Characterization of metabolic responses to healthy diets and the association with blood pressure: application to the Optimal Macronutrient Intake Trial for Heart Health (OmniHeart), a Randomized Control Study

Background: Inter-individual variation in the response to diet is common but the underlying mechanism for such variation is unclear.

Design: 24-h urine samples from 158 participants, with pre-hypertension and stage 1 hypertension collected at baseline and following the consumption of a carbohydrate-rich, a protein-rich and a monounsaturated fat-rich healthy diet (6-weeks per diet) in a randomized, crossover study, were analyzed by proton (1H) nuclear magnetic resonance (NMR) spectroscopy. Urinary metabolite profiles were interrogated to identify typical and variable responses to each diet. We quantified the differences in absolute excretion of metabolites distinguishing between dietary comparisons within the typical response groups and established their associations with CVD risk factors using linear regression.

Conclusion: These data indicate inter-individual variations in BP in response to dietary change and highlight the potential influence of the gut microbiome in mediating this relationship. This approach provides a framework for stratification of individuals undergoing dietary management.