File Name: vegetarian diets and blood pressure a meta analysis .zip
A plant-based diet can reduce blood pressure and lower the risk for heart disease. High blood pressure, or hypertension, wreaks havoc on the heart and kidneys.
- Effects of vegetarian diets on blood pressure
- High Blood Pressure
- Hypertension – eating the right diet to lower high blood pressure
Effects of vegetarian diets on blood pressure
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Of initially identified publications, 21 cross-sectional studies met the inclusion criteria and were included in the systematic review and meta-analysis. No substantial effects were observed for all other inflammatory biomarkers. Despite strong associations between CRP and a vegan or vegetarian diet were seen, further research is needed, as most inflammatory biomarkers were investigated only in single studies so far. Since recent years, a growing trend for vegetarian and vegan diets can be recognized in Germany and other Western countries 1.
These plant-based diets were typically characterized by a higher consumption of fruits, vegetables, legumes, whole-grains, nuts, and various soy products 2 , corresponding to a lower intake of saturated fat and cholesterol 2 , as well as a larger amounts of antioxidant micronutrients like vitamins C and E, dietary fibre and phytochemicals 2 , 3.
Due to the increased awareness of environmental problems and compassion for animals, a growing trend toward veganism has remarkably emerged in the past few years. Another decisive factor for people turning to a vegan diet is the potential of health benefits. As a matter of fact, scientific evidence leads to the assumption that a vegetarian or vegan nutrition may be protective against many chronic inflammatory diseases like type 2 diabetes 4 , cardiovascular diseases 5 , or cancer 6.
Interestingly, recent research suggested associations between low-grade inflammation and increased risk of various chronic diseases. Hence, the development of chronic diseases could be influenced by inflammatory biomarkers acting as intermediate risk factors. On the contrary, concentrations of adiponectin were inversely associated with these diseases 10 , 11 , Recent scientific evidence suggested that plant-based diets may modulate inflammatory biomarker profiles, showing an attenuation of inflammation markers as for instance CRP, IL-6 and soluble intercellular adhesion molecule 1 sICAM-1 13 , 14 , Up to date, meta-analyses noticed that vegetarian nutrition is associated with lower CRP concentrations 3 , 16 , while the impact of an exclusive vegan diet on inflammatory biomarkers was only examined by few studies.
Therefore, we aimed to conduct a systematical review and meta-analysis to investigate the effects of a vegetarian or vegan diet on a comprehensive spectrum of inflammatory biomarkers, i. The systematic literature search produced a total of citations through database searching. In detail, we identified publications from Embase, from PubMed and 23 additional publications from manual searching the reference lists.
After initial screening by titles and abstracts, publications did not meet the study inclusion criteria and were excluded. From the remaining 60 citations, further 39 records were excluded following full-text assessment. In total, 21 studies have been included in the present systematic review.
Detailed processes of study selection are shown in Fig. Main characteristics of the included 21 studies are summarized in Table 1. Studies were conducted across 3 continents, most studies were conducted in Asia 12 studies 19 , 22 , 23 , 24 , 25 , 26 , 27 , 29 , 32 , 35 , 36 , followed by Europe 6 studies 18 , 20 , 21 , 28 , 30 , 37 and South America 3 studies 17 , 33 , All studies, with exception of one prospective study 29 , used a cross-sectional design.
However, the study with a prospective design has been considered as cross-sectional study, because we only used cross-sectional data from the baseline characteristics. Twenty studies investigated the association between a vegetarian diet and inflammatory biomarkers compared to omnivores 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , two studies of them examined also the association between a vegan diet and inflammatory biomarkers, in parallel to a vegetarian diet 18 , The study by Menzel et al.
Selected studies were published between 17 to Overall, analysis comprised a total number of vegetarians, vegans and omnivores, with a mean age of The BMI was on average Of all participants, The majority of the studies were conducted in apparently healthy participants comprising Of note, Ganie et al.
Hung et al. Moreover, six studies were conducted in participants diagnosed with impaired kidney function 26 , 30 , 32 , 35 , type 2 diabetes 31 or PCOS Seventeen studies used populations consisting of men and women, only Acosta-Navarra et al.
In total, In total, only 3 out of 21 studies investigated the association between a vegan diet and an omnivorous diet in respect to circulating CRP levels in apparently healthy individuals Fig.
