Effect of Plant Protein on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Siying S Li, Sonia Blanco Mejia, Lyubov Lytvyn, Sarah E Stewart, Effie Viguiliouk, Vanessa Ha, Russell J de Souza, Lawrence A Leiter, Cyril W C Kendall, David J A Jenkins, John L Sievenpiper, Siying S Li, Sonia Blanco Mejia, Lyubov Lytvyn, Sarah E Stewart, Effie Viguiliouk, Vanessa Ha, Russell J de Souza, Lawrence A Leiter, Cyril W C Kendall, David J A Jenkins, John L Sievenpiper

Abstract

Background: There is a heightened interest in plant-based diets for cardiovascular disease prevention. Although plant protein is thought to mediate such prevention through modifying blood lipids, the effect of plant protein in specific substitution for animal protein on blood lipids remains unclear. To assess the effect of this substitution on established lipid targets for cardiovascular risk reduction, we conducted a systematic review and meta-analysis of randomized controlled trials using the Grading of Recommendations Assessment, Development, and Evaluation system.

Methods and results: MEDLINE, EMBASE, and the Cochrane Registry were searched through September 9, 2017. We included randomized controlled trials of ≥3 weeks comparing the effect of plant protein in substitution for animal protein on low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B. Two independent reviewers extracted relevant data and assessed risk of bias. Data were pooled by the generic inverse variance method and expressed as mean differences with 95% confidence intervals. Heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic). The overall quality (certainty) of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system. One-hundred twelve randomized controlled trials met the eligibility criteria. Plant protein in substitution for animal protein decreased low-density lipoprotein cholesterol by 0.16 mmol/L (95% confidence interval, -0.20 to -0.12 mmol/L; P<0.00001; I2=55%; moderate-quality evidence), non-high-density lipoprotein cholesterol by 0.18 mmol/L (95% confidence interval, -0.22 to -0.14 mmol/L; P<0.00001; I2=52%; moderate-quality evidence), and apolipoprotein B by 0.05 g/L (95% confidence interval, -0.06 to -0.03 g/L; P<0.00001; I2=30%; moderate-quality evidence).

Conclusions: Substitution of plant protein for animal protein decreases the established lipid targets low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B. More high-quality randomized trials are needed to improve our estimates.

Clinical trial registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02037321.

Keywords: animal protein; cholesterol; dyslipidemia; lipids; meta‐analysis; protein; soy; systematic review; vegetable protein.

© 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Figures

Figure 1
Figure 1
Search summary.
Figure 2
Figure 2
Primary analyses. Pooled effect estimates for each end point (squares) shown. Paired analyses were applied to all crossover trials. Data are expressed as mean differences (95% confidence intervals [CIs]), using generic inverse‐variance random‐effects models. Interstudy heterogeneity was tested using the Cochran Q statistic (χ2) at a significance level of P<0.10 and quantified by I2; levels of ≥50% represented substantial heterogeneity. All outcomes had significant pooled effect estimates. Heterogeneity was significant and substantial for low‐density lipoprotein cholesterol (LDL‐C) and non–high‐density lipoprotein cholesterol (HDL‐C), and significant but not substantial for apolipoprotein B (Apo‐B).

References

    1. World Health Statistics 2012. Geneva, Switzerland: World Health Organization; 2012.
    1. Global Status Report on Noncommunicable Diseases 2010. Geneva, Switzerland: World Health Organization; 2011.
    1. Anderson TJ, Grégoire J, Pearson GJ, Barry AR, Couture P, Dawes M, Francis GA, Genest J Jr, Grover S, Gupta M, Hegele RA, Lau DC, Leiter LA, Lonn E, Mancini GBJ, McPherson R, Ngui D, Poirier P, Sievenpiper JL, Stone JA, Thanassoulis G, Ward R. 2016 Canadian Cardiovascular Society guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol. 2016;32:1263–1282.
    1. Grundy SM, Cleeman JI, Merz CNB, Brewer HB, Clark LT, Hunninghake DB, Pasternak RC, Smith SC, Stone NJ; National Heart, Lung, and Blood Institute; American College of Cardiology Foundation; American Heart Association . Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Circulation. 2004;110:227–239.
    1. King CK, Glass R, Bresee JS, Duggan C. Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. MMWR Recomm Rep. 2003;52:1–16.
    1. Ferdowsian HR, Barnard ND. Effects of plant‐based diets on plasma lipids. Am J Cardiol. 2009;104:947–956.
    1. Mahon AK, Flynn MG, Stewart LK, McFarlin BK, Iglay HB, Mattes RD, Lyle RM, Considine RV, Campbell WW. Protein intake during energy restriction: effects on body composition and markers of metabolic and cardiovascular health in postmenopausal women. J Am Coll Nutr. 2008;26:182–189.
    1. USDA. Scientific Report of the 2015 Dietary Guidelines Advisory Committee. In: DGAC‐USDA , editor. 2015. . Access date: June 3, 2017
    1. Jenkins DJ, Mirrahimi A, Srichaikul K, Berryman CE, Wang L, Carleton A, Abdulnour S, Sievenpiper JL, Kendall CW, Kris‐Etherton PM. Soy protein reduces serum cholesterol by both intrinsic and food displacement mechanisms. J Nutr. 2010;140:2302s–2311s.
    1. Sabaté J, Oda K, Ros E. Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials. Arch Intern Med. 2010;170:821–827.
    1. Blanco Mejia S, Kendall CWC, Viguiliouk E, Augustin LS, Ha V, Cozma AI, Mirrahimi A, Maroleanu A, Chiavaroli L, Leiter LA, de Souza RJ, Jenkins DJA, Sievenpiper JL. Effect of tree nuts on metabolic syndrome criteria: a systematic review and meta‐analysis of randomised controlled trials. BMJ Open. 2014;4:e004660.
    1. Ha V, Sievenpiper JL, de Souza RJ, Jayalath VH, Mirrahimi A, Agarwal A, Chiavaroli L, Mejia SB, Sacks FM, Di Buono M, Bernstein AM, Leiter LA, Kris‐Etherton PM, Vuksan V, Bazinet RP, Josse RG, Beyene J, Kendall CW, Jenkins DJ. Effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction: a systematic review and meta‐analysis of randomized controlled trials. CMAJ. 2014;186:E252–E262.
    1. Katan MB, Grundy SM, Jones P, Law M, Miettinen T, Paoletti R. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin Proc. 2003;78:965–978.
    1. Solà R, Bruckert E, Valls R‐M, Narejos S, Luque X, Castro‐Cabezas M, Doménech G, Torres F, Heras M, Farrés X, Vaquer J‐V, Martínez J‐M, Almaraz M‐C, Anguera A. Soluble fibre (Plantago ovata husk) reduces plasma low‐density lipoprotein (LDL) cholesterol, triglycerides, insulin, oxidised LDL and systolic blood pressure in hypercholesterolaemic patients: a randomised trial. Atherosclerosis. 2010;211:630–637.
