The SA Journal Diabetes & Vascular Disease Volume 17 No 1 (July 2020)

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SA JOURNAL OF DIABETES & VASCULAR DISEASE RESEARCH ARTICLE
VOLUME 17 NUMBER 1 • JULY 2020 9
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Lower protein diet may lessen risk for cardiovascular disease
A mino acids are the building blocks
of proteins. A subcategory, called
sulphur amino acids, including methionine
and cysteine, play various roles in
metabolism and health. ‘For decades it
has been understood that diets restricting
sulphur amino acids were beneficial for
longevity in animals,’ said John Richie,
a professor of public health sciences at
Penn State College of Medicine. ‘This
study provides the first epidemiological
evidence that excessive dietary intake of
sulphur amino acids may be related to
chronic disease outcomes in humans.’
Richie led a team that examined the
diets and blood biomarkers of more than
11 000 participants from a national study
and found that participants who ate
foods containing fewer sulphur amino
acids tended to have a decreased risk for
cardiometabolic disease based on their
bloodwork.
The team evaluated data from the Third
National Examination and Nutritional
Health Survey. They compiled a composite
cardiometabolic disease risk score based
on the levels of certain biomarkers in
participants’ blood after a 10–16-hour
fast including cholesterol, triglycerides,
glucose and insulin.
‘These biomarkers are indicative of
an individual’s risk for disease, just as
high cholesterol levels are a risk factor
for cardiovascular disease,’ Richie said.
‘Many of these levels can be impacted on
by a person’s longer-term dietary habits
leading up to the test.’
Participants were excluded from the
study if they reported having either
congestive heart failure, heart attack
or a reported change in diet due to a
heart disease diagnosis. Individuals were
also omitted if they reported a dietary
intake of sulphur amino acids below the
estimated average requirement of 15 mg/
kg/day recommended by the Food and
Nutrition Board of the National Academy
of Medicine.
For a person weighing 132 pounds,
food choices for a day that meet the
requirement might include a medium
slice of bread, a half an avocado, an egg,
a half cup of raw cabbage, six cherry
tomatoes, two ounces of chicken breast,
a cup of brown rice, three quarters of
a cup of zucchini, three tablespoons
of butter, a cup of spinach, a medium
apple, an eight-inch diameter pizza and
a tablespoon of almonds. Nutritionists
collected information about participants’
diets by doing in-person 24-hour recalls.
Nutrient intakes were then calculated
using the US Department of Agriculture
Survey Nutrient Database.
After accounting for body weight,
the researchers found that average
sulphur amino acid intake was almost
two-and-a-half times higher than the
estimated average requirement. Xiang
Gao, associate professor and director of
the nutritional epidemiology laboratory at
the Penn State University and co-author
of the study, suggested this may be due
to trends in the average diet of a person
living in the USA.
‘Many people in the US consume
a diet rich in meat and dairy products
and the estimated average requirement
is only expected to meet the needs of
half of healthy individuals,’ Gao said.
‘Therefore, it is not surprising that many
are surpassing the average requirement
when considering these foods contain
higher amounts of sulphur amino acids.’
The researchers found that higher
sulphur amino acid intake was associated
with a higher composite cardiometabolic
risk score after accounting for potential
confounders such as age, gender and
history of diabetes and hypertension.
They also found that high sulphur amino
acid intake was associated with every
type of food except grains, vegetables
and fruit.
‘Meats and other high-protein foods
are generally higher in sulphur amino acid
content,’ said Zhen Dong, lead author
on the study and College of Medicine
graduate. ‘People who eat lots of plant-
based products like fruits and vegetables
will consume lower amounts of sulphur
amino acids. These results support some
of the beneficial health effects observed
in those who eat vegan or other plant-
based diets.’
Dong said that while this study
evaluated only dietary intake and
cardiometabolic disease risk factors at one
point in time, the association between
increased sulphur amino acid intake
and risk for cardiometabolic disease was
strong. She said the data support the
formation of a prospective, longitudinal
study evaluating sulphur amino acid
intake and health outcomes over time.
‘Here we saw an observed association
between certain dietary habits and
higher levels of blood biomarkers that
put a person at risk for cardiometabolic
diseases,’ Richie said. ‘A longitudinal
study would allow us to analyse whether
people who eat a certain way do end up
developing the diseases these biomarkers
indicate a risk for.’
Source: Medical Brief 2020