Original Article
European Journal of Clinical Nutrition (2008) 62, 781–788; doi:10.1038/sj.ejcn.1602768; published online 25 April 2007
Long-term effects of a plant-based dietary portfolio of cholesterol-lowering foods on blood pressure
Contributors: DJAJ, CWCK and DAF contributed to study concept and design; DJAJ, CWCK, DAF, TK, AM, THN, JMWW, RdS, AE and EV contributed to acquisition of data; DJAJ, CWCK, TK, RGJ, LAL and WS contributed to analysis and interpretation of data; DJAJ and CWCK contributed to drafting of the manuscript; DJAJ, CWCK, DAF, AM, THN, JMWW, RdS, AE, EV, EAT, KGL, RGJ, LAL and WS contributed to critical revision of the manuscript for important intellectual content; EV contributed to statistical expertise; DJAJ and CWCK contributed to obtaining funding; CWCK, DAF, AM, THN, JMWW, RdS, AE, EAT, KGL, RGJ, LAL and WS contributed to administrative, technical or material support; DJAJ, CWCK and DAF study supervision.
D J A Jenkins1,2,3,4, C W C Kendall1,3, D A Faulkner1,3, T Kemp5, A Marchie1,3, T H Nguyen1,3, J M W Wong1,3, R de Souza1,3, A Emam1,3, E Vidgen1,3, E A Trautwein6, K G Lapsley7, R G Josse1,2,3,4, L A Leiter1,2,3,4 and W Singer1,2,3,4
- 1Clinical Nutrition & Risk Factor Modification Center, St Michael's Hospital, Toronto, ON, Canada
- 2Department of Medicine, Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, ON, Canada
- 3Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
- 4Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- 5Dewsbury and District Hospital, Dewsbury, West Yorkshire, UK
- 6Unilever Food and Health Research Institute, Unilever R&D Vlaardingen, The Netherlands
- 7The Almond Board of California, Modesto, CA, USA
Correspondence: Professor DJA Jenkins, Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, 61 Queen St. East, Toronto, ON M5C 2T2, Canada. E-mail: cyril.kendall@utoronto.ca
Received 21 April 2006; Revised 12 February 2007; Accepted 13 February 2007; Published online 25 April 2007.
Abstract
Objective:
To determine the effect on blood pressure of dietary advice to consume a combination of plant-based cholesterol-lowering foods (dietary portfolio).
Methods:
For 1 year, 66 hyperlipidemic subjects were prescribed diets high in plant sterols (1.0 g/1000 kcal), soy protein (22.5 g/1000 kcal), viscous fibers (10 g/1000 kcal) and almonds (22.5 g/1000 kcal). There was no control group. Seven-day diet record, blood pressure and body weight were monitored initially monthly and later at 2-monthly intervals throughout the study.
Results:
Fifty subjects completed the 1-year study. When the last observation was carried forward for non-completers (n=9) or those who changed their blood pressure medications (n=7), a small mean reduction was seen in body weight 0.7
0.3 kg (P=0.036). The corresponding reductions from baseline in systolic and diastolic blood pressure at 1 year (n=66 subjects) were -
4.21.3 mm Hg (P=0.002) and -
2.30.7 mm Hg (P=0.001), respectively. Blood pressure reductions occurred within the first 2 weeks, with stable blood pressures 6 weeks before and 4 weeks after starting the diet. Diastolic blood pressure reduction was significantly related to weight change (r=0.30, n=50, P=0.036). Only compliance with almond intake advice related to blood pressure reduction (systolic: r=-
0.34, n=50, P=0.017; diastolic: r=-
0.29, n=50, P=0.041).
Conclusions:
A dietary portfolio of plant-based cholesterol-lowering foods reduced blood pressure significantly, related to almond intake. The dietary portfolio approach of combining a range of cholesterol-lowering plant foods may benefit cardiovascular disease risk both by reducing serum lipids and also blood pressure.
Keywords:
blood pressure, National Cholesterol Education Program diet, cardiovascular risk
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