Franco-De-Moraes et al. Forest plots of the effect of a vegan and vegetarian diet on CRP concentrations compared to omnivorous diet in apparently healthy participants. Forest plot showing the overall effect of a vegan diet A or a vegetarian diet B on CRP concentrations compared to omnivorous diet in apparently healthy participants. When results of three or more studies were available, a meta-analysis has been performed.
Hence, in vegans a meta-analysis was only possible for CRP. As depicted in Fig. Furthermore, Menzel et al. In detail, 14 studies 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 27 , 29 , 33 , 34 , 36 were conducted in apparently healthy participants and six in diseased individuals, i. In addition, also different statistical methods e. Egger regression or Funnel plot regression showed no evidence for publication bias Supplemental Table S2.
With regard to E-selectin and MCP-1, no significant differences between apparently healthy vegetarians and omnivores have been observed Table 2. Lower levels of IL-6 have been observed by Ganie et al.
Regarding pre-diseased participants, Lee et al. Furthermore, Ganie et al. Studies were categorized into high-quality or low-quality studies using a cut-off point of 6 stars. Accordingly, the present systematic review provides evidence that vegan and vegetarian diets are associated with lower CRP levels, a major marker of inflammation and a mediator of inflammatory processes.
Of note, the association was stronger in pre-diseased vegetarians with impaired kidney function. However, with exception of CRP the most inflammatory biomarkers of interest were investigated only in single studies so far. Given that CRP is an established biomarker of systemic low-grade inflammation linked to various diseases, e.
These anti-inflammatory properties might reduce risk of chronic inflammatory diseases in vegan or vegetarian populations. Moreover, Haghighatdoost et al. Taken together, our findings provide evidence that a vegan or vegetarian diet may be beneficial to prevent or counteract inflammatory state underlying numerous chronic diseases and therefore might be a nutritional approach to reduce risk of chronic diseases. Moreover, adoption of a vegan or vegetarian diet may also have beneficial effects in pre-diseased populations.
Next to the decreased level of CRP in vegetarian patients with impaired kidney function, a plant-based diet may hamper the development or progression of some complications of chronic kidney disease, due to the associated cardioprotective, anti-oxidant, and lipid-lowering properties Current evidence proposed this also for other cardiometabolic diseases, as vegetarian and vegan diets present potential advantages in managing type 2 diabetes offering additional benefits for the comorbidities of cardiovascular disease, kidney disease, and neuropathy Up to date, the mechanisms by which vegan or vegetarian diets might reduce the low-grade inflammatory state remain underestimated, but research holds great promise in revealing the mechanisms linking dietary patterns with inflammation.
Accordingly, it has been suggested that exposure to animal foods may favor an intestinal environment which could trigger systemic inflammation However, a recent systematic review from noticed no consistent association between a vegan or vegetarian diet and microbiota composition compared to omnivores Interestingly, recent studies revealed the role in regulating of gut microbiota and gut homeostasis by inflammasomes These represent a group of protein complexes that recognize a diverse set of inflammation-inducing stimuli and promote the secretion of pro-inflammatory cytokines Those mechanisms may affect the immune homeostasis related to coinciding decrease in the future-risk for metabolic diseases, e.
Although further research is clearly required, the role of inflammasomes in regulating of gut flora represents a new promising research field which may help elucidate the mechanisms by which diet impacts gut microflora, inflammation and health Despite 21 studies have been identified for inclusion in this review, many inflammatory biomarkers of interest were not investigated upon or were only explored in single studies.
Thus, the present meta-analysis could not provide comprehensive conclusion about the associations between a vegan or vegetarian diet and each inflammatory marker. Therefore, more research is highly warranted to evaluate associations between a vegan or vegetarian diet and inflammatory biomarkers.
Our study covered a comprehensive spectrum of biomarkers that reflect chronic inflammation and immune reactions, including a set of novel molecules at the site of adipose-tissue induced inflammatory response. Importantly, we focused on comprehensive nutritional vegan or vegetarian habits rather than on the use of single dietary supplements or artificial dietary approaches, which allows translation of the findings to general populations.
