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

Oonagh Markey, Dafni Vasilopoulou, Kirsty E Kliem, Albert Koulman, Colette C Fagan, Keith Summerhill, Laura Y Wang, Alistair S Grandison, David J Humphries, Susan Todd, Kim G Jackson, David I Givens, Julie A Lovegrove, Oonagh Markey, Dafni Vasilopoulou, Kirsty E Kliem, Albert Koulman, Colette C Fagan, Keith Summerhill, Laura Y Wang, Alistair S Grandison, David J Humphries, Susan Todd, Kim G Jackson, David I Givens, Julie A Lovegrove

Abstract

Background: Dairy 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.

Methods: In 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).

Results: Following 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.

Conclusion: The 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 registration: ClinicalTrials.gov Identifier: NCT02089035 , date 05-01-2014.

Keywords: Cardiovascular disease; Dairy products; Dietary fat composition; Fatty acids; Food-exchange model; Monounsaturated fatty acids; Nutrition assessment; Phospholipids; Saturated fatty acids.

Figures

Fig. 1
Fig. 1
Flow of participants through the different stages of the RESET study
Fig. 2
Fig. 2
Change-from-baseline in the plasma phospholipid profile of SFA: 16 : 0 (a) and MUFAs: 18 : 1cis-9 and 18 : 1trans-9 (b) following 12-week diets that incorporated control and modified dairy products. Values are means ± SEM, n = 54. Significance shown as * p <0.001, ** p < 0.0001
Fig. 3
Fig. 3
Orthogonal PLS-DA, score plots at baseline (a) and post-intervention (b) calculated using plasma phospholipid FA concentrations in adults at moderate risk of cardiovascular disease (n = 54). FA, fatty acid; PLS-DA, partial least squares discriminant analysis

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