    1. Mensink RP, Zock PL, Kester AD, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta‐analysis of 60 controlled trials. Am J Clin Nutr. 2003;77:1146–1155.
    1. Vega‐López S, Lichtenstein AH. Dietary protein type and cardiovascular disease risk factors. Prev Cardiol. 2005;8:31–40.
    1. Forsythe WA, Green MS, Anderson JJ. Dietary protein effects on cholesterol and lipoprotein concentrations: a review. J Am Coll Nutr. 1986;5:533–549.
    1. Sacks FM, Lichtenstein A, Van Horn L, Harris W, Kris‐Etherton P, Winston M. Soy protein, isoflavones, and cardiovascular health: an American Heart Association Science Advisory for professionals from the Nutrition Committee. Circulation. 2006;113:1034–1044.
    1. EFSA Panel on Dietetic Products N, Allergies . Scientific Opinion on the substantiation of a health claim related to isolated soy protein and reduction of blood LDL‐cholesterol concentrations pursuant to Article 14 of Regulation (EC) No 1924/2006. EFSA J. 2012;10:2555 [17 pp.].
    1. The American Heart Association's Diet and Lifestyle Recommendations. Chicago, IL: American Heart Association; 2014.
    1. Canada's Food Guide. Health Canada; Ottawa, Ontario: 2007.
    1. U.S. Department of Health and Human Services and U.S. Department of Agriculture . 2015–2020 Dietary Guidelines for Americans 8 ed December 2015. Available at . Access date: 3 June 2017.
    1. Katz D. 2015 dietary guidelines: a plate full of politics. ; 2016. . Access date: March 16, 2016
    1. Anderson TJ, Grégoire J, Hegele RA, Couture P, Mancini GBJ, McPherson R, Francis GA, Poirier P, Lau DC, Grover S, Genest J Jr, Carpentier AC, Dufour R, Gupta M, Ward R, Leiter LA, Lonn E, Ng DS, Pearson GJ, Yates GM, Stone JA, Ur E. 2012 Update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol. 2013;29:151–167.
    1. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Version 510. United Kingdom: The Cochrane Collaboration; 2011.
    1. Moher D, Liberati A, Tetzlaff J, Altman D; PRISMA Group . Preferred reporting items for systematic reviews and meta‐analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.
    1. Guidance for Industry: Evidence‐Based Review System for the Scientific Evaluation of Health Claims. In: Food and Drug Administration: Silver Springs, MD; 2009. . Access date: June 3, 2017
    1. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, Norris S, Falck‐Ytter Y, Glasziou P, DeBeer H, Jaeschke R, Rind D, Meerpohl J, Dahm P, Schunemann HJ. GRADE guidelines, 1: introduction‐GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64:383–394.
    1. Guyatt GH, Oxman AD, Kunz R, Atkins D, Brozek J, Vist G, Alderson P, Glasziou P, Falck‐Ytter Y, Schunemann HJ. GRADE guidelines, 2: framing the question and deciding on important outcomes. J Clin Epidemiol. 2011;64:395–400.
    1. Balshem H, Helfand M, Schunemann HJ, Oxman AD, Kunz R, Brozek J, Vist GE, Falck‐Ytter Y, Meerpohl J, Norris S, Guyatt GH. GRADE guidelines, 3: rating the quality of evidence. J Clin Epidemiol. 2011;64:401–406.
    1. Guyatt GH, Oxman AD, Vist G, Kunz R, Brozek J, Alonso‐Coello P, Montori V, Akl EA, Djulbegovic B, Falck‐Ytter Y, Norris SL, Williams JW Jr, Atkins D, Meerpohl J, Schunemann HJ. GRADE guidelines, 4: rating the quality of evidence—study limitations (risk of bias). J Clin Epidemiol. 2011;64:407–415.
    1. Guyatt GH, Oxman AD, Montori V, Vist G, Kunz R, Brozek J, Alonso‐Coello P, Djulbegovic B, Atkins D, Falck‐Ytter Y, Williams JW Jr, Meerpohl J, Norris SL, Akl EA, Schunemann HJ. GRADE guidelines, 5: rating the quality of evidence—publication bias. J Clin Epidemiol. 2011;64:1277–1282.
    1. Guyatt GH, Oxman AD, Kunz R, Brozek J, Alonso‐Coello P, Rind D, Devereaux PJ, Montori VM, Freyschuss B, Vist G, Jaeschke R, Williams JW Jr, Murad MH, Sinclair D, Falck‐Ytter Y, Meerpohl J, Whittington C, Thorlund K, Andrews J, Schunemann HJ. GRADE guidelines 6: rating the quality of evidence—imprecision. J Clin Epidemiol. 2011;64:1283–1293.
    1. Guyatt GH, Oxman AD, Kunz R, Woodcock J, Brozek J, Helfand M, Alonso‐Coello P, Glasziou P, Jaeschke R, Akl EA, Norris S, Vist G, Dahm P, Shukla VK, Higgins J, Falck‐Ytter Y, Schunemann HJ; GRADE Working Group . GRADE guidelines, 7: rating the quality of evidence—inconsistency. J Clin Epidemiol. 2011;64:1294–1302.
    1. Guyatt GH, Oxman AD, Kunz R, Woodcock J, Brozek J, Helfand M, Alonso‐Coello P, Falck‐Ytter Y, Jaeschke R, Vist G, Akl EA, Post PN, Norris S, Meerpohl J, Shukla VK, Nasser M, Schunemann HJ; GRADE Working Group . GRADE guidelines, 8: rating the quality of evidence—indirectness. J Clin Epidemiol. 2011;64:1303–1310.
    1. Guyatt GH, Oxman AD, Sultan S, Glasziou P, Akl EA, Alonso‐Coello P, Atkins D, Kunz R, Brozek J, Montori V, Jaeschke R, Rind D, Dahm P, Meerpohl J, Vist G, Berliner E, Norris S, Falck‐Ytter Y, Murad MH, Schunemann HJ; GRADE Working Group . GRADE guidelines, 9: rating up the quality of evidence. J Clin Epidemiol. 2011;64:1311–1316.
    1. Brunetti M, Shemilt I, Pregno S, Vale L, Oxman AD, Lord J, Sisk J, Ruiz F, Hill S, Guyatt GH, Jaeschke R, Helfand M, Harbour R, Davoli M, Amato L, Liberati A, Schunemann HJ. GRADE guidelines, 10: considering resource use and rating the quality of economic evidence. J Clin Epidemiol. 2013;66:140–150.
