The impact of type of dietary protein, animal versus vegetable, in modifying cardiometabolic risk factors: A position paper from the International Lipid Expert Panel (ILEP)

Zhubi-Bakija, Fjolla; Bytyçi, Ibadete; Henein, Michael Y.; Rexhaj, Zarife; Zhubi, Esra; Alnouri, Fahad; Amar, Fahma; Atanasov, A; Bajraktari, Gani; Banach, Maciej; Bartłomiejczyk, Marcin A.; Bjelaković, Bojko; Bruckert, Éric; Cafferata, Alberto; Češka, Richard; Cicero, Arrigo Francesco Giuseppe; Collet, Xavier; Descamps, Olivier; Djurić, Dragan; Durst, Ronen; Ezhov, M.; Fras, Zlatko; Gaiță, Dan; Hernández, Adrian V.; Jones, Steven R.; Jóźwiak, Jacek Jerzy; Kakauridze, N.; Niki, Kiyomi; Khera, Amit; Kostner, Karam; Kubilius, Raimondas; Latkovskis, Gustavs; Mancini, G.B. John; Ad, Marais; Martin, Seth S.; Martinez, J A; Mazidi, Mohsen; Mikhailidis, Dimitri P.; Mirrakhimov, Erkin M; Miserez, André R.; Mitchenko, O.; Moriarty, Patrick M.; Nabavi, Seyed Mohammad; Nair, Devaki; Panagiotakos, Demosthenes B.; Paragh, György; Pella, Daniel; Penson, Peter E.; Petrulionienė, Ž.; Pirro, Matteo; Postadzhiyan, Arman; Puri, Raman; Reda, Ashraf; Reiner, Željko; Riadh, Jemaa; Richter, Dimitri; Rizzo, Manfredi; Ruscica, Massimiliano; Sahebkar, Amirhossein; Sattar, Naveed; Șerban, Maria-Corina; Shehab, Abdulla; Shek, Aleksandr B.; Sirtori, Cesare R.; Stefanutti, Claudia; Tomasik, Tomasz; Tóth, Peter P.; Viigimaa, Margus; Vinereanu, Dragoş; Vohnout, Branislav; Haehling, Stephan von; Vráblík, Michal; Wong, Nathan D.; Yeh, Hung‐I; Zhisheng, Jiang; Zirlik, Andreas

doi:10.1016/j.clnu.2020.05.017

Cited by 95 publications

(69 citation statements)

References 98 publications

(220 reference statements)

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“…Although mortality due to ischemic heart disease (IHD) curtailed from 2005 to 2015, it remains the leading cause of death [ 3 ]. Prior studies have reported a modest increase in the incidence of the total, cardiovascular and cancer mortality with red meat consumption [ [4] , [5] , [6] , [7] ]. Addressing this plight, the 2019 American College of Cardiology (ACC)/ American Heart Association (AHA) Guideline on the Primary Prevention of Cardiovascular Disease recommended a diet consisting of fruits, vegetables, legumes, nuts, whole grains and fish to reduce cardiovascular risk (Class: I, Level of Evidence: BR) [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of effect of vegetarian diet on ischemic heart disease and all-cause mortality

Balakumaran

Kumar

Verghese

et al. 2021

American Journal of Preventive Cardiology

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Objective To summarize the association between vegetarian versus non-vegetarian diet on mortality due to ischemic heart disease, cerebrovascular disease, or all-cause mortality. Methods We searched PubMed, Cochrane databases, and ClinicalTrials.Gov from the inception of the databases to October 2019 with no language restriction. Randomized controlled trials or prospective observational studies comparing the association between vegetarian versus non-vegetarian diets among adults and reporting major adverse cardiovascular outcomes were selected. We used Paule-Mandel estimator for tau2 with Hartung–Knapp adjustment for random effects model to estimate risk ratio [RR] with 95% confidence interval [CI].The primary outcome of interest was all-cause mortality. The secondary outcome was ischemic heart disease mortality. Results Eight observational studies ( n = 131,869) were included in the analysis. Over a weighted mean follow-up of 10.68 years, very low certainty of evidence concluded that a vegetarian diet compared with a non-vegetarian diet was associated with similar risk of all-cause (RR: 0.84, 95% CI: 0.65–1.07, I 2 : 97%) or cerebrovascular mortality (RR: 0.84, 95% CI: 0.63–1.14, I 2 : 90%), but was associated with a reduced risk of ischemic heart disease mortality (RR: 0.70, 95% CI: 0.55–0.89, I 2 : 82%). Conclusion A vegetarian diet, compared with a non-vegetarian diet, was associated with a reduced risk of ischemic heart disease mortality, whereas it had no effect on all-cause and cerebrovascular mortality. However, the results are to be considered with caution considering the low certainty of evidence. Despite recent studies supporting no restriction on animal protein intake gaining wide media attention and public traction, consideration for vegetarianism amongst those with risk factors for coronary artery disease should be contemplated.

