Reformulation initiative for partial replacement of saturated with unsaturated fats in dairy foods attenuates the increase in LDL cholesterol and improves flow-mediated dilatation compared with conventional dairy: the randomized, controlled REplacement of SaturatEd fat in dairy on Total cholesterol (RESET) study

Background Modifying dairy fat composition by increasing the MUFA content is a potential strategy to reduce dietary SFA intake for cardiovascular disease (CVD) prevention in the population. Objectives To determine the effects of consuming SFA-reduced, MUFA-enriched (modified) dairy products, compared with conventional dairy products (control), on the fasting cholesterol profile (primary outcome), endothelial function assessed by flow-mediated dilatation (FMD; key secondary outcome), and other cardiometabolic risk markers. Methods A double-blind, randomized, controlled crossover 12-wk intervention was conducted. Participants with a 1.5-fold higher (moderate) CVD risk than the population mean replaced habitual dairy products with study products (milk, cheese, and butter) to achieve a high-fat, high-dairy isoenergetic daily dietary exchange [38% of total energy intake (%TE) from fat: control (dietary target: 19%TE SFA; 11%TE MUFA) and modified (16%TE SFA; 14%TE MUFA) diet]. Results Fifty-four participants (57.4% men; mean ± SEM age: 52 ± 3 y; BMI: 25.8 ± 0.5 kg/m2) completed the study. The modified diet attenuated the rise in fasting LDL cholesterol observed with the control diet (0.03 ± 0.06 mmol/L and 0.19 ± 0.05 mmol/L, respectively; P = 0.03). Relative to baseline, the %FMD response increased after the modified diet (0.35% ± 0.15%), whereas a decrease was observed after the control diet (−0.51% ± 0.15%; P< 0.0001). In addition, fasting plasma nitrite concentrations increased after the modified diet, yet decreased after the control diet (0.02 ± 0.01 μmol/L and −0.03 ± 0.02 μmol/L, respectively; P = 0.01). Conclusions In adults at moderate CVD risk, consumption of a high-fat diet containing SFA-reduced, MUFA-enriched dairy products for 12 wk showed beneficial effects on fasting LDL cholesterol and endothelial function compared with conventional dairy products. Our findings indicate that fatty acid modification of dairy products may have potential as a public health strategy aimed at CVD risk reduction. This trial was registered at clinicaltrials.gov as NCT02089035

A 25-hydroxycholecalciferol–fortified dairy drink is more effective at raising a marker of postprandial vitamin D status than cholecalciferol in men with suboptimal vitamin D status

Background: One strategy for improving population vitamin D status is consumption of fortified foods. However, the effects of dairy products fortified with different vitamin D isoforms on postprandial vitamin D status and metabolic outcomes have not been addressed. Objective: We investigated whether consumption of dairy drinks fortified with either 25-hydroxycholecalciferol [25(OH)D3] or cholecalciferol (vitamin D3) had differential effects on 24-h circulating plasma 25(OH)D3 concentration (a marker of vitamin D status) and cardiometabolic risk markers. Methods: A randomized, controlled, 3-way crossover, double-blind, postprandial study was conducted in 17 men with suboptimal vitamin D status [mean 6 SEM age: 49 6 3 y; body mass index (in kg/m2): 26.4 6 0.6; and plasma 25(OH)D3 concentration: 31.7 6 3.4 nmol/L]. They were randomly assigned to consume 3 different test meals (4.54 MJ, 51 g fat, 125 g carbohydrate, and 23 g protein),which contained either a nonfortified dairy drink (control), 20 mg 25(OH)D3-fortified (+HyD3) dairy drink, or 20 mg vitamin D3–fortified (+D3) dairy drink with toasted bread and jam on different occasions, separated by a 2-wk washout. Plasma 25(OH)D3 concentrations and cardiometabolic risk markers, including vascular stiffness, serum lipids, and inflammatory markers, were measured frequently within 8 h postprandially and 24 h after the dairy drink was consumed. Results: Plasma 25(OH)D3 concentrations (the primary outcome) were significantly higher after the +HyD3 dairy drink was consumed compared with +D3 and control (P = 0.019), which was reflected in the 1.5-fold and 1.8-fold greater incremental area under the curve for the 0–8 h response, respectively. The change in plasma 25(OH)D3 concentrations from baseline to 24 h for the +HyD3 dairy drink was also 0.9-fold higher than the +D3 dairy drink and 4.4-fold higher than the control (P < 0.0001), which were not significantly different from each other. Conclusion: The dairy drink fortified with 25(OH)D3 was more effective at raising plasma 25(OH)D3 concentrations postprandially than was the dairy drink fortified with vitamin D3 in men with suboptimal vitamin D status

