Consumption of regular-fat vs reduced-fat cheese reveals gender-specific changes in LDL particle size - a randomized controlled trial.

BACKGROUND: Regular-fat cheese does not seem to increase low density lipoprotein cholesterol (LDL-C) concentrations compared to reduced-fat cheese. However, plasma LDL-C concentrations do not reflect levels and size of LDL particles, which might be a better predictor of cardiovascular risk. METHODS: The aim was to compare the effects of regular-fat cheese vs reduced-fat cheese and carbohydrate-rich foods on LDL particle size distribution in adults with ≥ 2 metabolic syndrome (MetS) risk factors. The study was part of a 12 weeks' randomized controlled trial in which subjects had been randomly allocated to 1 of 3 intervention groups; regular-fat cheese (REG), reduced-fat cheese (RED) or a no-cheese/carbohydrate (CHO) group. Subjects in the REG and RED groups consumed 80 g cheese/d per 10 MJ, whereas subjects in the CHO consumed bread and jam corresponding to 90 g/d and 25 g/d per 10 MJ, respectively. Fasting blood samples at wk. 0 (baseline) and wk. 12 were analyzed for LDL particle size distribution and cholesterol content using nuclear magnetic resonance (NMR) spectroscopy. RESULTS: A total of 85 subjects [mean ± SD age: 54.0 ± 12.8 y; BMI: 28.7 ± 3.6 kg/m2] completed the study. Overall, regular-fat cheese did not impact lipoprotein particle number and size differently than reduced-fat cheese. In men (n = 23), the REG diet decreased total LDL particle number (LDL-P, - 223.2 ± 91.1 nmol/l, P = 0.01) compared with the RED diet. The reduction was primarily in the medium-sized LDL fraction (- 128.5 ± 51.8 nmol/l, P = 0.01). In women (n = 62), the REG diet increased the concentration of cholesterol in the small high density lipoprotein (HDL) particles compared with the CHO diet (2.9 ± 1.0 mg/dl, P = 0.006). CONCLUSION: Overall, regular-fat cheese did not alter LDL particle size distribution compared to reduced-fat cheese after a 12 wk. intervention in subjects with ≥2 MetS risk factors. However, our results suggest that lipoprotein response to cheese intake is gender-specific. This warrants further investigation. TRIAL REGISTRATION: This trial was registered at Clinicaltrials.gov as NCT0261471. Registered 30 November 2015 - Retrospectively registered.

High intake of regular-fat cheese compared with reduced-fat cheese does not affect LDL cholesterol or risk markers of the metabolic syndrome: a randomized controlled trial.

BACKGROUND: Regular-fat cheese contains a high amount of saturated fat. Therefore, dietary guidelines in many countries recommend the consumption of reduced-fat cheese as opposed to regular-fat cheese. However, the negative effect of regular-fat cheese is still under debate. OBJECTIVES: The aim was to compare the effects of regular-fat cheese with an equal amount of reduced-fat cheese and an isocaloric amount of carbohydrate-rich foods on LDL cholesterol and risk factors for the metabolic syndrome (MetS). DESIGN: The study was a 12-wk randomized parallel intervention preceded by a 2-wk run-in period. A total of 164 subjects with ≥2 MetS risk factors were randomly allocated to 1 of 3 intervention groups: regular-fat cheese (REG), reduced-fat cheese (RED), or a no-cheese, carbohydrate control (CHO) group. Subjects in the REG and RED groups replaced part of their daily habitual diet with 80 g cheese/10 MJ, whereas subjects in the CHO group did the same with bread and jam corresponding to 90 g and 25 g/10 MJ, respectively. RESULTS: A total of 139 subjects completed the intervention. The primary outcome, LDL cholesterol, was not significantly different between the REG and RED diets or between the REG and CHO diets. There was no significant difference in HDL cholesterol between the REG and RED diets, but HDL cholesterol tended to be higher with the REG diet than with the CHO diet (0.06 ± 0.03 mmol/L; P = 0.07). Insulin, glucose, and triacylglycerol concentrations as well as blood pressure and waist circumference did not differ significantly between the 3 diets. CONCLUSION: A high daily intake of regular-fat cheese for 12 wk did not alter LDL cholesterol or MetS risk factors differently than an equal intake of reduced-fat cheese or an isocaloric amount of carbohydrate-rich foods. This trial was registered at www.clinicaltrials.gov as NCT02616471.

Diets with high-fat cheese, high-fat meat, or carbohydrate on cardiovascular risk markers in overweight postmenopausal women: a randomized crossover trial.

BACKGROUND: Heart associations recommend limited intake of saturated fat. However, effects of saturated fat on low-density lipoprotein (LDL)-cholesterol concentrations and cardiovascular disease risk might depend on nutrients and specific saturated fatty acids (SFAs) in food. OBJECTIVE: We explored the effects of cheese and meat as sources of SFAs or isocaloric replacement with carbohydrates on blood lipids, lipoproteins, and fecal excretion of fat and bile acids. DESIGN: The study was a randomized, crossover, open-label intervention in 14 overweight postmenopausal women. Three full-diet periods of 2-wk duration were provided separated by 2-wk washout periods. The isocaloric diets were as follows: 1) a high-cheese (96-120-g) intervention [i.e., intervention containing cheese (CHEESE)], 2) a macronutrient-matched nondairy, high-meat control [i.e., nondairy control with a high content of high-fat processed and unprocessed meat in amounts matching the saturated fat content from cheese in the intervention containing cheese (MEAT)], and 3) a nondairy, low-fat, high-carbohydrate control (i.e., nondairy low-fat control in which the energy from cheese fat and protein was isocalorically replaced by carbohydrates and lean meat (CARB). RESULTS: The CHEESE diet caused a 5% higher high-density lipoprotein (HDL)-cholesterol concentration (P = 0.012), an 8% higher apo A-I concentration (P < 0.001), and a 5% lower apoB:apo A-I ratio (P = 0.008) than did the CARB diet. Also, the MEAT diet caused an 8% higher HDL-cholesterol concentration (P < 0.001) and a 4% higher apo A-I concentration (P = 0.033) than did the CARB diet. Total cholesterol, LDL cholesterol, apoB, and triacylglycerol were similar with the 3 diets. Fecal fat excretion was 1.8 and 0.9 g higher with the CHEESE diet than with CARB and MEAT diets (P < 0.001 and P = 0.004, respectively) and 0.9 g higher with the MEAT diet than with the CARB diet (P = 0.005). CHEESE and MEAT diets caused higher fecal bile acid excretion than did the CARB diet (P < 0.05 and P = 0.006, respectively). The dominant type of bile acids excreted differed between CHEESE and MEAT diets. CONCLUSIONS: Diets with cheese and meat as primary sources of SFAs cause higher HDL cholesterol and apo A-I and, therefore, appear to be less atherogenic than is a low-fat, high-carbohydrate diet. Also, our findings confirm that cheese increases fecal fat excretion. This trial was registered at clinicaltrials.gov as NCT01739153.