Cardiovascular diseases (CVD) are a group of diseases that affect the heart and blood vessels and include coronary heart disease, cerebrovascular disease, and peripheral artery disease. Ideal cardiovascular health can be achieved by avoiding smoking, normal body mass index, exercise status, and an adequate and balanced diet pattern (WHO, 2017).

 Proteins are found in the matrix of foods of plant and animal origin. Due to their unique amino acid pattern and biological activities, they cause different effects on cardiovascular health (1).

 Research showing the health benefits of protein in the diet should be interpreted with caution, as increased consumption of protein-rich foods often leads to other changes in the diet (i.e. energy intake, increase / decrease in intake of other food groups).

 For example, since proteins have an appetite suppressing effect and delaying gastric emptying, a decrease in carbohydrate intake may be seen, but an increase in saturated fat intake may also occur due to excessive animal protein consumption.

ANIMAL PROTEIN

  Foods of animal origin are foods with high content of protein, saturated fatty acids and cholesterol in high amounts and good quality. Red meat, poultry, eggs, and dairy products are widely consumed sources of animal protein.

 Red meat

  Red meat consumption is generally considered to be a major risk for cardiovascular disease (CVD). The reason is the saturated fat and cholesterol content.

  First, when comparing people's daily diet or carbohydrate consumption, the total intake of saturated fat is not consistently associated with CVD risk. In other words, it is necessary to examine the general diet pattern of the people.

  Second, the negative health effects of red meat may be related to the high sodium content or other preservatives found in processed meats (salami, sausage, sausage, etc.)

  The primary difference between unprocessed and processed meat is sodium and neutral preservatives. Processed meat compared to unprocessed meat; It contains 400% more sodium and 50% more nitrate (carcinogenic substance).

 In a meta-analysis of 20 studies, 1218,380 people at risk and 23,889 coronary heart disease patients were examined and showed that consumption of processed meat is associated with a higher risk of heart disease than red meat.

  General risks for coronary heart disease are defined as consuming more than 50 g of processed meat per day and over 100 g of red meat per day (3).

Chicken

  Relatively few studies have focused on poultry consumption as a risk factor for cardiovascular disease. Poultry consumption was not associated with CVD risk in some studies with high evidence level (2).

Fish

  The cardiovascular effects of fish and omega-3 consumption have been studied over the years. Moderate consumption of fish (2 servings per week) and consumption of omega-3s (250 mg per day) were associated with a lower risk of fatal cardiovascular disease compared to little or no consumption. Higher intakes do not appear to further reduce the risk (2).

Egg

  Egg is a high-quality protein food that supports the preservation of muscle tissue and increases protein synthesis (4). Epidemiological studies to date have shown that there is little association between high egg consumption and the risk of cardiovascular disease or death in the general population (5).

  The most abundant protein in egg white is ovalbumin. It is suggested that ovalbumin lowers serum cholesterol levels by reducing cholesterol absorption in the intestine (6).

Milk

  Milk has 80% casein and 20% whey (whey) proteins. Hydrolysates of casein and Whey proteins are reported to have a protective effect against hypertension and thus cardiovascular diseases by reducing blood pressure. (7). If you want more detailed information about milk, You can review my blog post titled as "IS DRINKING COW'S MILK HEALTHY?".

Cheese

  According to studies with consistent results and high level of evidence, cheese consumption is not associated with the risk of heart disease. Also, there is no evidence to suggest that low-fat cheese may be associated with lower CVD risk compared to regular-fat cheese (8, 9).

Yogurt

  Moderate-quality evidence supports a neutral relationship between yogurt consumption and the risk of heart disease. At this point, the difference between normal fat and low-fat yogurt cannot be determined in terms of heart disease risk (9).

PLANT PROTEIN

Legumes

 Legumes (peas, beans, chickpeas, soy, lentils, etc.) are a rich source of phytolesterol and dietary fiber. Previous studies report that consuming plant protein instead of animal protein reduces blood cholesterol levels, which may reduce the risk of CVD (10).

