15 research outputs found
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Impact of partial replacement of saturated with monounsaturated fatty acids in dairy foods on markers of cardiovascular risk
Cardiovascular diseases (CVD) remain one of the leading causes of morbidity and mortality
worldwide. Current dietary guidelines advocate for a restriction of high intakes of saturated
fatty acids (SFA), an important risk factor for the development of CVD due to their
association with increased low-density lipoprotein cholesterol (LDL-C). Dairy foods are
major contributors of total SFA intake. The literature review explored aspects of dairy
consumption on CVD risk, highlighting current evidence which suggests a beneficial effect of
certain dairy products. A reduction of dietary SFA is also dependent on a suitable replacement
macronutrient. Supplementation of the dairy cow diet with plant oils/seeds provides an
alternative strategy to partially replacing SFA in milk fat with monounsaturated fatty acids
(MUFA). Few interventions studies have extensively investigated the impact of fatty acid
(FA) modified dairy products on traditional and novel CVD risk markers. The RESET
intervention study aimed to address this knowledge gap in both a chronic and acute-withinchronic
setting in adults at moderate CVD risk. A food-exchange model (38% total energy
(%TE) from fat) was implemented and adherence assessed from 4 day weighed food diaries
and phospholipid FA (PL-FA) analysis. Consumption of the FA-modified diet for 12 weeks
(dietary target: 16%TE SFA; 14%TE MUFA) led to a significant attenuation in fasted LDL-C
concentrations from baseline values and compared to matched control products (19%TE SFA;
11%TE MUFA). At the beginning and end of each dietary intervention, the postprandial
investigation was performed using sequential test meals representative of the assigned dairy
diet. Following the FA-modified diet and test meals, a decrease in the postprandial iAUC
summary response for apolipoprotein B (apoB) was observed, suggestive of an effect on
triacylglyceride-rich lipoproteins (TRL). Changes in postprandial summary responses of
plasma total lipid FA reflected the intake of the test meals. Additionally, the FA-modified diet
appeared to modestly impact on both fasted concentrations and postprandial responses of
nitrite, which may be indicative of an effect on endothelial function. Little to no impact was
observed for other outcome measures. The impact of APOE genotype, retrospectively
assessed, fasted and postprandial outcome measures following the two dairy diets, was
explored. Significant pre-intervention fasted baseline differences in high-density lipoprotein
cholesterol (HDL-C), small and medium HDL particle distribution and non-esterified fatty
acids (NEFA) between E4 carriers and E3/E3, were observed. There was no interaction
between genotype and treatment on any of the outcome measures. In summary, consumption
of FA-modified dairy products appear to beneficially impact on certain markers of CVD risk, compared to matched control products. However, further research should address the impact
of other types of FA-modified dairy products in both healthy and at risk populations
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Dairy and cardiovascular health: friend or foe?
Cardiovascular disease (CVD) prevalence at a global level is predicted to increase substantially over the next decade due to the increasing ageing population and incidence of obesity. Hence, there is an urgent requirement to focus on modifiable contributors to CVD risk, including a high dietary intake of saturated fatty acids (SFA). As an important source of SFA in the UK diet, milk and dairy products are often targeted for SFA reduction. The current paper acknowledges that milk is a complex food and that simply focusing on the link between SFA and CVD risk overlooks the other beneficial nutrients of dairy foods. The body of existing prospective evidence exploring the impact of milk and dairy consumption on risk factors for CVD is reviewed. The current paper highlights that high milk consumption may be beneficial to cardiovascular health, while illustrating that the evidence is less clear for cheese and butter intake. The option of manipulating the fatty acid profile of ruminant milk is discussed as a potential dietary strategy for lowering SFA intake at a population level. The review highlights that there is a necessity to perform more well-controlled human intervention-based research that provides a more holistic evaluation of fat-reduced and fat-modified dairy consumption on CVD risk factors including vascular function, arterial stiffness, postprandial lipaemia and markers of inflammation. Additionally, further research is required to investigate the impact of different dairy products and the effect of the specific food matrix on CVD development
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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
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Food chain approach to lowering the saturated fat of milk and dairy products
Lactating cow diets were supplemented with high oleic acid sunflower oil over two production periods spanning two years, to modify the milk fat, partially replacing saturated fatty acids (SFA) with cis-monounsaturated fatty acids (MUFA). The resulting milk was used for ultra-high temperature (UHT) milk, butter and Cheddar cheese production, and fatty acid profiles were compared with those of conventionally-produced products. Fat from products made with modified milk had lower SFA and higher cis- and trans-MUFA concentrations than that of conventional products. This was consistent over production periods, demonstrating that this food chain approach could be adopted on a wider scale
Food chain approach to lowering the saturated fat of milk and dairy products
Lactating cow diets were supplemented with high‐oleic acid sunflower oil over two production periods spanning two years, to modify the milk fat, partially replacing saturated fatty acids with cis‐monounsaturated fatty acids. The resulting milk was used for ultrahigh‐temperature milk, butter and Cheddar cheese production, and fatty acid profiles were compared with those of conventionally produced products. Fat from products made with modified milk had lower saturated fatty acids and higher cis‐ and trans‐monounsaturated fatty acid concentrations than that of conventional products. This was consistent over both production periods, demonstrating that this food chain approach could be adopted on a wider scale
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Impact of dairy fat manipulation on endothelial function and lipid regulation in human aortic endothelial cells exposed to human plasma samples: an in vitro investigation from the RESET study
Purpose Longer-term intake of fatty acid (FA)-modified dairy products (SFA-reduced, MUFA-enriched) was reported
to attenuate postprandial endothelial function in humans, relative to conventional (control) dairy. Thus, we performed an
in vitro study in human aortic endothelial cells (HAEC) to investigate mechanisms underlying the effects observed in vivo.