    1. Guyatt G, Oxman AD, Sultan S, Brozek J, Glasziou P, Alonso‐Coello P, Atkins D, Kunz R, Montori V, Jaeschke R, Rind D, Dahm P, Akl EA, Meerpohl J, Vist G, Berliner E, Norris S, Falck‐Ytter Y, Schunemann HJ. GRADE guidelines, 11: making an overall rating of confidence in effect estimates for a single outcome and for all outcomes. J Clin Epidemiol. 2013;66:151–157.
    1. Guyatt GH, Oxman AD, Santesso N, Helfand M, Vist G, Kunz R, Brozek J, Norris S, Meerpohl J, Djulbegovic B, Alonso‐Coello P, Post PN, Busse JW, Glasziou P, Christensen R, Schunemann HJ. GRADE guidelines, 12: preparing summary of findings tables‐binary outcomes. J Clin Epidemiol. 2013;66:158–172.
    1. Guyatt GH, Thorlund K, Oxman AD, Walter SD, Patrick D, Furukawa TA, Johnston BC, Karanicolas P, Akl EA, Vist G, Kunz R, Brozek J, Kupper LL, Martin SL, Meerpohl JJ, Alonso‐Coello P, Christensen R, Schunemann HJ. GRADE guidelines, 13: preparing summary of findings tables and evidence profiles‐continuous outcomes. J Clin Epidemiol. 2013;66:173–183.
    1. Lane DM. Online statistics education: a multimedia course of study. 2007. . Access date: June 3, 2017
    1. Elbourne DR, Altman DG, Higgins JP, Curtin F, Worthington HV, Vail A. Meta‐analyses involving cross‐over trials: methodological issues. Int J Epidemiol. 2002;31:140–149.
    1. Duval S, Tweedie R. Trim and fill: a simple funnel‐plot‐based method of testing and adjusting for publication bias in meta‐analysis. Biometrics. 2000;56:455–463.
    1. Abd‐Mishani M, Hosseinpour‐Niazi S, Delshad H, Bahadori‐Monfared A, Mirmiran P, Azizi F. Effect of modified diet on lipid profiles in type 2 diabetic patients. Iran J Endocrinol Metab. 2014;16:103–110.
    1. Abete I, Parra D, Martinez JA. Legume‐, fish‐, or high‐protein‐based hypocaloric diets: effects on weight loss and mitochondrial oxidation in obese men. J Med Food. 2009;12:100–108.
    1. Ahmed MS, Calabria AC, Kirsztajn GM. Short‐term effects of soy protein diet in patients with proteinuric glomerulopathies. J Bras Nefrol. 2011;33:150–159.
    1. Allen JK, Becker DM, Kwiterovich PO, Lindenstruth KA, Curtis C. Effect of soy protein‐containing isoflavones on lipoproteins in postmenopausal women. Menopause. 2007;14:106–114.
    1. Appt SE, Tormala R, Franke AA, Mikkola TS, Tikkanen MJ, Ylikorkala O, Clarkson TB. Soy‐tibolone combination: effect on lipids in postmenopausal monkeys and women. Maturitas. 2008;60:216–222.
    1. Ashton E, Ball M. Effects of soy as tofu vs meat on lipoprotein concentrations. Eur J Clin Nutr. 2000;54:14–19.
    1. Azadbakht L, Shakerhosseini R, Atabak S, Jamshidian M, Mehrabi Y, Esmaill‐Zadeh A. Beneficiary effect of dietary soy protein on lowering plasma levels of lipid and improving kidney function in type II diabetes with nephropathy. Eur J Clin Nutr. 2003;57:1292–1294.
    1. Azadbakht L, Kimiagar M, Mehrabi Y, Esmaillzadeh A, Padyab M, Hu FB, Willett WC. Soy inclusion in the diet improves features of the metabolic syndrome: a randomized crossover study in postmenopausal women. Am J Clin Nutr. 2007;85:735–741.
    1. Azadbakht L, Atabak S, Esmaillzadeh A. Soy protein intake, cardiorenal indices, and C‐reactive protein in type 2 diabetes with nephropathy. Diabetes Care. 2008;31:648–654.
    1. Bähr M, Fechner A, Krämer J, Kiehntopf M, Jahreis G. Lupin protein positively affects plasma LDL cholesterol and LDL:HDL cholesterol ratio in hypercholesterolemic adults after four weeks of supplementation: a randomized, controlled crossover study. Nutr J. 2013;12:1–10.
    1. Bähr M, Fechner A, Kiehntopf M, Jahreis G. Consuming a mixed diet enriched with lupin protein beneficially affects plasma lipids in hypercholesterolemic subjects: a randomized controlled trial. Clin Nutr. 2014;34:7–14.
    1. Bakhit RM, Klein BP, Essex‐Sorlie D, Ham JO, Erdman JW Jr, Potter SM. Intake of 25 g of soybean protein with or without soybean fiber alters plasma lipids in men with elevated cholesterol concentrations. J Nutr. 1994;124:213–222.
    1. Basaria S, Wisniewski A, Dupree K, Bruno T, Song MY, Yao F, Ojumu A, John M, Dobs AS. Effect of high‐dose isoflavones on cognition, quality of life, androgens, and lipoprotein in post‐menopausal women. J Endocrinol Invest. 2009;32:150–155.
    1. Baum JA, Teng H, Erdman JW, Weigel RM, Klein BP, Persky VW, Freels S, Surya P, Bakhit RM, Ramos E, Shay NF, Potter SM. Long‐term intake of soy protein improves blood lipid profiles and increases mononuclear cell low‐density‐lipoprotein receptor messenger RNA in hypercholesterolemic, postmenopausal women. Am J Clin Nutr. 1998;68:545–551.
    1. Beavers KM, Serra MC, Beavers DP, Hudson GM, Willoughby DS. The lipid‐lowering effects of 4 weeks of daily soymilk or dairy milk ingestion in a postmenopausal female population. J Med Food. 2010;13:650–656.
    1. Blum A, Lang N, Peleg A, Vigder F, Israeli P, Gumanovsky M, Lupovitz S, Elgazi A, Ben‐Ami M. Effects of oral soy protein on markers of inflammation in postmenopausal women with mild hypercholesterolemia. Am Heart J. 2003;145:e7.
    1. Borodin EA, Menshikova IG, Dorovskikh VA, Feoktistova NA, Shtarberg MA, Yamamoto T, Takamatsu K, Mori H, Yamamoto S. Effects of two‐month consumption of 30 g a day of soy protein isolate or skimmed curd protein on blood lipid concentration in Russian adults with hyperlipidemia. J Nutr Sci Vitaminol (Tokyo). 2009;55:492–497.
    1. Bricarello LP, Kasinski N, Bertolami MC, Faludi A, Pinto LA, Relvas WG, Izar MC, Ihara SS, Tufik S, Fonseca FA. Comparison between the effects of soy milk and non‐fat cow milk on lipid profile and lipid peroxidation in patients with primary hypercholesterolemia. Nutrition. 2004;20:200–204.
