Effect of a high-protein diet on maintenance of blood pressure levels achieved after initial weight loss: the DiOGenes randomized study.
Randomized trials have shown significant blood pressure (BP) reductions after increased protein compared with carbohydrate intake, but the effect on BP maintenance after initial weight loss is unclear. We examined the effect of a high-protein diet on the maintenance of reduced BP after weight loss in 420 overweight adults from the Diet, Obesity and Genes study. After an 8-week weight-loss period (>8% BW), subjects (42±6 years) were randomized to either a high-protein diet (23-28 en% protein) or a lower-protein control diet (10-15 en% protein) for 26 weeks. BMI after weight loss was 30.3±4.3 kg m(-2), BP was 118/73 mm Hg and 28 subjects (6.5%) used antihypertensive agents. Systolic BP during 26 weeks of weight maintenance dietary intervention increased in both treatment groups, but it was 2.2 mm Hg less (95% CI: -4.6 to 0.2 mm Hg, P=0.08) in the high-protein group than in the lower-protein control group. In 191 (pre)hypertensive subjects (baseline systolic BP⩾120 mm Hg), a larger difference was observed (-4.2 mm Hg (-7.7, -0.7), P=0.02). The effect was attenuated after adjustment for initial BP (-3.4 mm Hg (-6.9, -0.03), P=0.048), and after additional adjustment for weight change (-2.7 mm Hg (-6.1, 0.4), P=0.11). Adjustment for 24-h urinary excretion of sodium and potassium did not change the results. Diastolic BP yielded similar results. These findings suggest that a BP reduction after weight loss is better maintained when the intake of protein is increased at the expense of carbohydrates. This effect is partly mediated by body weight.
1] Top Institute Food and Nutrition, Wageningen, The Netherlands [2] Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
M F
MF
Engberink
1] Top Institute Food and Nutrition, Wageningen, The Netherlands [2] Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
J M
JM
Geleijnse
1] Top Institute Food and Nutrition, Wageningen, The Netherlands [2] Lifestyle Medicine Program, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
S J L
SJ
Bakker
Department of Nutrition, Exercise and Sports (NEXS), Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
T M
TM
Larsen
Department of Pharmacology and Toxicology, Medical Faculty, National Transport Hospital, Sofia, Bulgaria.
T
T
Handjieva-Darlesnka
Department of Social Medicine, Preventive Medicine and Nutrition Clinic, University of Crete, Crete, Greece.
A
A
Kafatos
Department of Physiology and Nutrition, University of Navarra, Pamplona, Spain.
J A
JA
Martinez
Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
A F H
AF
Pfeiffer
Obesity Management Center, Institute of Endocrinology, Prague, Czech Republic.
M
M
Kunešová
Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK.
S A
SA
Jebb
Institute of Preventive Medicine, Centre for Health and Society, Copenhagen, Denmark.
C
C
Holst
Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Copenhagen, Denmark.
A
A
Astrup
Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, The Netherlands.
W H M
WH
Saris
Top Institute Food and Nutrition, Wageningen, The Netherlands.
E J
EJ
Brink
1] Top Institute Food and Nutrition, Wageningen, The Netherlands [2] Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, The Netherlands.
M A
MA
van Baak
D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D050528:Diet, Carbohydrate-Restricted; D004044:Dietary Proteins / Q000008:administration & dosage*; D005060:Europe; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000178:diet therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009765:Obesity / Q000175:diagnosis / Q000178:diet therapy* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
D004044:Dietary Proteins