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Effect of a high-protein diet on maintenance of blood pressure levels achieved after initial weight loss: the DiOGenes randomized study

Journal of Human Hypertension volume 29, pages 58–63 (2015)Cite this article

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Abstract

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.

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Acknowledgements

The DiOGenes project (http://www.diogenes-eu.org) is funded by a grant from the European Union Food Quality and Safety Priority of the Sixth Framework Program (contract no. FP6-2005-513946). DiOGenes is supported by the European Community (contract no. FOOD-CT-2005-513946). The writing of this report and the determination of 24-h urinary sodium and potassium excretion was funded by Top Institute (TI) Food and Nutrition (project number A-1003), Wageningen, The Netherlands. TI Food and Nutrition is a public/private partnership that generates vision on scientific breakthroughs in food and nutrition, resulting in the development of innovative products and technologies (www.tifn.nl). Partners are major food companies and Dutch research organizations.

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Authors and Affiliations

  1. Top Institute Food and Nutrition, Wageningen, The Netherlands

    M F Engberink, J M Geleijnse, S J L Bakker, E J Brink & M A van Baak

  2. Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands

    M F Engberink & J M Geleijnse

  3. Lifestyle Medicine Program, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    S J L Bakker

  4. Department of Nutrition, Exercise and Sports (NEXS), Faculty of Science, University of Copenhagen, Copenhagen, Denmark

    T M Larsen

  5. Department of Pharmacology and Toxicology, Medical Faculty, National Transport Hospital, Sofia, Bulgaria

    T Handjieva-Darlesnka

  6. Department of Social Medicine, Preventive Medicine and Nutrition Clinic, University of Crete, Crete, Greece

    A Kafatos

  7. Department of Physiology and Nutrition, University of Navarra, Pamplona, Spain

    J A Martinez

  8. Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany

    A F H Pfeiffer

  9. Obesity Management Center, Institute of Endocrinology, Prague, Czech Republic

    M Kunešová

  10. Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK

    S A Jebb

  11. Institute of Preventive Medicine, Centre for Health and Society, Copenhagen, Denmark

    C Holst

  12. Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Copenhagen, Denmark

    A Astrup

  13. 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 Saris & M A van Baak

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  1. M F Engberink
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  14. E J Brink
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Correspondence to M A van Baak.

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Engberink, M., Geleijnse, J., Bakker, S. et al. Effect of a high-protein diet on maintenance of blood pressure levels achieved after initial weight loss: the DiOGenes randomized study. J Hum Hypertens 29, 58–63 (2015). https://doi.org/10.1038/jhh.2014.30

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