The relationship between dietary protein intake and blood pressure: results from the PREMIER study

Abstract

Observational and clinical studies suggest that high protein intake, particularly protein from plant sources, might reduce blood pressure (BP). To examine the association of dietary protein with BP, we analysed data from PREMIER, an 18-month clinical trial (n ¼ 810) that examined the effects of two multi-component lifestyle modifications on BP. We examined the association of protein intake with BP, and in particular the independent relationship of plant and animal protein with BP. Multivariable linear regression analyses were performed with both cross-sectional and longitudinal data. Dietary plant protein was inversely associated with both systolic and diastolic BP in cross-sectional analyses at the 6-month follow-up (P ¼ 0.0045 and 0.0096, respectively). Fruit and vegetable intake was also inversely associated with both systolic and diastolic BP cross-sectionally at 6 months (P ¼ 0.0003 and 0.0157, respectively). In longitudinal analyses, a high intake of plant protein at 6 months was marginally associated with a reduction of both systolic and diastolic BP from baseline to 6 months only (P ¼ 0.0797 and 0.0866, respectively), independent of change in body weight and waist circumference. Furthermore, increased intake of plant protein, and fruits and vegetables was significantly associated with a lower risk of hypertension at 6 but not at 18 months. Results of this study indicate that plant protein had a beneficial effect on BP and was associated with a lower risk of hypertension at 6 months. Our data, in conjunction with other research, suggest that an increased intake of plant protein may be useful as a means to prevent and treat hypertension.

Decreased Serum Albumin Predicts Hypertension in a Japanese Health Screening Population

“…Although the relationship between the dietary protein intake and blood pressure remains controversial (16,17), recent evidence from randomized controlled trials suggests that an increased intake of protein may lower blood pressure (18)(19)(20)(21)(22)(23)(24)(25). The slightly decreased levels of serum albumin observed in apparently healthy subjects in the present study may possibly result from an inadequate protein intake.…”

Dietary Serine Intake and Higher Risk of Hypertension: Tehran Lipid and Glucose Study

“…Vegetable proteins showed an inverse association with BP (16)(17)(18), whereas animal protein predominantly did not show any relation with BP (16,(26)(27)(28)(29). Furthermore, by increasing the serine intake, the dietary fiber significantly decreased, whereas SFA significantly increased.…”

“…Serine is a non-essential amino acid that is needed to some of signaling pathways and biosynthetic functions including synthesis of glycine, cysteine, tryptophan, sphingolipids, posphatidylserine, DNA and RNA components, and remethylation of homocysteine; it further acts as one of the carbon unit donors in the folate cycle (14). Although serine is one of the prominent amino acids in proteins with vegetable source (15) and plant protein has inverse relation with BP (16)(17)(18), the findings of previous cross-sectional studies suggest no relation between dietary serine intake and BP (11,13). However, a recent investigation from the European Prospective Investigation into Cancer (EPIC) study demonstrated that higher serum concentration of serine is a strong predictor of hypertension development (19).…”

Dietary intervention for blood pressure control: a call for action!

“…Lee et al did not suggest that the source of protein was a factor in explaining the BP effect. However, the increased protein was from a plant source, and a recent study suggested that plant protein may contribute to BP lowering, whereas animal protein does not (5). Future studies should be conducted to apply this dietary strategy in a larger population to confirm its BP-lowering effect and to examine its effect in a different population whose dietary intake is similar to that of the typical American.…”