled BP effect was -2.11 mm Hg systolic (95% CI: -2.86, -1.37) for a weighed mean contrast in protein intake of 41 g per day. A non-significant inverse association of -0.52 mm Hg systolic (95% CI: -1.10, +0.05) per 11 g (∼1 s.d.) was found for plant protein in cross-sectional studies, whereas animal protein was not associated with BP. In prospective studies and RCTs, however, the associations of plant protein and animal protein with BP were broadly similar. These findings suggest that increasing the intake of protein at the expense of carbohydrates may have a beneficial effect on BP. The BP effect of specific types of protein remains to be established.

An important cornerstone in the control of antimicrobial resistance (AMR) is a well-designed quantitative system for the surveillance of spread and temporal trends in AMR. Since 2008, the Dutch national AMR surveillance system, based on routine data from medical microbiological laboratories (MMLs), has developed into a successful tool to support the control of AMR in the Netherlands. It provides background information for policy making in public health and healthcare services, supports development of empirical antibiotic therapy guidelines and facilitates in-depth research. In addition, participation of the MMLs in the national AMR surveillance network has contributed to sharing of knowledge and quality improvement. A future improvement will be the implementation of a new semantic standard together with standardised data transfer, which will reduce errors in data handling and enable a more real-time surveillance. Furthermore, the scientific impact and the possibility of detecting outbreaks may be amplified by merging the AMR surveillance database with databases from selected pathogen-based surveillance programmes containing patient data and genotypic typing data.

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