The Impact of High Protein Diets on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies
Abstract
:1. Introduction
2. Materials and Methods
- Focused questions:
- P (population): patients free of cardiovascular disease.
- I (intervention): high protein diet.
- C (comparison): low or normal protein diet.
- O (outcome): cardiovascular disease.
- Research question: Does a high protein diet affect cardiovascular outcomes?
2.1. Search Strategy
2.2. Study Selection & Data Extraction
2.3. Quality and Risk of Bias Assessment
2.4. Data Synthesis and Analysis
3. Results
3.1. Search Results
3.2. Study Characteristics
3.3. Primary Outcomes
3.3.1. Cardiovascular Death
3.3.2. Stroke
3.4. Secondary Outcome
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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Group A | and | Group B |
---|---|---|
Protein diet OR | Cardiovascular disease OR | |
Protein intake OR | CVD OR | |
Dietary protein consumption OR | Cardiovascular morbidity OR | |
High protein score OR | Cardiovascular mortality OR | |
Carbohydrate diet OR | Cardiovascular events OR | |
Carbohydrate intake OR | Myocardial infarction OR | |
Dietary carbohydrate consumption OR | Ischemic heart disease OR | |
Fat intake OR | Ischemic heart disease | |
Fat diet OR | Coronary artery disease OR | |
Dietary fat consumption OR | Coronary heart disease OR | |
Dietary pattern OR | Stroke OR | |
Macronutrients intake OR | Cerebral infarcts OR | |
Energy consumption | Intraparenchymal hemorrhage |
Study | Country | Type of Study | Population | Years of Enrollment | Age (y) | Follow-Up (y) | Exposure | Exposure Assessment | Exposure Follow-Up | Outcomes |
---|---|---|---|---|---|---|---|---|---|---|
Chan et al., 2019 [49] | China | Prospective cohort | 2262 men and women | 2001–2003 | 65 and over | 13.8 | Quantity and source of protein intake | 280-item FFQ | Every 1 year | Death from all causes, cancer, and CVD |
Chen et al., 2019 [23] | Netherlands | Prospective cohort | 7786 men and women | 1989–2008 | 63.7 ± 8.7 | 13 (8.3–19.1) | Quantity and source of protein intake | 170-item FFQ, 389-item FFQ | Every 3–5 years | All-cause and cause-specific mortality |
Dehghan et al., 2017 [50] | International | Prospective cohort | 135,335 men and women | 2003–2013 | 50.3 ± 10 | 7.4 (5.3–9.3) | Dietary intake of fats and carbohydrates | FFQ | Every 3 years | Total mortality and major cardiovascular events (fatal CVD, non-fatal MI, stroke, and heart failure), MI, stroke, CVD mortality, and non-CVD mortality. |
Haring et al., 2015 [51] | US | Prospective cohort | 11,601 men and women | 1987–1989 | 45–64 | 22.7 | Dietary protein intake | 66-item FFQ | 6 years from baseline | Non-fatal stroke |
Hernández-Alonso et al., 2015 [25] | Spain | Prospective cohort | 7216 men and women | 2003–2009 | men 55–80 women 60–80 | 4.8 | Quantity and source of protein intake | 137-item FFQ | Cardiovascular events (i.e., MI, stroke, or death from cardiovascular causes), and death by cardiovascular, cancer, and all-cause | |
Liu et al., 2000 [52] | US | Prospective cohort | 75,521 women | 1984 | 38–63 | 10 | dietary glycemic load, carbohydrate content, and frequency of intake of individual foods | 126-item FFQ | every 2 years | Fatal CHD and nonfatal MI |
Larsson et al., 2012 [15] | Sweeden | Prospective cohort | 34,670 women | 1997 | 61.4 (49–83) | 10.4 | Quantity and source of protein intake | 96-item FFQ | Non-fatal stroke | |
Kelemen et al., 2004 [53] | US | Prospective cohort | 29,017 women | 1986 | 75.8 | 15 | Quantity and source of protein intake | FFQ | At 2, 5, and 7 years | Mortality from all causes, cancer, and CVD |
Hu et al., 1999 [13] | US | Prospective cohort | 80,082 women | 1976 | 45.8 (34–59) | 14 | Quantity and source of protein intake | 61-item FFQ, 116-item FFQ | Every 2 years | Fatal CHD and nonfatal MI |
Hu et al., 2000 [54] | US | Prospective cohort | 44,875 men | 1986 | 53.8 (40–75) | 8 | Prudent and Western dietary pattern score | 131-FFQ | Every 2 years | Fatal CHD and nonfatal MI |
Preis et al., 2010 (2 studies) [55,56] | US | Prospective cohort | 43,960 men | 1986 | 40–75 | 18 | Quantity and source of protein intake | 131-FFQ | Every 4 years | Fatal CHD and nonfatal MI, non-fatal stroke |
Guallar-Castillon et al., 2010 [57] | Spain | Prospective cohort | 40,757 men and women | 1992–1996 | 29–69 | 11 | Westernized and Evolved Mediterranean dietary pattern score | computerized dietary history | CHD events (fatal and non-fatal acute MI or angina requiring revascularization). | |
Song 2016 [58] | US | Prospective cohort | 131,342 men and women | 1976–1986 | 30–75 | 32 | Animal versus plant protein | FFQ | Every 4 years | All-cause and cause-specific mortality |
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Mantzouranis, E.; Kakargia, E.; Kakargias, F.; Lazaros, G.; Tsioufis, K. The Impact of High Protein Diets on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Nutrients 2023, 15, 1372. https://doi.org/10.3390/nu15061372
Mantzouranis E, Kakargia E, Kakargias F, Lazaros G, Tsioufis K. The Impact of High Protein Diets on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Nutrients. 2023; 15(6):1372. https://doi.org/10.3390/nu15061372
Chicago/Turabian StyleMantzouranis, Emmanouil, Eleftheria Kakargia, Fotis Kakargias, George Lazaros, and Konstantinos Tsioufis. 2023. "The Impact of High Protein Diets on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies" Nutrients 15, no. 6: 1372. https://doi.org/10.3390/nu15061372