title: Effects of protein intake on blood pressure, insulin sensitivity and blood lipids in children: a systematic review.
abstract: High protein intake in early childhood is associated with obesity, suggesting possible adverse effects on other cardiometabolic outcomes. However, studies in adults have suggested beneficial effects of protein intake on blood pressure (BP) and lipid profile. Whether dietary protein intake is associated with cardiovascular and metabolic health in children is unclear. Therefore, we aimed to systematically review the evidence on the associations of protein intake with BP, insulin sensitivity and blood lipids in children. We searched the databases Medline, Embase, Cochrane Central and PubMed for interventional and observational studies in healthy children up to the age of 18 years, in which associations of total, animal and/or vegetable protein intake with one or more of the following outcomes were reported: BP; measures of insulin sensitivity; cholesterol levels; or TAG levels. In the search, we identified 6636 abstracts, of which fifty-six studies met all selection criteria. In general, the quality of the included studies was low. Most studies were cross-sectional, and many did not control for potential confounders. No overall associations were observed between protein intake and insulin sensitivity or blood lipids. A few studies suggested an inverse association between dietary protein intake and BP, but evidence was inconclusive. Only four studies examined the effects of vegetable or animal protein intake, but with inconsistent results. In conclusion, the literature, to date provides insufficient evidence for effects of protein intake on BP, insulin sensitivity or blood lipids in children. Future studies could be improved by adequately adjusting for key confounders such as energy intake and obesity.
authors.affiliation: Department of Epidemiology,Erasmus MC, University Medical Center,PO Box 2040,3000CA,Rotterdam,the Netherlands.
authors.forename: Trudy
authors.initials: T
authors.lastname: Voortman
authors.affiliation: Department of Epidemiology,Erasmus MC, University Medical Center,PO Box 2040,3000CA,Rotterdam,the Netherlands.
authors.forename: Anna
authors.initials: A
authors.lastname: Vitezova
authors.affiliation: Medical Library, Erasmus MC, University Medical Center,PO Box 2040,3000CA,Rotterdam,the Netherlands.
authors.forename: Wichor M
authors.initials: WM
authors.lastname: Bramer
authors.affiliation: Department of Epidemiology,Erasmus MC, University Medical Center,PO Box 2040,3000CA,Rotterdam,the Netherlands.
authors.forename: Charlotte L
authors.initials: CL
authors.lastname: Ars
authors.affiliation: Department of Epidemiology,Erasmus MC, University Medical Center,PO Box 2040,3000CA,Rotterdam,the Netherlands.
authors.forename: Paula K
authors.initials: PK
authors.lastname: Bautista
authors.affiliation: Department of Epidemiology,Erasmus MC, University Medical Center,PO Box 2040,3000CA,Rotterdam,the Netherlands.
authors.forename: Adriana
authors.initials: A
authors.lastname: Buitrago-Lopez
authors.affiliation: Department of Epidemiology,Erasmus MC, University Medical Center,PO Box 2040,3000CA,Rotterdam,the Netherlands.
authors.forename: Janine F
authors.initials: JF
authors.lastname: Felix
authors.affiliation: Department of Epidemiology,Erasmus MC, University Medical Center,PO Box 2040,3000CA,Rotterdam,the Netherlands.
authors.forename: Elisabeth T M
authors.initials: ET
authors.lastname: Leermakers
authors.affiliation: Department of Epidemiology,Erasmus MC, University Medical Center,PO Box 2040,3000CA,Rotterdam,the Netherlands.
authors.forename: Ayesha
authors.initials: A
authors.lastname: Sajjad
authors.affiliation: Department of Epidemiology,Erasmus MC, University Medical Center,PO Box 2040,3000CA,Rotterdam,the Netherlands.
authors.forename: Sanaz
authors.initials: S
authors.lastname: Sedaghat
authors.affiliation: Department of Epidemiology,Erasmus MC, University Medical Center,PO Box 2040,3000CA,Rotterdam,the Netherlands.
authors.forename: Anne
authors.initials: A
authors.lastname: Tharner
authors.affiliation: Department of Epidemiology,Erasmus MC, University Medical Center,PO Box 2040,3000CA,Rotterdam,the Netherlands.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Department of Epidemiology,Erasmus MC, University Medical Center,PO Box 2040,3000CA,Rotterdam,the Netherlands.
authors.forename: Edith H
authors.initials: EH
authors.lastname: van den Hooven
mesh_terms: D000293:Adolescent; D000818:Animals; D001794:Blood Pressure / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D004044:Dietary Proteins / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007223:Infant; D007333:Insulin Resistance / Q000502:physiology*; D008055:Lipids / Q000097:blood*; D016239:MEDLINE; D008297:Male; D014280:Triglycerides / Q000097:blood; D014675:Vegetables
chemical_list: D004044:Dietary Proteins; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol
keywords: Systematic review