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Section: Introductionmentioning

confidence: 99%

Meta-analysis of effect of vegetarian diet on ischemic heart disease and all-cause mortality

Balakumaran

Kumar

Verghese

et al. 2021

American Journal of Preventive Cardiology

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“…Furthermore, nuts and seeds are a source of protein. Although at lower levels as compared to animal-derived protein in terms of needs for muscle hypertrophy, the consumption of nuts and seeds is inversely correlated with cardiovascular events and mortality, as demonstrated by recent studies [57,58]. Regarding the ALA content of nuts and seeds, one ounce (28 g) of flaxseed, chia seeds, hemp seed or walnuts exceeds the Adequate Intake (AIs) for ALA, which is 1.1 g/day for women and 1.6 g/day for men, and 1.4 g/day and 1.3 g/day during pregnancy and lactation, respectively [59,60].…”

Section: Nutrition Factsmentioning

confidence: 90%

Section: Alternative Plant Sources Of N3-pufasmentioning

confidence: 99%

Beyond Fish Oil Supplementation: The Effects of Alternative Plant Sources of Omega-3 Polyunsaturated Fatty Acids upon Lipid Indexes and Cardiometabolic Biomarkers—An Overview

2020

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Cardiovascular diseases remain a global challenge, and lipid-associated biomarkers can predict cardiovascular events. Extensive research on cardiovascular benefits of omega-3 polyunsaturated fatty acids (n3-PUFAs) is geared towards fish oil supplementation and fish-rich diets. Nevertheless, vegetarianism and veganism are becoming more popular across all segments of society, due to reasons as varied as personal, ethical and religious values, individual preferences and environment-related principles, amongst others. Due to the essentiality of PUFAs, plant sources of n3-PUFAs warrant further consideration. In this review, we have critically appraised the efficacy of plant-derived n3-PUFAs from foodstuffs and supplements upon lipid profile and selected cardiometabolic markers. Walnuts and flaxseed are the most common plant sources of n3-PUFAs, mainly alpha-linolenic acid (ALA), and feature the strongest scientific rationale for applicability into clinical practice. Furthermore, walnuts and flaxseed are sources of fibre, potassium, magnesium, and non-essential substances, including polyphenols and sterols, which in conjunction are known to ameliorate cardiovascular metabolism. ALA levels in rapeseed and soybean oils are only slight when compared to flaxseed oil. Spirulina and Chlorella, biomasses of cyanobacteria and green algae, are important sources of n3-PUFAs; however, their benefits upon cardiometabolic markers are plausibly driven by their antioxidant potential combined with their n3-PUFA content. In humans, ALA is not sufficiently bioconverted into eicosapentaenoic and docosahexaenoic acids. However, evidence suggests that plant sources of ALA are associated with favourable cardiometabolic status. ALA supplementation, or increased consumption of ALA-rich foodstuffs, combined with reduced omega-6 (n6) PUFAs intake, could improve the n3/n6 ratio and improve cardiometabolic and lipid profile.

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“…Protein intake for CVD patients remains controversial [80][81][82]. Some studies have shown that red meat increases the risk of CHD and should be reduced or substituted by other protein sources such as dairy products, which have been inversely correlated with hypertension, obesity and IR [83,84]. A high-protein intake also remains inconclusive for DM patients [80] since it has been associated with increased cardiometabolic disease risk [85], whereas a higher intake of plant protein is associated with a lower risk of DM [86].…”

Section: Proteinsmentioning

confidence: 99%

Nutrients and Dietary Approaches in Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease: A Narrative Review

et al. 2021

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Cardiovascular disease (CVD) is the most common cause of morbidity and mortality in developed countries. The prevalence of CVD is much higher in patients with type 2 diabetes mellitus (T2DM), who may benefit from lifestyle changes, which include adapted diets. In this review, we provide the role of different groups of nutrients in patients with T2DM and CVD, as well as dietary approaches that have been associated with better and worse outcomes in those patients. Many different diets and supplements have proved to be beneficial in T2DM and CVD, but further studies, guidelines, and dietary recommendations are particularly required for patients with both diseases.

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The impact of type of dietary protein, animal versus vegetable, in modifying cardiometabolic risk factors: A position paper from the International Lipid Expert Panel (ILEP)

Cited by 95 publications

References 98 publications

Meta-analysis of effect of vegetarian diet on ischemic heart disease and all-cause mortality

Meta-analysis of effect of vegetarian diet on ischemic heart disease and all-cause mortality

Beyond Fish Oil Supplementation: The Effects of Alternative Plant Sources of Omega-3 Polyunsaturated Fatty Acids upon Lipid Indexes and Cardiometabolic Biomarkers—An Overview

Nutrients and Dietary Approaches in Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease: A Narrative Review

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