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Fatty acid-modified dairy vs. conventional dairy and endothelial function (full-text)

Am J Clin Nutr 2022 Jan 10; nqab428. Effect of fat reformulated dairy food consumption on postprandial flow-mediated dilatation and cardiometabolic risk biomarkers compared with conventional dairy: a randomized, controlled trial Oonagh Markey 1, Dafni Vasilopoulou 1, Kirsty E Kliem 2 3, Colette C Fagan 1 3, Alistair S Grandison 1, Rachel Sutton 1, David J Humphries 1 3, Susan Todd 4, Kim G Jackson 1 3, David I Givens 3, Julie A Lovegrove 1 3 Affiliations

  • 1 Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom.

  • 2 Animal, Dairy, and Food Chain Sciences, University of Reading, Reading, United Kingdom.

  • 3 Institute for Food, Nutrition, and Health, University of Reading, Reading, United Kingdom.

  • 4 Department of Mathematics and Statistics, University of Reading, Reading, United Kingdom.

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. © The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.

Fig.1 ) Nutritional composition of the sequential high-fat mixed test breakfast (0 min) and lunch meals (330 min) that incorporated the fatty acid–modified or conventional (control) dairy products



1 Values are total energy and macronutrient quantities of each test meal according to modified and control diet. CHO, carbohydrate; FA, fatty acid; TFA, trans fatty acid. 2 Measurement of energy, total fat, protein, and carbohydrate content of the dairy product samples was conducted in duplicate by SGS UK Ltd. (Ealing, London; ISO 17,025 accredited laboratory). 3 Lipids extracted from the dairy product samples were analyzed in triplicate for FA composition by GC–flame ionization detection using a standardized procedure, as described previously.


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