Saturated Fat and Cardiovascular Diseases: The Role of Milk Products in Reducing Risk
Arne Vernon Astrup, MD, DSc
Chairman, Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen; Director, Danish Nordea Foundation, OPUS Research Centre
Current dietary recommendations advocate reducing saturated fatty acid intake to decrease the risk of cardiovascular disease. However, a growing body of evidence suggests that milk products, including cheese, may reduce cardiovascular disease risk despite their saturated fatty acid content.
Highlights:
|
Saturated fat and cardiovascular disease risk
The evidence from epidemiological, clinical and mechanistic studies is consistent in finding that coronary heart disease risk is modestly reduced when polyunsaturated fatty acids replace saturated fatty acids.1 However, there is no evidence of any benefit in substituting carbohydrates or monounsaturated fatty acids for saturated fatty acids,1 and there is no clear association between saturated fatty acid intake, insulin resistance and diabetes risk.1
Milk fat and cardiovascular disease risk
In a recent U.S. prospective cohort study, higher trans-palmitoleate levels, found in full-fat dairy, were associated with a three-fold reduction in the incidence of type 2 diabetes ( ptrend <0.001) as well as significantly lower C-reactive protein levels and insulin resistance.2
Another recent prospective study showed that biomarkers of milk fat were significantly inversely related to a first myocardial infarction in women (with a similar trend in men) and also found an inverse association between myocardial infarction and reported intakes of cheese (in both men and women) and fermented milk (only in men).3
Focus on food
Recent research emphasizes the fact that the overall effect of a food on cardiovascular disease risk cannot be assessed by its content of saturated fat.1 Several observational studies suggest that cheese protects against cardiovascular disease, and experimental studies show that cheese consumption does not produce the effects on blood lipids that would be expected from its saturated fatty acid content. Lorenzen et al. have shown that this phenomenon is partly explained by the high calcium content of cheese. Foods high in saturated fatty acids that are also high in calcium not only do not produce the expected increases in LDL cholesterol but do produce a beneficial increase in HDL cholesterol.4
These data are supported by two recent meta-analyses indicating that milk-product intake is associated with a reduced risk of cardiovascular disease5,6 and type 2 diabetes.5
References
- Astrup A et al. The role of reducing intake of saturated fat in the prevention of cardiovascular disease: where does the evidence stand in 2010? Am J Clin Nutr 2011;doi: 10.3945/ajcn.110.004622.
- Mozaffarian D et al. Trans-palmitoleic acid, metabolic risk factors, and new-onset diabetes in U.S. adults. A cohort study. Ann Intern Med 2010;153:790-799.
- Warensjö E et al. Biomarkers of milk fat and the risk of myocardial infarction in men and women: a prospective, matched case-control study. Am J Clin Nutr 2010;92:194–202.
- Lorenzen JK and Astrup A. Dairy calcium intake modifies responsiveness of fat metabolism and blood lipids to a high-fat diet. Br J Nutr (in press).
- Elwood PC et al. The survival advantage of milk and dairy consumption: an overview of evidence from cohort studies of vascular diseases, diabetes and cancer. J Am Coll Nutr 2008;27(6):723S-734S.
- Soedamah-Muthu SS et al. Milk and dairy consumption and incidence of cardiovascular diseases and all-cause mortality: dose-response meta-analysis of prospective cohort studies. Am J Clin Nutr doi: 10.3945/ajcn.2010.29866.
Keywords: Saturated fat , cardiovascular disease , type 2 diabetes
