Abstract
Cholesterol synthesized in the body or ingested is an essential lipid component for human survival from our earliest life. Newborns ingest about 3–4 times the amount per body weight through mother's milk compared to the dietary intake of adults. A birth level of 1.7 mmol/L plasma total cholesterol will increase to 4–4.5 mmol/L during the nursing period and continue to increase from adulthood around 40% throughout life. Coronary artery disease and other metabolic disorders are strongly associated with low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol as well as triacylglycerol concentration. Milk fat contains a broad range of fatty acids and some have a negative impact on the cholesterol rich lipoproteins. The saturated fatty acids (SFAs), such as palmitic acid (C16:0), myristic acid (C14:0), and lauric acid (C12:0), increase total plasma cholesterol, especially LDL, and constitute 11.3 g/L of bovine milk, which is 44.8% of total fatty acid in milk fat. Replacement of dairy SFA and trans-fatty acids with polyunsaturated fatty acids decreases plasma cholesterol, especially LDL cholesterol, and is associated with a reduced risk of cardiovascular disease. Available data shows different effects on lipoproteins for different dairy products and there is uncertainty as to the impact a reasonable intake amount of dairy items has on cardiovascular risk. The aim of this review is to elucidate the effect of milk components and dairy products on total cholesterol, LDL, HDL, and the LDL/HDL quotients. Based on eight recent randomized control trials of parallel or cross-over design and recent reviews it can be concluded that replacement of saturated fat mainly (but not exclusively) derived from high-fat dairy products with low-fat dairy products lowers LDL/HDL cholesterol and total/HDL cholesterol ratios. Whey, dairy fractions enriched in polar lipids, and techniques such as fermentation, or fortification of cows feeding can be used to produce dairy products with more beneficial effects on plasma lipid profile.
Highlights
Cholesterol is an essential lipid component in cell membranes and a precursor of bioactive lipids such as bile acids and steroid hormones
Dairy fat contains a high concentration of saturated fatty acids (SFAs) and since dairy products are a considerable part of habitual diets, they have generally been a target for restriction advice in order to reduce intake of saturated fat
The presence of trans-fatty acids (tFAs) in dairy fat increases the low-density lipoprotein (LDL)/high-density lipoprotein (HDL) linearly with dose and, theoretically, by lowering the tFA intake by 0.5% of energy, this might reduce the cardiovascular risk by 1.5Á6%
Summary
Cholesterol is an essential lipid component in cell membranes and a precursor of bioactive lipids such as bile acids and steroid hormones. In a study designed to compare the effects of the physical state of milk fat on plasma cholesterol diets providing 20E% (of which 16E% is SFA) as dairy fat either as whole milk, butter or hard cheese were compared [14] (Table 1). In this strictly controlled cross-over study on 14 healthy young men, they found no support for a hypocholesterolemic milk factor. The results from this study showed that at equal fat and protein content, cheese decreased total plasma cholesterol by 3%, but the LDL:HDL ratio was not different between the diets. The milk group was instructed to include 3Á5 defined portions of dairy products in their daily diet while
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