In comparison to other meta-analyses 3 , 16 , our study comprises no mixture of vegetarian and vegan diet, but performed strict separate analyses regarding vegans and vegetarians. Moreover, we investigated the association between biomarker profiles in apparently healthy and diseased patients, respectively. Some limitations of our study deserve to be mentioned. RCTs are considered as the gold standard for establishing causal conclusions, however, published RCTs of vegan or vegetarian diets on inflammatory biomarkers based on our inclusion criteria are missing.
The majority of the studies included a low number of participants. Furthermore, high heterogeneity among the studies in vegetarians was detected. It should be noted that our analysis is restricted by the data provided within the available studies each having its own methodological characteristics and potential drawbacks.
In this respect, we should acknowledge the differences in the assay quality measurements and selection of investigated inflammatory biomarkers. In conclusion, this systematic review and meta-analysis provide evidence that either vegan or vegetarian diet is associated with lower CRP concentrations compared to omnivores in apparently healthy participants and metabolically afflicted patients.
Further research is highly warranted, as several biomarkers of interest were only investigated in single studies so far. A systematic literature search was conducted to identify relevant articles using PubMed and Embase databases until 15th of April No restriction was made in terms of language or the date of study publications.
Additionally, reference lists of related original articles, review articles and meta-analyses were further screened for potentially eligible publications using a manual approach. When necessary, the relevant authors were contacted by the investigators to acquire important missing information; in case of non-respondents, studies were excluded. Vegan diet implies the complete exclusion of any animal products consumption less than one meal per month.
Participants of the control groups were considered if they eat meat products omnivorous western diet. The present review included all study designs, i. Only studies published in English or German have been included in the present study.
Further, studies investigating a modified vegan or vegetarian diet eg.
High Blood Pressure
There is increasing evidence that plant based diets are associated with lower cardiovascular risk. Meta-analysis of observational studies published between and June that reported one or more cardio-metabolic risk factors in vegans and controls eating an omnivorous diet were undertaken. Macro-nutrient intake and cardio-metabolic risk factors were compared by dietary pattern. The inverse-variance method was used to pool mean differences. Compared to controls vegans had a lower body mass index However in several large studies from Taiwan a vegan diet was not associated with favourable cardio-metabolic risk factors compared to the control diets. In most countries a vegan diet is associated with a more favourable cardio- metabolic profile compared to an omnivorous diet.
Hypertension — more commonly known as high blood pressure — is one of the most common diseases in industrialised countries. A plant-based diet is suitable for both the prevention and treatment of hypertension. The cardiovascular system is one of the most important organ systems in the human body. It allows blood to distribute all necessary nutrients, hormones, the oxygen we breathe, and many other chemical compounds from and to all cells and organs in the body. In this way, it also helps with regulating, stabilising, and maintaining body temperature and pH, as well as fighting diseases. The cardiovascular system consists of the blood, heart, and blood vessels.
It is not clear whether less strict plant-based diets PBDs containing some animal products exert a similar effect. The main objective of this meta-analysis was to assess whether PBDs reduce BP in controlled clinical trials. Risk of bias, sensitivity, heterogeneity, and publication bias were assessed. Similar effects were seen on DBP. There was no evidence of publication bias and some heterogeneity was detected. The certainty of the results is high for the lacto-ovo vegetarian and Dietary Approach to Stop Hypertension diets, moderate for the Nordic and Mediterranean diets, low for the vegan diet, and very low for the high-fruit and vegetable and high-fiber diets. J Hypertens Journal of hypertension [, 39 1 ].
In the 7 controlled trials (a total of participants; mean age, years), consumption of vegetarian diets was associated with a reduction in.
Hypertension – eating the right diet to lower high blood pressure
Background: Vegetarian dietary patterns are recommended for cardiovascular disease CVD prevention and management due to their favorable effects on cardiometabolic risk factors, however, the role of vegetarian dietary patterns in CVD incidence and mortality remains unclear. Objective: To update the European Association for the Study of Diabetes EASD clinical practice guidelines for nutrition therapy, we undertook a systematic review and meta-analysis of the association of vegetarian dietary patterns with major cardiovascular outcomes in prospective cohort studies that included individuals with and without diabetes using the Grading of Recommendations, Assessment, Development, and Evaluation GRADE approach. Two independent reviewers extracted data and assessed study quality Newcastle-Ottawa Scale. Heterogeneity was assessed Cochran Q-statistic and quantified I 2 -statistic.
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Selection of clinical trials and observational studies for meta-analysis of association between vegetarian diets and blood pressure.