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The benefits of milk products on blood pressure: a role for bioactive peptides

Yves Pouliot Yves Pouliot, PhD

Director, Institute of Nutraceuticals and Functional Foods (INAF), Laval University

Hypertension (blood pressure ≥ 140/90 mmHg) is responsible for more deaths than any other risk factor for cardiovascular disease and is predicted to become the leading cause of death and disability worldwide by 2020.”1 Currently, more than five million Canadians have hypertension and nine in 10 will develop it unless they follow a healthy lifestyle.2

Highlights

  1. Hypertension is a very significant risk factor for cardiovascular disease.
  2. Several components derived from milk products, including bioactive peptides, appear to be important factors in blood pressure management.
  3. The DASH diet (8-10 servings of fruits and vegetables and ~ 3 servings of milk products per day) is recommended for the prevention and management of hypertension.

Hypertension can be prevented, blood pressure lowered, and other CVD risks favourably affected by a healthy diet, regular physical activity, moderation in alcohol consumption, reductions in dietary sodium and, in some, stress reduction (see table).2 Several studies, including the landmark Dietary Approaches to Stop Hypertension Study (DASH diet: high in fruits and vegetables and ~3 servings of milk products/day, including 39 g of cheese), have demonstrated a beneficial role of adequate milk product consumption in blood pressure control.1

In its most recent clinical practice guidelines, the Canadian Hypertension Society recommended the DASH diet for the prevention and management of hypertension in hypertensive and normotensive individuals at increased risk.3 In fact, the DASH diet has been shown to reduce systolic blood pressure in the range of 8-14 mmHg.4

Potential mechanisms

Calcium is posited as one of the main nutrients responsible for the beneficial impact of milk products on blood pressure (BP) control.5 Other minerals in milk, such as magnesium and potassium, may also help regulate BP, but their individual contributions are difficult to isolate as they are often found in foods rich in calcium.5 The most important factor may relate to the bioactive peptides derived from milk products, including cheese.

Role of bioactive peptides

Both casein and whey protein contain specific bioactive peptides that have been shown to have an angiotensin-1-converting enzyme (ACE) inhibitory effect, a key process in BP control.5 Other studies have demonstrated that certain milk-derived peptide combinations also have hypotensive effects via the modulation of endothelin-1 release by endothelial cells.5

With respect to cheese, casein-derived bioactive peptides are more relevant; for example, isoleucine-proline-proline (Ile-Pro-Pro) and valine-proline-proline (Val-Pro-Pro) have been shown to exert antihypertensive activity.6 A recent meta-analysis (comprising nine studies with a total of 623 participants) of these specific tripeptides on BP control confirmed their hypotensive effects in prehypertensive and hypertensive individuals. Significant decreases of 4.8 mm Hg in systolic BP and 2.2 mmHg in diastolic BP were found after the pooling of these trials. When trials were separated by BP status, hypotensive effects appeared to be greater in hypertensive vs. prehypertensive subjects. As a trend, the hypotensive effects became more obvious as the intervention lengthened.7

Managing Hypertension

References

  1. Kris-Etherton PM et al. Milk products, dietary patterns and blood pressure management. J Am Coll Nutr 2009;28(1):103S-119S.
  2. Canadian Hypertension Society. www.hypertension.ca
  3. Khan NA et al. The 2008 Canadian Hypertension Education Program recommendations for the management of hypertension: part 2 – therapy. Can J Cardiol 2008;24(6):465-475.
  4. Chobanian AV et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 Report. J Am Med Assoc 2003;289(19):2560-2572.
  5. German JB et al. A reappraisal of the impact of dairy foods and milk fat on cardiovascular disease risk. Eur J Nutr 2009 DOI:10.1007/s00394-009-0002-5.
  6. Phelan M et al. Casein-derived bioactive peptides: biological effects, industrial uses, safety aspects and regulatory status: Review. International Dairy Journal 2009(19):643-654.
  7. Xu JY et al. Effect of milk tripeptides on blood pressure: a meta-analysis of randomized controlled trials. J Nutr 2008;24:933-940.

Keywords: peptides , bioactive peptides , DASH diet , casein , whey protein , angiotensin converting enzyme , hypertension , cardiovascular disease , protein


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