D. Vasilopoulou

Dairy and cardiovascular health: friend or foe?

Cardiovascular disease (CVD) prevalence at a global level is predicted to increase substantially over the next decade due to the increasing ageing population and incidence of obesity. Hence, there is an urgent requirement to focus on modifiable contributors to CVD risk, including a high dietary intake of saturated fatty acids (SFA). As an important source of SFA in the UK diet, milk and dairy products are often targeted for SFA reduction. The current paper acknowledges that milk is a complex food and that simply focusing on the link between SFA and CVD risk overlooks the other beneficial nutrients of dairy foods. The body of existing prospective evidence exploring the impact of milk and dairy consumption on risk factors for CVD is reviewed. The current paper highlights that high milk consumption may be beneficial to cardiovascular health, while illustrating that the evidence is less clear for cheese and butter intake. The option of manipulating the fatty acid profile of ruminant milk is discussed as a potential dietary strategy for lowering SFA intake at a population level. The review highlights that there is a necessity to perform more well-controlled human intervention-based research that provides a more holistic evaluation of fat-reduced and fat-modified dairy consumption on CVD risk factors including vascular function, arterial stiffness, postprandial lipaemia and markers of inflammation. Additionally, further research is required to investigate the impact of different dairy products and the effect of the specific food matrix on CVD development.

Combined oral contraceptive pills containing desogestrel or drospirenone enhance large vessel and microvasculature vasodilation in healthy premenopausal women

Please cite this paper as: Thompson, Przemska, Vasilopoulou, Newens, and Williams (2011). Combined Oral Contraceptive Pills Containing Desogestrel or Drospirenone Enhance Large Vessel and Microvasculature Vasodilation in Healthy Premenopausal Women. Microcirculation 18(5), 339–346.

Effect of feeding high-oleic sunflower oil to dairy cows on the milk fatty acid profile – RESET study

O. Markey, K. E. Kliem, D. J. Humphries, R. Morgan, D. Vasilopoulou, A. Grandison, C. Fagan, S. Todd, K. G. Jackson, J. A. Lovegrove and D. I. Givens Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, Food Production and Quality Division and Department of Mathematics and Statistics, University of Reading, Reading, RG6 6AP

Plasma phospholipid fatty acid profile confirms compliance to a novel saturated fat-reduced, monounsaturated fat-enriched dairy product intervention in adults at moderate cardiovascular risk: a randomized controlled trial

BackgroundDairy products are a major contributor to dietary SFA. Partial replacement of milk SFA with unsaturated fatty acids (FAs) is possible through oleic-acid rich supplementation of the dairy cow diet. To assess adherence to the intervention of SFA-reduced, MUFA-enriched dairy product consumption in the RESET (REplacement of SaturatEd fat in dairy on Total cholesterol) study using 4-d weighed dietary records, in addition to plasma phospholipid FA (PL-FA) status.MethodsIn a randomised, controlled, crossover design, free-living UK participants identified as moderate risk for CVD (n = 54) were required to replace habitually consumed dairy foods (milk, cheese and butter), with study products with a FA profile typical of retail products (control) or SFA-reduced, MUFA-enriched profile (modified), for two 12-week periods, separated by an 8-week washout period. A flexible food-exchange model was used to implement each isoenergetic high-fat, high-dairy diet (38% of total energy intake (%TE) total fat): control (dietary target: 19%TE SFA; 11%TE MUFA) and modified (16%TE SFA; 14%TE MUFA).ResultsFollowing the modified diet, there was a smaller increase in SFA (17.2%TE vs. 19.1%TE; p < 0.001) and greater increase in MUFA intake (15.4%TE vs. 11.8%TE; p < 0.0001) when compared with the control. PL-FA analysis revealed lower total SFAs (p = 0.006), higher total cis-MUFAs and trans-MUFAs (both p < 0.0001) following the modified diet.ConclusionThe food-exchange model was successfully used to achieve RESET dietary targets by partial replacement of SFAs with MUFAs in dairy products, a finding reflected in the PL-FA profile and indicative of objective dietary compliance.Trial registrationClinicalTrials.gov Identifier: NCT02089035, date 05-01-2014.

