"Compared with the carbohydrate diet, estimated 10-year coronary heart
disease risk was lower and similar on the protein and unsaturated fat
diets."

JAMA. 2005 Nov 16;294(19):2455-64.Click here to read  Links

    Comment in:
        JAMA. 2005 Nov 16;294(19):2497-8.

    Effects of protein, monounsaturated fat, and carbohydrate intake on
blood pressure and serum lipids: results of the OmniHeart randomized trial.

        * Appel LJ,
        * Sacks FM,
        * Carey VJ,
        * Obarzanek E,
        * Swain JF,
        * Miller ER 3rd,
        * Conlin PR,
        * Erlinger TP,
        * Rosner BA,
        * Laranjo NM,
        * Charleston J,
        * McCarron P,
        * Bishop LM;
        * OmniHeart Collaborative Research Group.

    Welch Center for Prevention, Epidemiology and Clinical Research,
Division of General Internal Medicine, Johns Hopkins University School
of Medicine, Baltimore, Md 21205-2223, USA. lappel@jhmi.edu

    CONTEXT: Reduced intake of saturated fat is widely recommended for
prevention of cardiovascular disease. The type of macronutrient that
should replace saturated fat remains uncertain. OBJECTIVE: To compare
the effects of 3 healthful diets, each with reduced saturated fat
intake, on blood pressure and serum lipids. DESIGN, SETTING, AND
PARTICIPANTS: Randomized, 3-period, crossover feeding study (April 2003
to June 2005) conducted in Baltimore, Md, and Boston, Mass. Participants
were 164 adults with prehypertension or stage 1 hypertension. Each
feeding period lasted 6 weeks and body weight was kept constant.
INTERVENTIONS: A diet rich in carbohydrates; a diet rich in protein,
about half from plant sources; and a diet rich in unsaturated fat,
predominantly monounsaturated fat. MAIN OUTCOME MEASURES: Systolic blood
pressure and low-density lipoprotein cholesterol. RESULTS: Blood
pressure, low-density lipoprotein cholesterol, and estimated coronary
heart disease risk were lower on each diet compared with baseline.
Compared with the carbohydrate diet, the protein diet further decreased
mean systolic blood pressure by 1.4 mm Hg (P = .002) and by 3.5 mm Hg (P
= .006) among those with hypertension and decreased low-density
lipoprotein cholesterol by 3.3 mg/dL (0.09 mmol/L; P = .01),
high-density lipoprotein cholesterol by 1.3 mg/dL (0.03 mmol/L; P =
.02), and triglycerides by 15.7 mg/dL (0.18 mmol/L; P<.001). Compared
with the carbohydrate diet, the unsaturated fat diet decreased systolic
blood pressure by 1.3 mm Hg (P = .005) and by 2.9 mm Hg among those with
hypertension (P = .02), had no significant effect on low-density
lipoprotein cholesterol, increased high-density lipoprotein cholesterol
by 1.1 mg/dL (0.03 mmol/L; P = .03), and lowered triglycerides by 9.6
mg/dL (0.11 mmol/L; P = .02). Compared with the carbohydrate diet,
estimated 10-year coronary heart disease risk was lower and similar on
the protein and unsaturated fat diets. CONCLUSION: In the setting of a
healthful diet, partial substitution of carbohydrate with either protein
or monounsaturated fat can further lower blood pressure, improve lipid
levels, and reduce estimated cardiovascular risk.Clinical Trials
Registration ClinicalTrials.gov Identifier: NCT00051350.

    PMID: 16287956 [PubMed - indexed for MEDLINE]