Effect of fat-reformulated dairy food consumption on postprandial flow-mediated dilatation and cardiometabolic risk biomarkers compared with conventional dairy: a randomized controlled trial

Abstract

Background Longer-term consumption of saturated fatty acid (SFA)-reduced, monounsaturated fatty acid (MUFA)-enriched dairy products have been reported to improve fasting flow-mediated vasodilation (FMD). Yet, their impact on endothelial function in the postprandial state warrants investigation. Objectives To compare the impact of a fatty acid (FA)-modified with a conventional (control) dairy diet on the postprandial %FMD (primary outcome) and systemic cardiometabolic responses to representative meals, and retrospectively explore whether treatment effects differ by apolipoprotein (APO)E or endothelial nitric oxide synthase (eNOS) Glu298Asp gene polymorphisms. Methods In a crossover-design randomized controlled study, 52 adults with moderate cardiovascular disease risk consumed dairy products [38% total energy intake (%TE) from fat: FA-modified (target: 16%TE SFAs; 14%TE MUFAs) or control (19%TE SFAs; 11%TE MUFAs)] for 12-wk, separated by an 8-wk washout. Blood sampling and FMD measurements (0-480 min) were performed pre- and post-intervention after sequential mixed meals that were representative of the assigned dairy diets (0 min; ∼50 g fat; 330 min; ∼30 g fat). Results Relative to pre-intervention (∆), the FA-modified dairy diet and meals (treatment) attenuated the increase in the incremental AUC (iAUC), but not AUC, for the %FMD response observed with the conventional treatment (–135 ± 69 vs + 199 ± 82% x min; P = 0.005). The ∆ iAUC, but not AUC, for the apoB response decreased after FA-modified yet increased after the conventional treatment (–4 ± 3 vs + 3 ± 3 mg/mL × min; P = 0.004). The ∆ iAUC decreased for total plasma SFAs (P = 0.003) and trans 18:1 (P < 0.0001) and increased for cis-MUFAs (P < 0.0001) following conventional, relative to the FA-modified treatment. No treatment x APOE- or eNOS-genotype interactions were evident for any outcome. Conclusions This study provides novel insights into the longer-term effects of FA-modified dairy food consumption on postprandial cardiometabolic responses. Clinical Trial Registry: Unique identifier: NCT02089035. URL: https://clinicaltrials.gov/ct2/show/NCT02089035

A natural and safe diglyceride (DAG)‐MFGM reconstituted milk: preparation, physiochemical, in‐vitro digestion, and sterilisation safety

“…In this context, unsaturated fats (USFAs) or structural lipids are attracting great attention with abundant essential fatty acids, and can lower cholesterol levels and prevent metabolic diseases. Meanwhile, it is indicated that dairy products modified with USFAs can effectively reduce the risk of cardiovascular disease (Vasilopoulou et al ., 2020; Markey et al ., 2022).…”

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

“…Supplementation of the dairy cow diet with plant oil or oilseeds is a reformulation initiative for partial replacement of milk SFAs with unsaturated fatty acids (FAs), primarily in the form of cis -MUFA [ 1 , 5 , 6 ]. In the REplacement of SaturatEd fat in dairy on Total cholesterol (RESET) study, we demonstrated that longer-term (12-wk) consumption of SFA-reduced, MUFA-enriched (FA-modified) milk, cheese and butter (∼ 41 g/day dairy fat) attenuated the rise in fasting serum LDL-cholesterol concentrations, enhanced endothelial-dependent flow-mediated dilatation (FMD) and plasma nitrite concentrations among a cohort of adults at moderate CVD risk, relative to conventional dairy products [ 1 ].…”

“…In the REplacement of SaturatEd fat in dairy on Total cholesterol (RESET) study, we demonstrated that longer-term (12-wk) consumption of SFA-reduced, MUFA-enriched (FA-modified) milk, cheese and butter (∼ 41 g/day dairy fat) attenuated the rise in fasting serum LDL-cholesterol concentrations, enhanced endothelial-dependent flow-mediated dilatation (FMD) and plasma nitrite concentrations among a cohort of adults at moderate CVD risk, relative to conventional dairy products [ 1 ]. More recently, we presented evidence from the same ‘at risk’ cohort which indicated that longer-term intake of FA-modified dairy products, enhanced the postprandial (non-fasted) circulating apolipoprotein (apo)B response to representative sequential meals, but attenuated the %FMD response observed with the conventional dairy treatment [ 5 ]. In the context of dietary SFA replacement and cardiometabolic disease risk, this highlights the importance of considering biomarker assessment in the postprandial state [ 5 ].…”

“…More recently, we presented evidence from the same ‘at risk’ cohort which indicated that longer-term intake of FA-modified dairy products, enhanced the postprandial (non-fasted) circulating apolipoprotein (apo)B response to representative sequential meals, but attenuated the %FMD response observed with the conventional dairy treatment [ 5 ]. In the context of dietary SFA replacement and cardiometabolic disease risk, this highlights the importance of considering biomarker assessment in the postprandial state [ 5 ].…”

“…Livingstone et al [ 7 ] conducted the first in vitro study to examine the effect of concentrations of individual dairy FA and FA mixtures extracted from conventional and FA-modified cheese on biomarkers of endothelial function in human aortic endothelial cells (HAEC). Building on this previous work [ 7 ] and to complement the findings from our human study [ 1 , 5 ], we exposed HAEC to ex vivo plasma to provide more physiologically relevant insights into the mechanisms underlying the impact of FA-reformulated dairy foods on vascular function, nitric oxide (NO) production (a potent vasodilator) and CVD development. Within the framework of the RESET study, the aim of this in vitro work was to investigate the longer-term impact of consuming FA-modified compared to conventional dairy food treatments on markers of endothelial function and expression of genes involved in lipid regulation and endothelial activation in HAEC incubated for 24 h with plasma samples isolated from adults with moderate CVD risk after consumption of representative sequential high-fat meals.…”