Consumer acceptance of dairy products with a saturated fatty acid–reduced, monounsaturated fatty acid–enriched content

Agriculture-based reformulation initiatives, including oleic acid-rich lipid supplementation of the dairy cow diet, provide a novel means for reducing intake of saturated fatty acids (SFA) at a population level. In a blinded manner, this study evaluated the consumer acceptance of SFA-reduced, monounsaturated fatty acid-enriched (modified) milk, Cheddar cheese, and butter when compared with control and commercially available comparative samples. The effect of providing nutritional information about the modified cheese was also evaluated. Consumers (n = 115) rated samples for overall liking (appearance, flavor, and texture) using 9-point hedonic scales. Although no significant differences were found between the milk samples, the modified cheese was liked significantly less than a regular-fat commercial alternative for overall liking and liking of specific modalities and had a lower liking of texture score compared with the control cheese. The provision of health information significantly increased the overall liking of the modified cheese compared with tasting the same sample in a blinded manner. Significant differences were evident between the butter samples for overall liking and modalities of liking; all of the samples were significantly more liked than the commercial butter and sunflower oil spread. In conclusion, this study illustrated that consumer acceptance of SFA-reduced, monounsaturated fatty acid-enriched dairy products was dependent on product type. Future research should consider how optimization of the textural properties of fatty acid-modified (and fat-reduced) cheese might enhance consumer acceptance of this product.

Chronic consumption of conventional and saturated-fat reduced dairy products have differential effects on low-density lipoprotein cholesterol levels in adults at moderate cardiovascular disease risk

Reducing the intake of dietary saturated fatty acids (SFA) to ⩽10 % of total energy intake is a key public health strategy aimed at lowering current cardiovascular disease (CVD) incidence. Consumption of dairy products (including butter) represents approximately 35 % of total dietary SFA intake(1). Supplementation of the bovine diet with oleic acid-rich plant oil has been reported to depress SFA and increase cis-monounsaturated fatty acids levels in milk, providing a strategy to lower total dietary SFA intake (2). This human intervention study aimed to investigate whether consumption of SFA-reduced, compared with conventional dairy products, would impact on the fasting lipid profile, glucose and insulin concentrations of adults at moderate CVD risk. Fifty-four adults (mean age 53 (SD 13) years, BMI 26 (SD 3) kg/m2), completed a double blind, randomised, controlled 12-week cross-over study with an 8-week washout period between treatment arms. Participants replaced habitual dairy foods/snacks with SFA-reduced or conventional UHT milk, Cheddar cheese and butter (fatty acid (FA) composition of SFA-reduced vs. conventional dairy products: total SFA: -7·0 g/d, C18:1cis: 3·0 g/d, C18:1trans: 2·4 g/d), achieving an isoenergetic daily dietary exchange (41 g/d total fat). At the beginning and end of each treatment period, fasting blood samples were collected for biochemical analysis. LDL-C was estimated using the Friedewald formula. The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated using the glucose and insulin data.

Food chain approach to lowering the saturated fat of milk and dairy products

Lactating cow diets were supplemented with high‐oleic acid sunflower oil over two production periods spanning two years, to modify the milk fat, partially replacing saturated fatty acids with cis‐monounsaturated fatty acids. The resulting milk was used for ultrahigh‐temperature milk, butter and Cheddar cheese production, and fatty acid profiles were compared with those of conventionally produced products. Fat from products made with modified milk had lower saturated fatty acids and higher cis‐ and trans‐monounsaturated fatty acid concentrations than that of conventional products. This was consistent over both production periods, demonstrating that this food chain approach could be adopted on a wider scale.