Methods This sub-study was conducted within the framework of the RESET study, a 12-week randomised controlled crossover trial with FA-modified and control dairy diets. HAEC were incubated for 24 h with post-intervention plasma samples from
eleven adults (age: 57.5±6.0 years; BMI: 25.7±2.7 kg/m2
) at moderate cardiovascular disease risk following representative
sequential mixed meals. Markers of endothelial function and lipid regulation were assessed.
Results Relative to control, HAEC incubation with plasma following the FA-modified treatment increased postprandial NOx
production (P-interaction=0.019), yet up-regulated relative E-selectin mRNA gene expression (P-interaction=0.011). There
was no impact on other genes measured.
Conclusion Incubation of HAEC with human plasma collected after longer-term dairy fat manipulation had a beneficial
impact on postprandial NOx production. Further ex vivo research is needed to understand the impact of partial replacement
of SFA with unsaturated fatty acids in dairy foods on pathways involved in endothelial function
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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
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Manipulation of starch bioaccessibility in wheat endosperm to regulate starch digestion, postprandial glycemia, insulinemia, and gut hormone responses: a randomized controlled trial in healthy ileostomy participants
Background: Cereal crops, particularly wheat, are a major dietary source of starch, and the bioaccessibility of starch has implications for postprandial glycemia. The structure and properties of plant foods have been identified as critical factors in influencing nutrient bioaccessibility; however, the physical and biochemical disassembly of cereal food during digestion has not been widely studied.
Objectives: The aims of this study were to compare the effects of 2 porridge meals prepared from wheat endosperm with different degrees of starch bioaccessibility on postprandial metabolism (e.g., glycemia) and to gain insight into the structural and biochemical breakdown of the test meals during gastroileal transit.
Design: A randomized crossover trial in 9 healthy ileostomy participants was designed to compare the effects of 55 g starch, provided as coarse (2-mm particles) or smooth (0.2-mm particles) wheat porridge, on postprandial changes in blood glucose, insulin, C-peptide, lipids, and gut hormones and on the resistant starch (RS) content of ileal effluent. Undigested food in the ileal output was examined microscopically to identify cell walls and encapsulated starch.
Results: Blood glucose, insulin, C-peptide, and glucose-dependent insulinotropic polypeptide concentrations were significantly lower (i.e., 33%, 43%, 40%, and 50% lower 120-min incremental AUC, respectively) after consumption of the coarse porridge than after the smooth porridge (P , 0.01). In vitro, starch digestion was slower in the coarse porridge than in the smooth porridge (33% less starch digested at 90 min, P , 0.05, paired t test). In vivo, the structural integrity of coarse particles (~2 mm) of wheat endosperm was retained during gastroileal transit. Microscopic examination revealed a progressive loss of starch from the periphery toward the particle core. The structure of the test meal had no effect on the amount or pattern of RS output.
Conclusion: The structural integrity of wheat endosperm is largely retained during gastroileal digestion and has a primary role in influencing the rate of starch amylolysis and, consequently, postprandial metabolism.
This trial was registered at isrctn.org as ISRCTN40517475
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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
Postprandial lipid responses after long-term intake of dairy products varying in fatty acid composition [Abstract]
Postprandial lipid responses after long-term intake of dairy products varying in fatty acid composition [Abstract