It is well established that plant oils reduce milk saturated fatty acid content and enhance concentrations of conjugated linoleic acid (CLA) and trans C18:1in milk fat, but there is increasing evidence to suggest that milk fat CLA responses are often transient and decline over time. It is probable that time dependent adaptations in ruminal biohydrogenation and changes in milk fatty acid composition to lipid supplements are, at least in part, related to the composition of the basal diet. To test this hypothesis, 18 Holstein cows were used in a continuous randomized block design to examine changes in milk fatty acid composition over time in response to plant oils included in diets of variable composition. Cows were randomly allocated to one of three basal diets containing (g/kg dry matter (DM)) maize silage (267) and concentrates (733) (diet C); maize silage (332), grass hay (148) and concentrates (520) (diet M), or grass hay (642) and concentrates (358) (diet H). Basal rations were offered for 21 days, after which diets were supplemented with 50 g sunflower per kg DM (diets C-S and M-S) or 50 g linseed oil per kg DM (diet H-L). Oils were included in all rations incrementally over a five day period (days 0–4), and responses to 50 g/kg DM of the respective oils were evaluated for 17 days (days 4 to 20). Milk fatty acid composition was intensively monitored from days −2 to 20. In contrast to the H-L diet, both C-S and M-S treatments decreased (P<0·05) DM intake, milk fat content and yield, while the C-S diet also reduced (P<0·05) milk yield. Milk fatcis-9,trans-11 CLA andtrans-11 C18:1contents were enhanced on the C-S and M-S treatments but the increases were transient reaching the highest concentrations between days 4 and 6 (cis-9,trans-11 CLA: 1·94 and 2·18 g per 100 g total fatty acids;trans-11 C18:1: 4·88 and 6·23 g per 100 g total fatty acids, respectively) but declined thereafter. In marked contrast, concentrations ofcis-9,trans-11 CLA andtrans-11 C18:1in milk from the H-L diet increased gradually over time, responses that were maintained until the end of the experiment (2·89 and 7·49 g per 100 g total fatty acids, respectively).Decreases in milk fatcis-9,trans-11 CLA andtrans-11 C18:1after day 6 on the M-S and C-S diets were associated with concomitant increases in milk fattrans-10 C18:1content reaching 7·22 and 18·62 g per 100 g total fatty acids on day 18, respectively, whereas concentrations oftrans-10 C18:1in milk on the H-L diet remained low throughout the experiment (0·70 g per 100 g total fatty acids on day 18). Furthermore, milk fattrans-11,cis-13 CLA,trans-11,trans-13 CLA andtrans-12,trans-14 CLA contents were all enhanced on the H-L diet, while the M-S and C-S diets increasedtrans-8,cis-10 CLA,trans-10,cis-12 CLA andtrans-9,cis-11 CLA concentrations. Across all diets, decreases in milk fat content were associated with increases in milktrans-10 C18:1,trans-10,cis-12 andtrans-9,cis-11 CLA concentrations (r2=0·93, 0·88 and 0·89, respectively). In conclusion, the relative abundance oftransC18:1and CLA isomers in milk fat were dependent on the composition of the basal diet, type of plant oil and duration of lipid supplementation, highlighting the challenges in developing nutritional strategies for the production of milk highly enriched with CLA over an extended period of time.

Background: Racial inequities for patients with heart failure (HF) have been widely documented. HF patients who receive cardiology care during a hospital admission have better outcomes. It is unknown whether there are differences in admission to a cardiology or general medicine service by race. This study examined the relationship between race and admission service, and its effect on 30-day readmission and mortality Methods: We performed a retrospective cohort study from September 2008 to November 2017 at a single large urban academic referral center of all patients self-referred to the emergency department and admitted to either the cardiology or general medicine service with a principal diagnosis of HF, who self-identified as white, black, or Latinx. We used multivariable generalized estimating equation models to assess the relationship between race and admission to the cardiology service. We used Cox regression to assess the association between race, admission service, and 30-day readmission and mortality. Results: Among 1967 unique patients (66.7% white, 23.6% black, and 9.7% Latinx), black and Latinx patients had lower rates of admission to the cardiology service than white patients (adjusted rate ratio, 0.91; 95% CI, 0.84–0.98, for black; adjusted rate ratio, 0.83; 95% CI, 0.72–0.97 for Latinx). Female sex and age >75 years were also independently associated with lower rates of admission to the cardiology service. Admission to the cardiology service was independently associated with decreased readmission within 30 days, independent of race. Conclusions: Black and Latinx patients were less likely to be admitted to cardiology for HF care. This inequity may, in part, drive racial inequities in HF outcomes.

The experiment was designed to study the effects of butters differing in conjugated linoleic acid (CLA) and trans 18:1 contents on lipoproteins associated with the risk of atherogenesis. New Zealand White male rabbits (9.6 weeks; 2.1 kg) were assigned for 6 or 12 weeks to three diets (n = 6 per diet) made of conventional pellets with 0.2% cholesterol and with 12% fat provided from a butter poor in trans-10 and trans-11 18:1 and in CLA (standard group), or rich in trans-10 18:1 (trans-10 18:1 group) or rich in trans-11 18:1 and in cis-9,trans-11 CLA (trans-11 18:1/CLA group). Blood samples were collected at the end of dietary treatments. Lipoproteins were separated by gradient-density ultracentrifugation. Lipid classes were determined enzymatically and apolipoproteins A-I and B by radial immunodiffusion. Mainly in the 12-week rabbits, higher plasma triglycerides and apolipoprotein B levels shown in the standard and trans-10 18:1 groups compared with those in the trans-11 18:1/CLA group are associated with higher plasma levels of very low density lipoproteins (VLDL) and low density lipoproteins (LDL) also shown in these two groups. In the 12-week rabbits, a shift towards denser LDL, considered as more atherogenic, was shown only in the trans-10 18:1 group. In these animals, the VLDL + LDL to HDL ratio was 1.7-2.3 times higher in the trans-10 18:1 group than in the other groups (P = 0.076). These results suggest a rather neutral effect of trans-11 18:1/CLA butter towards the risk of atherogenesis, whereas trans-10 18:1 butter would tend to be detrimental.

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