Dairy foods and body mass index over 20-years: evidence from Caerphilly Prospective Study

The prevalence of obesity has reached epidemic proportions with more than 600 million adults worldwide classified as clinically obese (body mass index (BMI) ⩾ 30 kg/m2)(1). Among the various approaches to tackle obesity and its comorbidities, a heathy diet is one of the key determinants for reducing obesity(2). Given that dairy products are naturally rich in protein and essential micronutrients, including calcium, potassium and vitamin A(3), they are recommended as an integral part of a healthy diet by many countries(4). However, dairy is also a major contributor to saturated fatty acids (SFA) and energy intake(5), thus their role in development of obes- ity has been questioned and explored by several studies(6). We investigated the association between total dairy, milk, cheese, cream and butter consumption and BMI change over a 20-year follow-up using the Caerphilly prospective study (CAPS). The CAPS included 2512 men aged 45–59 years, who were followed up at 5-year intervals for over 20-years. The associations of total dairy, milk, cheese, cream and butter consumption with BMI were examined cross-sectionally at baseline and longitudinally at 5, 10, 15 and 20-years follow-ups. General linear regression and logistic regression were used for data analysis. Men free of cardiovascular disease and diabetes (n = 1704) were included in the current analysis. Higher cheese consumption was associated with lower BMI at the 5-year follow-up (P = 0·008) but not at later follow-ups. There was no evidence that higher consumption of dairy products was associated with increased BMI during the over 20-years follow-up, although total dairy (P = 0·002) and milk consumption (P < 0·001) were inversely associated with BMI at baseline. For the future studies, the association between cheese consumption and BMI requires further investigation

Consumer acceptance of dairy products with a saturated fatty acid-reduced, monounsaturated fatty acid-enriched content

Agriculture-based reformulation initiatives, including oleic acid-rich lipid supplementation of the dairy cow diet, provide a novel means for reducing intake of saturated fatty acids (SFA) at a population level. In a blinded manner, this study evaluated the consumer acceptance of SFA-reduced, monounsaturated fatty acid-enriched (modified) milk, Cheddar cheese, and butter when compared with control and commercially available comparative samples. The effect of providing nutritional information about the modified cheese was also evaluated. Consumers (n = 115) rated samples for overall liking (appearance, flavor, and texture) using 9-point hedonic scales. Although no significant differences were found between the milk samples, the modified cheese was liked significantly less than a regular-fat commercial alternative for overall liking and liking of specific modalities and had a lower liking of texture score compared with the control cheese. The provision of health information significantly increased the overall liking of the modified cheese compared with tasting the same sample in a blinded manner. Significant differences were evident between the butter samples for overall liking and modalities of liking; all of the samples were significantly more liked than the commercial butter and sunflower oil spread. In conclusion, this study illustrated that consumer acceptance of SFA-reduced, monounsaturated fatty acid-enriched dairy products was dependent on product type. Future research should consider how optimization of the textural properties of fatty acid-modified (and fat-reduced) cheese might enhance consumer acceptance of this product

Proteomic/peptidomic profile and Escherichia coli growth inhibitory effect of in vitro digested soya protein

