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Long-term effects of a plant-based dietary portfolio of cholesterol-lowering foods on blood pressure

Jenkins, D.J.A., C.W.C. Kendall, D.A . Faulkner, T. Kemp, A. Marchie, T.H. Nguyen, J.M.W. Wong, R. de Souza, A. Emam, E. Vidgen, E.A. Trautwein, K.G. Lapsley, R.G. Josse, L.A. Leiter, W. Singer, 2008. Long-term effects of a plant-based dietary portfolio of cholesterol-lowering foods on blood pressure. Eur J Clin Nutr. 62, 781-788.

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/l000 kcal), viscous fibers (10 g/1 000 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±0.3kg (P = 0.036). The corresponding reductions from baseline in systolic and diastolic blood pressure at 1 year (n = 66 subjects) were -4.2±1.3mm Hg (P = 0.002) and – 2.3±0.7mm Hg (P = 0.00l), 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.