Comparison of the impact of SFAs from cheese and butter on cardiometabolic risk factors: a randomized controlled trial

Abstract

Controversies persist concerning the association between intake of dietary saturated fatty acids (SFAs) and cardiovascular disease risk. We compared the impact of consuming equal amounts of SFAs from cheese and butter on cardiometabolic risk factors. In a multicenter, crossover, randomized controlled trial, 92 men and women with abdominal obesity and relatively low HDL-cholesterol concentrations were assigned to sequences of 5 predetermined isoenergetic diets of 4 wk each separated by 4-wk washouts: 2 diets rich in SFAs (12.4-12.6% of calories) from either cheese or butter; a monounsaturated fatty acid (MUFA)-rich diet (SFAs: 5.8%, MUFAs: 19.6%); a polyunsaturated fatty acid (PUFA)-rich diet (SFAs: 5.8%, PUFAs: 11.5%); and a low-fat, high-carbohydrate diet (fat: 25%, SFAs: 5.8%). Serum HDL-cholesterol concentrations were similar after the cheese and butter diets but were significantly higher than after the carbohydrate diet (+3.8% and +4.7%, respectively; < 0.05 for both). LDL-cholesterol concentrations after the cheese diet were lower than after the butter diet (-3.3%, < 0.05) but were higher than after the carbohydrate (+2.6%), MUFA (+5.3%), and PUFA (+12.3%) diets ( < 0.05 for all). LDL-cholesterol concentrations after the butter diet also increased significantly (from +6.1% to +16.2%, < 0.05) compared with the carbohydrate, MUFA, and PUFA diets. The LDL-cholesterol response to treatment was significantly modified by baseline values (-interaction = 0.02), with the increase in LDL cholesterol being significantly greater with butter than with cheese only among individuals with high baseline LDL-cholesterol concentrations. There was no significant difference between all diets on inflammation markers, blood pressure, and insulin-glucose homeostasis. The results of our study suggest that the consumption of SFAs from cheese and butter has similar effects on HDL cholesterol but differentially modifies LDL-cholesterol concentrations compared with the effects of carbohydrates, MUFAs, and PUFAs, particularly in individuals with high LDL cholesterol. In contrast, SFAs from either cheese or butter have no significant effects on several other nonlipid cardiometabolic risk factors. This trial was registered at clinicaltrials.gov as NCT02106208.

Saturated Fatty Acids and Cardiovascular Disease: Replacements for Saturated Fat to Reduce Cardiovascular Risk

“…In a five-period, randomized controlled, crossover trial, the effect of consuming equal amounts of SFA from cheese (32% of energy from fat; 12.6% of energy from SFA) and butter (32% of energy from fat; 12.4% of energy from SFA) was compared to diets rich in MUFA (32% of energy from fat; 5.8% of energy from SFA; 19.6% of energy from MUFA), PUFA (32% of energy from fat; 5.8% of energy from SFA; 11.5% of energy from PUFA) and carbohydrate (58.9% of energy from carbohydrate, 25% of energy from fat; 5.8% of energy from SFA) [38]. After 4 weeks, total cholesterol and LDL cholesterol were significantly higher with the butter and cheese diets compared to the MUFA, PUFA and carbohydrate diets.…”

Serum low‐density lipoprotein as a dietary responsive biomarker of cardiovascular disease risk: Consensus and confusion

“…Secondly, the effect is confounded by the nature of the foods that contain the SFA, as the effect of SFA on LDL‐C varies between different foods; for example the lesser effects of SFA on LDL‐C in fermented dairy foods, such as cheese, relative to butter (Brassard et al . ). Thirdly, specific SFA have different effects on serum LDL‐C.…”

“…It is possible that the combination of these positive and negative effects explain the net finding of there being no association between of SFA and CVD mortality. Secondly, the effect is confounded by the nature of the foods that contain the SFA, as the effect of SFA on LDL-C varies between different foods; for example the lesser effects of SFA on LDL-C in fermented dairy foods, such as cheese, relative to butter (Brassard et al 2017). Thirdly, specific SFA have different effects on serum LDL-C.…”

Use of starch‐based fat replacers in foods as a strategy to reduce dietary intake of fat and risk of metabolic diseases

“…For instance, the randomized full-feeding crossover clinical trial with 92 women and men conducted between Laval University and University of Manitoba aimed to investigate the effects of consuming dairy saturated fat on cardiometabolic risk factors compared to the effects of carbohydrates and unsaturated fats (Brassard et al, 2017). For instance, the randomized full-feeding crossover clinical trial with 92 women and men conducted between Laval University and University of Manitoba aimed to investigate the effects of consuming dairy saturated fat on cardiometabolic risk factors compared to the effects of carbohydrates and unsaturated fats (Brassard et al, 2017).…”

“…For instance, the randomized full-feeding crossover clinical trial with 92 women and men conducted between Laval University and University of Manitoba aimed to investigate the effects of consuming dairy saturated fat on cardiometabolic risk factors compared to the effects of carbohydrates and unsaturated fats (Brassard et al, 2017). Findings from the study showed that serum TC, LDL-C, and high-density lipoprotein cholesterol (HDL-C) levels were significantly reduced in 92 subjects when 6% energy from dairy fat was isocalorically replaced by carbohydrates (Brassard et al, 2017). Each of the treatments lasted for 4 weeks, followed by a 4-week washout period (Babu, Parimalavalli, & Mohan, 2018).…”