Impact of chronic consumption of dairy products varying in fatty acid composition on postprandial lipid responses: preliminary insights from the RESET study

Impact of chronic consumption of dairy products varying in fatty acid composition on postprandial lipid responses: preliminary insights from the RESET study

A comparison of chronic consumption of dairy products varying in fatty acid composition on postprandial biomarkers of endothelial function: Results from the RESET study

D. Vasilopoulou, O. Markey, C.C. Fagan, K.E. Kliem, S. Todd, D.J. Humphries, K.G. Jackson2, D.I. Givens3 and J.A. Lovegrove Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, Institute for Food, Nutrition and Health, Department of Mathematics and Statistics, University of Reading, Reading, RG6 6AP and School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU

Postprandial lipid responses after long-term intake of dairy products varying in fatty acid composition [Abstract]

NMR metabolomic signatures reveal predictive plasma metabolites associated with long-term risk of developing breast cancer. IUNS 21st International Congress of NutritionBackground and objectives: The University of Southampton and International Malnutrition Task Force developed Malnutrition eLearning to reduce child mortality by Severe Acute Malnutrition (SAM) through training health professionals globally. Since made available in 2010, over 14,000 from 100+ countries used the course. To investigate its effectiveness, a 2-year evaluation study was conducted from 2015, face-to-face in Ghana and Central America (CA), and online in other countries.Methods: Using a mixed method approach, the study explored if and how Malnutrition eLearning supported knowledge gain and behavioural change (application of knowledge in clinical practice), and resulting clinical outcomes in the management of SAM. Assessments, questionnaires and interviews/focus groups were conducted with individual in-service and pre-service participants pre- and post-training, and 12 months of medical records data collection, observations and hospital personnel interviews were carried out from participating healthcare institutions.Results: Total 1,261 health professionals (Ghana:915, CA:142, other countries:201), and 10 hospitals and 2 community health centres in Ghana and 2 hospitals in CA participated in the study. 3,955 (pre:01/08/2014–31/07/2015) and 3,737 (post:01/08/2015– 31/07/2016) medical records of children (0-60 months) were collected from the hospitals, and summary data on malnutrition cases (pre:76, post:67) from community health centres. Individual participants scored significantly higher in the post assessment (mean difference(SD): 14.0(12.5), 95%CI(12.7, 15.2), p<0.001). 87% of in-service health professionals (102/117) applied their knowledge and changed clinical practice in screening, assessment, diagnosis and management of SAM. This group demonstrated retained knowledge 6-month after the training (mean difference from pre-assessment(SD): 12.7(11.7), 95%CI(10.4, 15.0),p<0.001). Significant increases (p<0.001) in recording malnutrition-markers, i.e. length/height and weight-for-length/ height z-score, and diagnosed SAM cases (pre: 491(12.4%), post: 810(21.7%)) were observed. Mortality by SAM was declined from 26(5.9%) to 14(1.9%) (p<0.001). The community centres initiated the management of SAM (pre:0/32, post:7/21).Conclusions: The results suggest that Malnutrition eLearning is effective in training the WHO guideline on the management of SAM. After a 2-day self-directed training with Malnutrition eLearning, the participants not only gained knowledge but were also able to apply the knowledge in their clinical practice, leading to significant impacts on clinical outcomes.Acknowledgement: This study was supported by the UK Department for International Development Nutrition Embedding Evaluation Programme, managed by PATH.This paper was presented at IUNS 21st International Congress of Nutrition, Buenos Aires, Argentina, 15-20 October. This is the peer-reviewed but unedited manuscript version of the following article: MARKEY, O. ...et al., 2017. Postprandial lipid responses after long-term intake of dairy products varying in fatty acid composition. Annals of Nutrition and Metabolism, 71 (Suppl 2), pp. 346 (DOI: 10.1159/000480486). The final, published version is available at https://doi.org/10.1159/000480486