 In the USA between 1980 and 2012, 131,342 participants were followed regularly, and in this high-evidence study, the energy intake of the participants from protein was 14% for animal protein and 4% for plant protein. Animal protein consumption was not associated with all-cause mortality, but was associated with higher mortality from heart disease. Plant protein has been found to be less associated with death from all causes and heart disease (5).

 Current epidemiological findings show that consumption of soybeans reduces the risk of heart disease due to its lowering effect on bad (LDL) cholesterol (11). For example, one study studied the general diet of the Japanese and found that soybean consumption (100g / day) was associated with a lower risk of death from heart disease (12).

Grains

 Turkey frequently consumed wheat, corn, and cereals such as rice peptide contained in the LUN decrease LDL (bad cholesterol) and total cholesterol levels (13). However, studies indicate that there is insufficient evidence to support the consumption of whole grain products to reduce the risk of cardiovascular disease (14).

  However, the amino acid varieties that are not found in legumes are complementary to each other due to their presence in grains and they are recommended to be consumed together according to the needs of people.

CONCLUSION

  Peptides in the structure of legumes can positively affect blood pressure and cholesterol metabolism and protect cardiovascular health. Current evidence supports a diet rich in plant protein to minimize the risk of CVD. It is also reported that some animal-derived proteins (eg fish / seafood, eggs, lean dairy products, poultry and lean meat) can be included in the diet instead of processed, simple carbohydrates and processed meats. Red meat consumption should not exceed 100 grams per day. All nutrients and food varieties should be prevented from excessive or inadequate consumption and provided according to individual needs. Therefore, individuals with cardiovascular disease or risk of disease should definitely seek help from a dietician.

RESOURCES:

1. Chesney K Richter, Plant Protein and Animal Proteins: Do They Differentially Affect Cardiovascular Disease Risk, American Society for Nutrition. Adv Nutr 2015; 6:712–28
2. Mozaffarian D. (2016) Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity–A Comprehensive Review, Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA 
3. M Nagao (2012), Meat consumption in relation to mortality from cardiovascular disease among Japanese men and women. European Journal of Clinical Nutrition
4. Andersen CJ. 2015. Bioactive egg components and inflammation. Nutrients., 7(9): 7889-7913. Doi:10.3390/ nu7095372 
5. Mingyang Song (2016) Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality, JAMAInternalMedicine 
6. Udenigwe, CC (2015), The Role of Food Peptides In Lipid Metabolism During Dyslipidemia And Associated Health Conditions. International Journal of Molecular Sciences. 16(5), 9303-9313.
7. S. Pal (2012), The effects of whey protein on cardiometabolic risk factors, School of Public Health, Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Western Australia, Australia 
8. O’Sullivan TA, Food sources of sat- urated fat and the association with mortality: a meta-analysis. Am J Public Health 2013;103: e31–42. 
9. Alexander DD, Dairy consump- tion and CVD: a systematic review and meta-analysis. Br J Nutr 2016; 115:737–50. 
10. Hua Li, Legume Consumption and All-Cause and Cardiovascular Disease Mortality, Hindawi BioMed Research International Volume 2017, Article ID 8450618, 6 pages 
11. D. Dan Ramdath, Beyond the Cholesterol-Lowering Effect of Soy Protein: A Review of the Effects of Dietary Soy and Its Constituents on Risk Factors for Cardiovascular Disease, Nutrients 2017, 9, 324; doi:10.3390/nu9040324 
12. Shimazu et al.Dietary patterns and cardiovascular disease mortality in Japan: a prospective cohort study. Int J Epidemiol. 2007 Jun;36(3):600-9. Epub 2007 Feb 22
13. Malaguti M (2014), Bioactive peptides in cereals and legumes: agronomical, biochemical and clinical aspects. International Journal of Molecular Sciences., 15(11): 21120- 21135. Doi:10.3390/ijms151121120. 
14. Kelly SAM (2017) Whole grain cereals for the primary or secondary prevention of cardiovascular disease (Review), The Cochrane Collaboration. Published by John Wiley & Sons, Ltd