Abstract
Introduction: Dairy fat is rich in saturated fatty acids known to increase serum low-density lipoprotein cholesterol (LDL-C) concentration, an important risk factor for cardiovascular disease (CVD). However, intake of fermented dairy products has been associated with reduced CVD risk in observational studies. How intakes of different fermented dairy products are associated with blood lipid concentrations may provide a possible explanation for the suggested reduced CVD risk.Aim: To examine the associations between different types of fermented dairy products, with various fat contents and dairy matrix structures, and blood lipid concentrations in a general population.Methods: In 11,377 women and men aged between 40-99 participating in the population-based Tromsø Study 2015-2016, multivariable linear regression was used to examine associations between total intake of fermented dairy products, intake of yogurt (including regular-fat, low-fat, and semi-solid yogurt), cheese (including regular-fat and low-fat), and liquid fermented dairy, and serum concentrations of total cholesterol, LDL-C, high-density lipoprotein cholesterol (HDL-C), and triglycerides. Dietary data was collected using a validated food frequency questionnaire. Analyses were adjusted for potential confounding factors, and cheese intake analyses were stratified by self-reported use of cholesterol-lowering drugs.Results: Cheese intake was positively associated with HDL-C [regression coefficient 0.02 mmol/l (95 % CI 0.01, 0.03)], and inversely associated with LDL-C [regression coefficient−0.03 mmol/l (95 % CI−0.04,−0.01)] and triglycerides [relative change −1.34 % (95 % CI: −2.29 %, −0.37 %)] per 25 g/day among non-users of cholesterol-lowering drugs, while no associations were found among users. Total intake of fermented dairy was inversely associated with triglycerides [relative change −1.11 % (95 % CI: −1.96 %, −0.24 %)] per 250 g/day, while no associations were found for yogurt intake. Intake of low-fat cheese was more favorably associated with blood lipids compared to regular-fat cheese, and semi-solid yogurt was inversely associated with LDL-C and triglycerides, while intake of liquid fermented dairy was not associated with any of the blood lipids.Conclusion: This study highlights the importance of investigating specific types of dairy products separately, based on fat content and dairy matrix, when examining effects on blood lipid concentrations, and stratifying statistical models by use of cholesterol-lowering drugs when relevant.
Highlights
Dairy fat is rich in saturated fatty acids known to increase serum low-density lipoprotein cholesterol (LDL-C) concentration, an important risk factor for cardiovascular disease (CVD)
Intake of semi-solid yogurt was inversely associated with LDL-C and triglycerides (regression coefficient−0.04 mmol/l and relative change −2.48 %, respectively, per 100 g/day increase in semisolid yogurt intake)
Intake of regular-fat cheese was positively associated with high-density lipoprotein cholesterol (HDL-C) among non-users of cholesterol-lowering drugs [regression coefficient 0.02 mmol/l] (Table 6) and positively associated with total cholesterol among users of cholesterol-lowering drugs [regression coefficient 0.07 mmol/l] (Table 7) per 25 g/day increase in regular-fat cheese intake. In this cross-sectional study, main findings were that cheese intake was positively associated with HDL-C, and inversely associated with LDL-C and triglyceride concentrations among those not using cholesterol-lowering drugs, while total intake of fermented dairy products was inversely associated with triglyceride concentrations only, and yogurt not associated with any of the blood lipids
Summary
Dairy fat is rich in saturated fatty acids known to increase serum low-density lipoprotein cholesterol (LDL-C) concentration, an important risk factor for cardiovascular disease (CVD). Despite the high saturated fat content in dairy products, a recent review article including meta-analyses of cohort studies found no associations between total dairy product consumption (including regular-fat and low-fat dairy products, high compared with low consumption, and dose–response intake) and risk of CVD [11]. A meta-analysis of RCTs, including healthy adults randomized to increased dairy food intake for more than a month without other dietary interventions, found that neither regular-fat dairy nor low-fat dairy had a significant effect on LDL-C or HDL-C [12]. The aim of this study is to examine the associations between total intake of fermented dairy products, as well as intake of yogurt (including both low-fat and regular-fat), cheese (including both low-fat and regular-fat), semi-solid yogurt, and fermented liquid dairy, respectively, and blood lipid concentrations in a general population
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