    1. Burns‐Whitmore B, Haddad E, Sabaté J, Rajaram S. Effects of supplementing n‐3 fatty acid enriched eggs and walnuts on cardiovascular disease risk markers in healthy free‐living lacto‐ovo‐vegetarians: a randomized, crossover, free‐living intervention study. Nutr J. 2014;13:1–9.
    1. Campbell SC, Khalil DA, Payton ME, Arjmandi BH. One‐year soy protein supplementation does not improve lipid profile in postmenopausal women. Menopause. 2010;17:587–593.
    1. Chen ST, Ferng SH, Yang CS, Peng SJ, Lee HR, Chen JR. Variable effects of soy protein on plasma lipids in hyperlipidemic and normolipidemic hemodialysis patients. Am J Kidney Dis. 2005;46:1099–1106.
    1. Chen ST, Chen JR, Yang CS, Peng SJ, Ferng SH. Effect of soya protein on serum lipid profile and lipoprotein concentrations in patients undergoing hypercholesterolaemic haemodialysis. Br J Nutr. 2006;95:366–371.
    1. Crouse JR III, Morgan T, Terry JG, Ellis J, Vitolins M, Burke GL. A randomized trial comparing the effect of casein with that of soy protein containing varying amounts of isoflavones on plasma concentrations of lipids and lipoproteins. Arch Intern Med. 1999;159:2070–2076.
    1. Cuevas AM, Irribarra VL, Castillo OA, Yanez MD, Germain AM. Isolated soy protein improves endothelial function in postmenopausal hypercholesterolemic women. Eur J Clin Nutr. 2003;57:889–894.
    1. Dent SB, Peterson CT, Brace LD, Swain JH, Reddy MB, Hanson KB, Robinson JG, Alekel DL. Soy protein intake by perimenopausal women does not affect circulating lipids and lipoproteins or coagulation and fibrinolytic factors. J Nutr. 2001;131:2280–2287.
    1. Duane WC. Effects of soybean protein and very low dietary cholesterol on serum lipids, biliary lipids, and fecal sterols in humans. Metabolism. 1999;48:489–494.
    1. Dunn C, Liebman M. Plasma lipid alterations in vegetarian males resulting from the substitution of tofu for cheese. Nutr Res. 1986;6:1343–1352.
    1. Finley JW, Burrell JB, Reeves PG. Pinto bean consumption changes SCFA profiles in fecal fermentations, bacterial populations of the lower bowel, and lipid profiles in blood of humans. J Nutr. 2007;137:2391–2398.
    1. Gardner CD, Newell KA, Cherin R, Haskell WL. The effect of soy protein with or without isoflavones relative to milk protein on plasma lipids in hypercholesterolemic postmenopausal women. Am J Clin Nutr. 2001;73:728–735.
    1. Gardner CD, Messina M, Kiazand A, Morris JL, Franke AA. Effect of two types of soy milk and dairy milk on plasma lipids in hypercholesterolemic adults: a randomized trial. J Am Coll Nutr. 2007;26:669–677.
    1. Giovannetti PM, Carroll KK, Wolfe BM. Constancy of fasting serum cholesterol of healthy young women upon substitution of soy protein isolate for meat and dairy protein in medium and low fat diets. Nutr Res. 1986;6:609–618.
    1. Goldberg AP, Lim A, Kolar JB, Grundhauser JJ, Steinke FH, Schonfeld G. Soybean protein independently lowers plasma cholesterol levels in primary hypercholesterolemia. Atherosclerosis. 1982;43:355–368.
    1. Greany KA, Nettleton JA, Wangen KE, Thomas W, Kurzer MS. Probiotic consumption does not enhance the cholesterol‐lowering effect of soy in postmenopausal women. J Nutr. 2004;134:3277–3283.
    1. Haub MD, Wells AM, Campbell WW. Beef and soy‐based food supplements differentially affect serum lipoprotein‐lipid profiles because of changes in carbohydrate intake and novel nutrient intake ratios in older men who resistive‐train. Metabolism. 2005;54:769–774.
    1. Hermansen K, Søndergaard M, Høie L, Carstensen M, Brock B. Beneficial effects of a soy‐based dietary supplement on lipid levels and cardiovascular risk markers in type 2 diabetic subjects. Diabetes Care. 2001;24:228–233.
    1. Hill AM, Harris Jackson KA, Roussell MA, West SG, Kris‐Etherton PM. Type and amount of dietary protein in the treatment of metabolic syndrome: a randomized controlled trial. Am J Clin Nutr. 2015;102:757–770.
    1. Hoie LH, Morgenstern EC, Gruenwald J, Graubaum HJ, Busch R, Luder W, Zunft HJ. A double‐blind placebo‐controlled clinical trial compares the cholesterol‐lowering effects of two different soy protein preparations in hypercholesterolemic subjects. Eur J Nutr. 2005;44:65–71.
    1. Høie LH, Graubaum H‐J, Harde A, Gruenwald J, Wernecke K‐D. Lipid‐lowering effect of 2 dosages of a soy protein supplement in hypercholesterolemia. Adv Ther. 2005;22:175–186.
    1. Hoie LH, Guldstrand M, Sjoholm A, Graubaum HJ, Gruenwald J, Zunft HJ, Lueder W. Cholesterol‐lowering effects of a new isolated soy protein with high levels of nondenaturated protein in hypercholesterolemic patients. Adv Ther. 2007;24:439–447.
    1. Hosseinpour‐Niazi S, Mirmiran P, Hedayati M, Azizi F. Substitution of red meat with legumes in the therapeutic lifestyle change diet based on dietary advice improves cardiometabolic risk factors in overweight type 2 diabetes patients: a cross‐over randomized clinical trial. Eur J Clin Nutr. 2015;69:592–597.
    1. Huff MW, Giovannetti PM, Wolfe BM. Turnover of very low‐density lipoprotein‐apoprotein B is increased by substitution of soybean protein for meat and dairy protein in the diets of hypercholesterolemic men. Am J Clin Nutr. 1984;39:888–897.
    1. Jenkins DJA, Wolever TMS, Spiller G, Buckley G, Lam Y, Jenkins AL, Josse RG. Hypocholesterolemic effect of vegetable protein in a hypocaloric diet. Atherosclerosis. 1989;78:99–107.
    1. Jenkins DJ, Kendall CW, Jackson CJ, Connelly PW, Parker T, Faulkner D, Vidgen E, Cunnane SC, Leiter LA, Josse RG. Effects of high‐ and low‐isoflavone soyfoods on blood lipids, oxidized LDL, homocysteine, and blood pressure in hyperlipidemic men and women. Am J Clin Nutr. 2002;76:365–372.
    1. Jenkins DJ, Srichaikul K, Wong JM, Kendall CW, Bashyam B, Vidgen E, Lamarche B, Rao AV, Jones PJ, Josse RG, Jackson CJ, Ng V, Leong T, Leiter LA. Supplemental barley protein and casein similarly affect serum lipids in hypercholesterolemic women and men. J Nutr. 2010;140:1633–1637.
