Prokopidis Konstantinos, Morgan Paul T, Veronese Nicola, Morwani-Mangnani Jordi, Triantafyllidis Konstantinos K, Kechagias Konstantinos S, Roberts Justin, Hurst Christopher, Stevenson Emma, Vlachopoulos Dimitris, Witard Oliver C
Department of Musculoskeletal and Ageing Science, University of Liverpool, Liverpool, UK; Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool Heart and Chest Hospital, Liverpool, UK.
Department of Sport and Exercise Sciences, Institute of Sport, 99 Oxford Road, Manchester Metropolitan University, Manchester, UK.
Clin Nutr. 2025 Jan;44:109-121. doi: 10.1016/j.clnu.2024.12.003. Epub 2024 Dec 7.
The increasing prevalence of cardiometabolic diseases highlights the urgent need for practical interventions to mitigate their associated public health burden. Whey protein supplementation has emerged as a potential intervention for improving markers of cardiometabolic health. The aim of this systematic review and meta-analysis was to examine the effect of whey protein ingestion on cardiometabolic profile in adults.
A systematic search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library from inception until June 2024. Eligible RCTs compared the effect of whey protein supplementation compared to placebo or a carbohydrate-based control on markers of cardiometabolic health. Using the random effects inverse-variance model, we estimated the mean difference (MD) in blood pressure, high- and low-density lipoproteins (HDL-cholesterol, LDL-cholesterol), total cholesterol, triglycerides, and homeostatic model assessment for insulin resistance (HOMA-IR) index.
This meta-analysis included 21 RCTs. Whey protein supplementation had no effect on HDL-cholesterol concentration but did elicit a reduction in LDL-cholesterol in individuals aged <50 years (P < 0.01) and when combined with exercise (MD: -5.38, 95 % confidence interval (95 % CI): -8.87 to -1.88, I = 0 %, P < 0.01). Total cholesterol was reduced with interventions that combined whey protein supplementation and exercise (MD: -8.58, -14.32 to -2.83, I = 55 %, P < 0.01), irrespective of age, protein dose, and body mass index ≥25 kg/m (MD: -6.71, 95 % CI: -11.60 to -1.83, I = 74 %, P < 0.01). Whey protein supplementation of ≥12 weeks was associated with reduced triglyceride levels (MD: -6.61, 95 % CI: -11.06 to -2.17, I = 70 %, P < 0.01). There was no clinically relevant effect of whey protein supplementation on blood pressure and HOMA-IR, however, changes pertinent to HDL-cholesterol, total cholesterol, and triglyceride reduction were primarily displayed in healthy adults.
Whey protein supplementation may be an effective intervention for reducing LDL and total cholesterol levels, particularly in healthy, overweight/obese adults aged <50 years, with the greatest benefits observed when combined with exercise. Healthy adults also showed a benefit regarding triglyceride levels.
心脏代谢疾病的患病率不断上升，凸显了采取切实可行的干预措施以减轻其相关公共卫生负担的迫切需求。补充乳清蛋白已成为改善心脏代谢健康指标的一种潜在干预措施。本系统评价和荟萃分析的目的是研究摄入乳清蛋白对成年人心脏代谢状况的影响。
从创刊至2024年6月，在PubMed、科学网、Scopus和考克兰图书馆进行了系统检索。符合条件的随机对照试验比较了补充乳清蛋白与安慰剂或基于碳水化合物的对照物对心脏代谢健康指标的影响。使用随机效应逆方差模型，我们估计了血压、高密度和低密度脂蛋白（高密度脂蛋白胆固醇、低密度脂蛋白胆固醇）、总胆固醇、甘油三酯以及胰岛素抵抗稳态模型评估（HOMA-IR）指数的平均差异（MD）。
该荟萃分析纳入了21项随机对照试验。补充乳清蛋白对高密度脂蛋白胆固醇浓度没有影响，但在年龄小于50岁的个体中以及与运动相结合时，确实使低密度脂蛋白胆固醇有所降低（P<0.01）（MD：-5.38，95%置信区间（95%CI）：-8.87至-1.88，I=0%，P<0.01）。补充乳清蛋白与运动相结合的干预措施使总胆固醇降低（MD：-8.58，-14.32至-2.83，I=55%，P<0.01），无论年龄、蛋白质剂量和体重指数≥25kg/m²（MD：-6.71，95%CI：-11.60至-1.83，I=74%，P<0.01）。补充乳清蛋白≥12周与甘油三酯水平降低相关（MD：-6.61，95%CI：-11.06至-2.17，I=70%，P<0.01）。补充乳清蛋白对血压和HOMA-IR没有临床相关影响，然而，与高密度脂蛋白胆固醇、总胆固醇和甘油三酯降低相关的变化主要出现在健康成年人中。
补充乳清蛋白可能是降低低密度脂蛋白和总胆固醇水平的有效干预措施，特别是在年龄小于50岁健康的超重/肥胖成年人中，与运动相结合时效果最佳。健康成年人在甘油三酯水平方面也有获益。