Plant proteins contain bioactive peptides with functional properties and physiological activities. In the present work, the bioactive peptides produced during in vitro gastrointestinal digestion of soya protein isolate were investigated. Protein samples were subjected to simulated gastrointestinal digestion with a generation of permeate (3 kDa) fractions. The permeate was analysed by nano-liquid chromatography electrospray ionisation tandem mass spectrometry (LC-nano ESI MS/MS) using a shotgun peptidomic approach, and the retentate was further digested with trypsin and analysed using a shotgun proteomic approach. Based on protein profile observed, the retentate was further tested for its potential antimicrobial activity by evaluating the inhibitory effect on E. coli growth. In the present study the peptidomic/ proteomic characterisation of permeate and retentate fractions revealed the presence of bioactive peptides and proteins associated with antioxidant, ACE-inhibitory, anti-hypertensive and antimicrobial activities. The presence of potentially antimicrobial proteins in the retentate fraction is supported by a marked E. coli F18þ growth inhibitory activity of the same fraction. In particular, the growth inhibitory effect was significant from one until six hours of incubation with 0.65–2.6 mg/ml of in vitro digested soya. The obtained data confirmed that soya-based supplements may have potential beneficial effects after human consumption, and they may be recycled for animal nutrition in line with the circular economy concept

Left sided inferior vena cava duplication and venous thromboembolism: case report and review of literature

The etiology of venous thromboembolism in young patients is frequently associated with hereditary coagulation abnormalities, immunologic diseases, and neoplasia. The advent of radiological advances, namely Computed Tomography (CT) scans and venography has identified vena cava malformations as a new etiologic factor worthy of consideration. In this case report, we describe the unusual occurrence of venous thromboembolism in association with a duplicated inferior vena cava. Duplications of the inferior vena cava (IVC) are seen with an incidence of 0.2% to 3.0% in the general population. Embryogenesis of the IVC is a complex process involving the intricate formation and regression of numerous anastomoses, potentially leading to various anomalies. We present a 23-year-old Caucasian woman with IVC duplication who developed a deep venous thrombosis and multiple pulmonary emboli. Anomaly of the IVC is a rare example of a congenital condition that predisposes to thromboembolism, presumably by favoring venous stasis. This diagnosis should be considered in patients under the age of 30 with spontaneous occurrence of blood clots

Postprandial fatty acid profile, but not cardiometabolic risk markers, is modulated by dairy fat manipulation in adults with moderate cardiovascular disease risk: the randomized controlled REplacement of SaturatEd fat in dairy on Total cholesterol (RESET) study

Background: Chronic consumption of dairy products with a saturated fatty acid (SFA)-reduced, monounsaturated fatty acid (MUFA)-enriched content was shown to impact favourably on brachial artery flow-mediated dilatation (FMD). However, their acute effect on postprandial cardiometabolic risk biomarkers requires investigation. Objective: The effects of sequential high-fat mixed meals rich in fatty acid (FA)-modified or conventional (control) dairy products on postprandial FMD (primary outcome) and systemic cardiometabolic biomarkers in adults with moderate cardiovascular risk (≥50% above population mean) were compared. Methods: In a randomized cross-over trial, fifty-two participants (mean ± SEM age 53 ± 2 y; BMI 25.9 ± 0.5 kg/m2) consumed high-dairy fat breakfast (0 min; ~50 g total fat: Modified: 25 g SFAs, 20 g MUFAs; Control: 32 g SFAs, 12 g MUFAs) and lunch (330 min; ~30 g total fat; Modified: 15 g SFAs, 12 g MUFAs; Control: 19 g SFAs, 7 g MUFAs). Blood samples were obtained before and until 480 min after breakfast, with FMD assessed at 0, 180, 300 and 420 min. Data were analysed by linear mixed models. Results: Postprandial changes in cardiometabolic biomarkers were comparable between the different dairy meals, with the exception of a tendency for a 4% higher area under the curve (AUC) for the %FMD response following the modified dairy fat meals (P = 0.075). Plasma total lipid FA analysis revealed that incremental AUC responses were 53% lower for total SFAs, 214% and 258% higher for total cis-MUFAs (predominantly cis-9 18:1), and trans-18:1 respectively following the modified, relative to control dairy meals (all P < 0.0001). Conclusions: In adults at moderate cardiovascular risk, acute consumption of sequential high-fat meals containing FA-modified dairy products had little impact on postprandial endothelial function or systemic cardiometabolic biomarkers, but a differential effect on the plasma total lipid FA profile, relative to conventional dairy fat meals