    1. Kestin M, Rouse IL, Correll RA, Nestel PJ. Cardiovascular disease risk factors in free‐living men: comparison of two prudent diets, one based on lactoovovegetarianism and the other allowing lean meat. Am J Clin Nutr. 1989;50:280–287.
    1. Kjolbaek L, Sorensen LB, Sondertoft NB, Rasmussen CK, Lorenzen JK, Serena A, Astrup A, Larsen LH. Protein supplements after weight loss do not improve weight maintenance compared with recommended dietary protein intake despite beneficial effects on appetite sensation and energy expenditure: a randomized, controlled, double‐blinded trial. Am J Clin Nutr. 2017;106:684–697.
    1. Kreijkamp‐Kaspers S, Kok L, Grobbee DE, de Haan EH, Aleman A, Lampe JW, van der Schouw YT. Effect of soy protein containing isoflavones on cognitive function, bone mineral density, and plasma lipids in postmenopausal women: a randomized controlled trial. JAMA. 2004;292:65–74.
    1. Kurowska EM, Jordan J, Spence JD, Wetmore S, Piche LA, Radzikowski M, Dandona P, Carroll KK. Effects of substituting dietary soybean protein and oil for milk protein and fat in subjects with hypercholesterolemia. Clin Invest Med. 1997;20:162–170.
    1. Laidlaw M, Mercer NJH. Serum cholesterol, triglyceride and lipoprotein response in hypercholesterolemic males to replacement of cow's milk with a soy beverage. Fed Proc. 1985;44(5):No. 6360.
    1. Laurin D, Jacques H, Moorjani S, Steinke FH, Gagne C, Brun D, Lupien PJ. Effects of a soy‐protein beverage on plasma lipoproteins in children with familial hypercholesterolemia. Am J Clin Nutr. 1991;54:98–103.
    1. Li J, Armstrong CL, Campbell WW. Effects of dietary protein source and quantity during weight loss on appetite, energy expenditure, and cardio‐metabolic responses. Nutrients. 2016;8:63.
    1. Liao FH, Shieh MJ, Yang SC, Lin SH, Chien YW. Effectiveness of a soy‐based compared with a traditional low‐calorie diet on weight loss and lipid levels in overweight adults. Nutrition. 2007;23:551–556.
    1. Lichtenstein AH, Jalbert SM, Adlercreutz H, Goldin BR, Rasmussen H, Schaefer EJ, Ausman LM. Lipoprotein response to diets high in soy or animal protein with and without isoflavones in moderately hypercholesterolemic subjects. Arterioscler Thromb Vasc Biol. 2002;22:1852–1858.
    1. Liu ZM, Ho SC, Chen YM, Ho YP. The effects of isoflavones combined with soy protein on lipid profiles, C‐reactive protein and cardiovascular risk among postmenopausal Chinese women. Nutr Metab Cardiovasc Dis. 2012;22:712–719.
    1. Liu ZM, Ho SC, Chen YM, Ho S, To K, Tomlinson B, Woo J. Whole soy, but not purified daidzein, had a favorable effect on improvement of cardiovascular risks: a 6‐month randomized, double‐blind, and placebo‐controlled trial in equol‐producing postmenopausal women. Mol Nutr Food Res. 2014;58:709–717.
    1. Lovati MR, Manzoni C, Canavesi A, Sirtori M, Vaccarino V, Marchi M, Gaddi G, Sirtori CR. Soybean protein diet increases low density lipoprotein receptor activity in mononuclear cells from hypercholesterolemic patients. J Clin Invest. 1987;80:1498–1502.
    1. Ma Y, Chiriboga D, Olendzki BC, Nicolosi R, Merriam PA, Ockene IS. Effect of soy protein containing isoflavones on blood lipids in moderately hypercholesterolemic adults: a randomized controlled trial. J Am Coll Nutr. 2005;24:275–285.
    1. Ma L, Grann K, Li M, Jiang Z. A pilot study to evaluate the effect of soy isolate protein on the serum lipid profile and other potential cardiovascular risk markers in moderately hypercholesterolemic Chinese adults. Ecol Food Nutr. 2011;50:473–485.
    1. Maki KC, Butteiger DN, Rains TM, Lawless A, Reeves MS, Schasteen C, Krul ES. Effects of soy protein on lipoprotein lipids and fecal bile acid excretion in men and women with moderate hypercholesterolemia. J Clin Lipidol. 2010;4:531–542.
    1. Markova MHS, Sucher S, Pivovarova O, Pfeiffer A. Metabolic and molecular effects of a high‐protein diet in subjects with type 2 diabetes. Diabetologia. 2015;58:S335.
    1. Matthan NR, Jalbert SM, Ausman LM, Kuvin JT, Karas RH, Lichtenstein AH. Effect of soy protein from differently processed products on cardiovascular disease risk factors and vascular endothelial function in hypercholesterolemic subjects. Am J Clin Nutr. 2007;85:960–966.
    1. McVeigh BL, Dillingham BL, Lampe JW, Duncan AM. Effect of soy protein varying in isoflavone content on serum lipids in healthy young men. Am J Clin Nutr. 2006;83:244–251.
    1. Mercer NJH, Carroll KK, Giovannetti PM. Effects on human plasma lipids of substituting soybean protein isolate for milk protein in the diet. Nutr Rep Int. 1987;35:279–287.
    1. Meredith L, Liebman M, Graves K. Alterations in plasma lipid levels resulting from tofu and cheese consumption in adult women. J Am Coll Nutr. 1989;8:573–579.
    1. Meyer BJ, Larkin TA, Owen AJ, Astheimer LB, Tapsell LC, Howe PR. Limited lipid‐lowering effects of regular consumption of whole soybean foods. Ann Nutr Metab. 2004;48:67–78.
    1. Miraghajani MS, Esmaillzadeh A, Najafabadi MM, Mirlohi M, Azadbakht L. Soy milk consumption, inflammation, coagulation, and oxidative stress among type 2 diabetic patients with nephropathy. Diabetes Care. 2012;35:1981–1985.
    1. Napora JK, Short RG, Muller DC, Carlson OD, Odetunde JO, Xu X, Carducci M, Travison TG, Maggio M, Egan JM, Basaria S. High dose isoflavones do not improve metabolic and inflammatory parameters in androgen deprived men with prostate cancer. J Androl. 2011;32:40–48.
    1. Onning G, Akesson B, Oste R, Lundquist I. Effects of consumption of oat milk, soya milk, or cow's milk on plasma lipids and antioxidative capacity in healthy subjects. Ann Nutr Metab. 1998;42:211–220.
    1. Padhi EM, Blewett HJ, Duncan AM, Guzman RP, Hawke A, Seetharaman K, Tsao R, Wolever TM, Ramdath DD. Whole soy flour incorporated into a muffin and consumed at 2 doses of soy protein does not lower LDL cholesterol in a randomized, double‐blind controlled trial of hypercholesterolemic adults. J Nutr. 2015;145:2665–2674.
    1. Pipe EA, Gobert CP, Capes SE, Darlington GA, Lampe JW, Duncan AM. Soy protein reduces serum LDL cholesterol and the LDL cholesterol:HDL cholesterol and apolipoprotein B:apolipoprotein A‐I ratios in adults with type 2 diabetes. J Nutr. 2009;139:1700–1706.
    1. Potter SM, Bakhit RM, Essex‐Sorlie DL, Weingartner KE, Chapman KM, Nelson RA, Prabhudesai M, Savage WD, Nelson AI, Winter LW. Depression of plasma cholesterol in men by consumption of baked products containing soy protein. Am J Clin Nutr. 1993;58:501–506.
    1. Puska P, Korpelainen V, Hoie LH, Skovlund E, Lahti T, Smerud KT. Soy in hypercholesterolaemia: a double‐blind, placebo‐controlled trial. Eur J Clin Nutr. 2002;56:352–357.
    1. Puska P, Korpelainen V, Hoie LH, Skovlund E, Smerud KT. Isolated soya protein with standardised levels of isoflavones, cotyledon soya fibres and soya phospholipids improves plasma lipids in hypercholesterolaemia: a double‐blind, placebo‐controlled trial of a yoghurt formulation. Br J Nutr. 2004;91:393–401.
    1. Roughead ZK, Hunt JR, Johnson LK, Badger TM, Lykken GI. Controlled substitution of soy protein for meat protein: effects on calcium retention, bone, and cardiovascular health indices in postmenopausal women. J Clin Endocrinol Metab. 2005;90:181–189.
    1. Santo AS, Cunningham AM, Alhassan S, Browne RW, Burton H, Leddy JJ, Grandjean PW, Horvath SM, Horvath PJ. NMR analysis of lipoprotein particle size does not increase sensitivity to the effect of soy protein on CVD risk when compared with the traditional lipid profile. Appl Physiol Nutr Metab. 2008;33:489–500.
    1. Shidfar F, Ehramphosh E, Heydari I, Haghighi L, Hosseini S, Shidfar S. Effects of soy bean on serum paraoxonase 1 activity and lipoproteins in hyperlipidemic postmenopausal women. Int J Food Sci Nutr. 2009;60:195–205.
    1. Shige H, Ishikawa T, Higashi K, Yamashita T, Tomiyasu K, Yoshida H, Hosoai H, Ito T, Nakajima K, Ayaori M, Yonemura A, Suzukawa M, Nakamura H. Effects of soy protein isolate (SPI) and casein on the postprandial lipemia in normolipidemic men. J Nutr Sci Vitaminol. 1998;44:113–127.
    1. Sirtori CR, Agradi E, Conti F. Soybean protein diet in the treatment of type II hyperlipoproteinaemia. Lancet. 1977;1:275–277.
    1. Sirtori CR, Pazzucconi F, Colombo L, Battistin P, Bondioli A, Descheemaeker K. Double‐blind study of the addition of high‐protein soya milk v. cows' milk to the diet of patients with severe hypercholesterolaemia and resistance to or intolerance of statins. Br J Nutr. 1999;82:91–96.
    1. Sirtori CR, Bosisio R, Pazzucconi F, Bondioli A, Gatti E, Lovati MR, Murphy P. Soy milk with a high glycitein content does not reduce low‐density lipoprotein cholesterolemia in type II hypercholesterolemic patients. Ann Nutr Metab. 2002;46:88–92.
    1. Steele MG. The effect on serum cholesterol levels of substituting milk with a soya beverage. Aust J Nutr Diet. 1992;49:24–28.
    1. Steinberg FM, Guthrie NL, Villablanca AC, Kumar K, Murray MJ. Soy protein with isoflavones has favorable effects on endothelial function that are independent of lipid and antioxidant effects in healthy postmenopausal women. Am J Clin Nutr. 2003;78:123–130.
    1. Sucher S, Markova M, Hornemann S, Pivovarova O, Rudovich N, Thomann R, Schneeweiss R, Rohn S, Pfeiffer AFH. Comparison of the effects of diets high in animal or plant protein on metabolic and cardiovascular markers in type 2 diabetes: a randomized clinical trial. Diabetes Obes Metab. 2017;19:944–952.
    1. Tabibi H, Imani H, Hedayati M, Atabak S, Rahmani L. Effects of soy consumption on serum lipids and apoproteins in peritoneal dialysis patients: a randomized controlled trial. Perit Dial Int. 2010;30:611–618.
    1. Takahira M, Noda K, Fukushima M, Zhang B, Mitsutake R, Uehara Y, Ogawa M, Kakuma T, Saku K. Randomized, double‐blind, controlled, comparative trial of formula food containing soy protein vs. milk protein in visceral fat obesity: FLAVO study. Circ J. 2011;75:2235–2243.
    1. Teede HJ, Dalais FS, Kotsopoulos D, Liang YL, Davis S, McGrath BP. Dietary soy has both beneficial and potentially adverse cardiovascular effects: a placebo‐controlled study in men and postmenopausal women. J Clin Endocrinol Metab. 2001;86:3053–3060.
    1. Teixeira SR, Potter SM, Weigel R, Hannum S, Erdman JW, Hasler CM. Effects of feeding 4 levels of soy protein for 3 and 6 wk on blood lipids and apolipoproteins in moderately hypercholesterolemic men. Am J Clin Nutr. 2000;71:1077–1084.
    1. Teixeira SR, Tappenden KA, Carson L, Jones R, Prabhudesai M, Marshall WP, Erdman JW. Isolated soy protein consumption reduces urinary albumin excretion and improves the serum lipid profile in men with type 2 diabetes mellitus and nephropathy. J Nutr. 2004;134:1874–1880.
    1. Thorp AA, Howe PR, Mori TA, Coates AM, Buckley JD, Hodgson J, Mansour J, Meyer BJ. Soy food consumption does not lower LDL cholesterol in either equol or nonequol producers. Am J Clin Nutr. 2008;88:298–304.
    1. Tonstad S, Smerud K, Hoie L. A comparison of the effects of 2 doses of soy protein or casein on serum lipids, serum lipoproteins, and plasma total homocysteine in hypercholesterolemic subjects. Am J Clin Nutr. 2002;76:78–84.
    1. Van Horn L, Liu K, Gerber J, Garside D, Schiffer L, Gernhofer N, Greenland P. Oats and soy in lipid‐lowering diets for women with hypercholesterolemia: is there synergy? J Am Diet Assoc. 2001;101:1319–1325.
    1. van Nielen M, Feskens EJM, Rietman A, Siebelink E, Mensink M. Partly replacing meat protein with soy protein alters insulin resistance and blood lipids in postmenopausal women with abdominal obesity. J Nutr. 2014;144:1423–1429.
    1. van Raaij JM, Katan MB, Hautvast JG, Hermus RJ. Effects of casein versus soy protein diets on serum cholesterol and lipoproteins in young healthy volunteers. Am J Clin Nutr. 1981;34:1261–1271.
    1. van Raaij JM, Katan MB, West CE, Hautvast JG. Influence of diets containing casein, soy isolate, and soy concentrate on serum cholesterol and lipoproteins in middle‐aged volunteers. Am J Clin Nutr. 1982;35:925–934.
    1. Vega‐Lopez S, Matthan NR, Ausman LM, Harding SV, Rideout TC, Ai M, Otokozawa S, Freed A, Kuvin JT, Jones PJ, Schaefer EJ, Lichtenstein AH. Altering dietary lysine:arginine ratio has little effect on cardiovascular risk factors and vascular reactivity in moderately hypercholesterolemic adults. Atherosclerosis. 2010;210:555–562.
    1. Vigna GB, Pansini F, Bonaccorsi G, Albertazzi P, Donega P, Zanotti L, De Aloysio D, Mollica G, Fellin R. Plasma lipoproteins in soy‐treated postmenopausal women: a double‐blind, placebo‐controlled trial. Nutr Metab Cardiovasc Dis. 2000;10:315–322.
    1. Weisse K, Brandsch C, Zernsdorf B, Nkengfack Nembongwe GS, Hofmann K, Eder K, Stangl GI. Lupin protein compared to casein lowers the LDL cholesterol:HDL cholesterol‐ratio of hypercholesterolemic adults. Eur J Nutr. 2010;49:65–71.
    1. West SG, Hilpert KF, Juturu V, Bordi PL, Lampe JW, Mousa SA, Kris‐Etherton PM. Effects of including soy protein in a blood cholesterol‐lowering diet on markers of cardiac risk in men and in postmenopausal women with and without hormone replacement therapy. J Womens Health (Larchmt). 2005;14:253–262.
    1. Wheeler ML, Fineberg SE, Fineberg NS, Gibson RG, Hackward LL. Animal versus plant protein meals in individuals with type 2 diabetes and microalbuminuria: effects on renal, glycemic, and lipid parameters. Diabetes Care. 2002;25:1277–1282.
    1. Wiebe SL, Bruce VM, McDonald BE. A comparison of the effect of diets containing beef protein and plant proteins on blood lipids of healthy young men. Am J Clin Nutr. 1984;40:982–989.
    1. Wofford MR, Rebholz CM, Reynolds K, Chen J, Chen CS, Myers L, Xu J, Jones DW, Whelton PK, He J. Effect of soy and milk protein supplementation on serum lipid levels: a randomized controlled trial. Eur J Clin Nutr. 2012;66:419–425.
    1. Wolfe BM, Giovannetti PM, Cheng DCH. Hypolipidemic effect of substituting soybean protein isolate for all meat and dairy protein in the diets of hypercholesterolemic men. Nutr Rep Int. 1981;24:1187–1198.
    1. Wolfe BM, Giovannetti PM. Elevation of VLDL‐cholesterol during substitution of soy protein for animal protein in diets of hypercholesterolemic Canadians. Nutr Rep Int. 1985;32:1057–1065.
    1. Wong WW, Smith EO, Stuff JE, Hachey DL, Heird WC, Pownell HJ. Cholesterol‐lowering effect of soy protein in normocholesterolemic and hypercholesterolemic men. Am J Clin Nutr. 1998;68:1385S–1389S.
    1. Robinson JG, Smith B, Maheshwari N, Schrott H. Pleiotropic effects of statins: benefit beyond cholesterol reduction? A meta‐regression analysis. J Am Coll Cardiol. 2005;46:1855–1862.
    1. Manson JE, Tosteson H, Ridker PM, Satterfield S, Hebert P, O'Connor GT, Buring JE, Hennekens CH. The primary prevention of myocardial infarction. N Engl J Med. 1992;326:1406–1416.
    1. Wang F, Zheng J, Yang B, Jiang J, Fu Y, Li D. Effects of vegetarian diets on blood lipids: a systematic review and meta‐analysis of randomized controlled trials. J Am Heart Assoc. 2015;4:e002408 DOI: .
    1. Jenkins DJ, Kendall CW, Marchie A, Faulkner DA, Wong JM, de Souza R, Emam A, Parker TL, Vidgen E, Lapsley KG, Trautwein EA, Josse RG, Leiter LA, Connelly PW. Effects of a dietary portfolio of cholesterol‐lowering foods vs lovastatin on serum lipids and C‐reactive protein. JAMA. 2003;290:502–510.
    1. Jenkins DJ, Jones PJ, Lamarche B, Kendall CW, Faulkner D, Cermakova L, Gigleux I, Ramprasath V, de Souza R, Ireland C, Patel D, Srichaikul K, Abdulnour S, Bashyam B, Collier C, Hoshizaki S, Josse RG, Leiter LA, Connelly PW, Frohlich J. Effect of a dietary portfolio of cholesterol‐lowering foods given at 2 levels of intensity of dietary advice on serum lipids in hyperlipidemia: a randomized controlled trial. JAMA. 2011;306:831–839.
    1. Jenkins DJA, Wong JMW, Kendall CWC, Esfahani A, Ng VWY, Leong TCK, Faulkner DA, Vidgen E, Paul G, Mukherjea R, Krul ES, Singer W. Effect of a 6‐month vegan low‐carbohydrate (“Eco‐Atkins”) diet on cardiovascular risk factors and body weight in hyperlipidaemic adults: a randomised controlled trial. BMJ Open. 2014;4:e003505.
    1. Estruch R, Ros E, Salas‐Salvadó J, Covas M‐I, Corella D, Arós F, Gómez‐Gracia E, Ruiz‐Gutiérrez V, Fiol M, Lapetra J, Lamuela‐Raventos RM, Serra‐Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Martínez‐González MA. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368:1279–1290.
    1. Knoops KB, de Groot LM, Kromhout D, Perrin AE, Moreiras‐Varela O, Menotti A, van Staveren WA. Mediterranean diet, lifestyle factors, and 10‐year mortality in elderly European men and women: the HALE project. JAMA. 2004;292:1433–1439.
    1. Kris‐Etherton P, Eckel RH, Howard BV, St. Jeor S, Bazzarre TL. Lyon Diet Heart Study: benefits of a Mediterranean‐style, National Cholesterol Education Program/American Heart Association Step I dietary pattern on cardiovascular disease. Circulation. 2001;103:1823–1825.
    1. Key TJ, Fraser GE, Thorogood M, Appleby PN, Beral V, Reeves G, Burr ML, Chang‐Claude J, Frentzel‐Beyme R, Kuzma JW, Mann J, McPherson K. Mortality in vegetarians and non‐vegetarians: a collaborative analysis of 8300 deaths among 76,000 men and women in five prospective studies. Public Health Nutr. 1998;1:33–41.
    1. Crowe FL, Appleby PN, Travis RC, Key TJ. Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians: results from the EPIC‐Oxford cohort study. Am J Clin Nutr. 2013;97:597–603.
    1. Fung TT, van Dam RM, Hankinson SE, Stampfer M, Willett WC, Hu FB. Low‐carbohydrate diets and all‐cause and cause‐specific mortality two cohort studies. Ann Intern Med. 2010;153:289–298.
    1. Kushi LH, Lew RA, Stare FJ, Ellison CR, el Lozy M, Bourke G, Daly L, Graham I, Hickey N, Mulcahy R, Kevaney J. Diet and 20‐year mortality from coronary heart disease. N Engl J Med. 1985;312:811–818.
    1. Pan A, Sun Q, Bernstein AM, Schulze MB, Manson JE, Stampfer MJ, Willett WC, Hu FB. Red meat consumption and mortality: results from 2 prospective cohort studies. Arch Intern Med. 2012;172:555–563.
    1. Snowdon DA. Animal product consumption and mortality because of all causes combined, coronary heart disease, stroke, diabetes, and cancer in Seventh‐day Adventists. Am J Clin Nutr. 1988;48:739–748.
    1. Kelemen LE, Kushi LH, Jacobs DR, Cerhan JR. Associations of dietary protein with disease and mortality in a prospective study of postmenopausal women. Am J Epidemiol. 2005;161:239–249.
    1. Armstrong B, Doll R. Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. Int J Cancer. 1975;15:617–631.
    1. Sanchez A, Rubano DA, Shavlik GW, Hubbard R, Horning MC. Cholesterolemic effects of the lysine/arginine ratio in rabbits after initial early growth. Arch Latinoam Nutr. 1988;38:229–238.
    1. Kurowska EM, Carroll KK. Effect of high levels of selected dietary essential amino acids on hypercholesterolemia and down‐regulation of hepatic LDL receptors in rabbits. Biochim Biophys Acta. 1992;1126:185–191.
    1. Park MS, Liepa GU. Effects of dietary protein and amino acids on the metabolism of cholesterol‐carrying lipoproteins in rats. J Nutr. 1982;112:1892–1898.
    1. Kohls KJ, Kies C, Fox HM. Blood serum lipid levels of humans given arginine, lysine and tryptophan supplements without food. Nutr Rep Int. 1987;35:5–11.
    1. Berryman CE, Preston AG, Karmally W, Deckelbaum RJ, Kris‐Etherton PM. Effects of almond consumption on the reduction of LDL‐cholesterol: a discussion of potential mechanisms and future research directions. Nutr Rev. 2011;69:171–185.
    1. Anderson JW, Johnstone BM, Cook‐Newell ME. Meta‐analysis of the effects of soy protein intake on serum lipids. N Engl J Med. 1995;333:276–282.
    1. Pasiakos S, Agarwal S, Lieberman H, Fulgoni V. Sources and amounts of animal, dairy, and plant protein intake of US adults in 2007–2010. Nutrients. 2015;7:5322.
    1. Halkjar J, Olsen A, Bjerregaard LJ, Deharveng G, Tjonneland A, Welch AA, Crowe FL, Wirfalt E, Hellstrom V, Niravong M, Touvier M, Linseisen J, Steffen A, Ocke MC, Peeters PHM, Chirlaque MD, Larranaga N, Ferrari P, Contiero P, Frasca G, Engeset D, Lund E, Misirli G, Kosti M, Riboli E, Slimani N, Bingham S. Intake of total, animal and plant proteins, and their food sources in 10 countries in the European Prospective Investigation into Cancer and Nutrition. Eur J Clin Nutr. 2015;63:S16–S36.
    1. Rizzo NS, Jaceldo‐Siegl K, Sabate J, Fraser GE. Nutrient profiles of vegetarian and nonvegetarian dietary patterns. J Acad Nutr Diet. 2013;113:1610–1619.
    1. Estruch R, Martínez‐González MA, Corella D, Salas‐Salvadó J, Ruiz‐Gutiérrez V, Covas MI, Fiol M, Gómez‐Gracia E, López‐Sabater MC, Vinyoles E, Arós F, Conde M, Lahoz C, Lapetra J, Sáez G, Ros E. Effects of a Mediterranean‐style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med. 2006;145:1–11.
    1. Jenkins DJA, Kendall CWC, Faulkner D, Vidgen E, Trautwein EA, Parker TL, Marchie A, Koumbridis G, Lapsley KG, Josse RG, Leiter LA, Connelly PW. A dietary portfolio approach to cholesterol reduction: combined effects of plant sterols, vegetable proteins, and viscous fibers in hypercholesterolemia. Metabolism. 2002;51:1596–1604.
    1. Mudryj AN, Yu N, Hartman TJ, Mitchell DC, Lawrence FR, Aukema HM. Pulse consumption in Canadian adults influences nutrient intakes. Br J Nutr. 2012;108(suppl 1):S27–S36.
    1. Mudryj AN, Aukema HM, Yu N. Intake patterns and dietary associations of soya protein consumption in adults and children in the Canadian Community Health Survey, Cycle 2.2. Br J Nutr. 2015;113:299–309.
    1. Asif M, Rooney LW, Ali R, Riaz MN. Application and opportunities of pulses in food system: a review. Crit Rev Food Sci Nutr. 2013;53:1168–1179.
    1. Wilson PWF, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837–1847.
    1. Rossouw JE, Lewis B, Rifkind BM. The value of lowering cholesterol after myocardial infarction. N Engl J Med. 1990;323:1112–1119.
    1. Stamler J, Wentworth D, Neaton JD. Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356 222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA. 1986;256:2823–2828.
    1. The Lipid Research Clinics Coronary Primary Prevention Trial results, I: reduction in incidence of coronary heart disease. JAMA. 1984;251:351–364.
    1. The Lipid Research Clinics Coronary Primary Prevention Trial results, II: the relationship of reduction in incidence of coronary heart disease to cholesterol lowering. JAMA. 1984;251:365–374.
    1. Cholesterol Treatment Trialists' (CTT) Collaboration , Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, Bhala N, Peto R, Barnes EH, Keech A, Simes J, Collins R. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta‐analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376:1670–1681.
    1. Cannon CP, Blazing MA, Giugliano RP, McCagg A, White JA, Theroux P, Darius H, Lewis BS, Ophuis TO, Jukema JW, De Ferrari GM, Ruzyllo W, De Lucca P, Im K, Bohula EA, Reist C, Wiviott SD, Tershakovec AM, Musliner TA, Braunwald E, Califf RM; IMPROVE‐IT Investigators . Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med. 2015;372:2387–2397.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する