用不饱和脂肪部分替代乳制品中的饱和脂肪的配方改革可降低 LDL 胆固醇的升高幅度，并改善血流介导的扩张，与常规乳制品相比：随机对照的乳制品中饱和脂肪替代总胆固醇（RESET）研究。
Reformulation initiative for partial replacement of saturated with unsaturated fats in dairy foods attenuates the increase in LDL cholesterol and improves flow-mediated dilatation compared with conventional dairy: the randomized, controlled REplacement of SaturatEd fat in dairy on Total cholesterol (RESET) study.
机构信息
Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom.
Animal, Dairy and Food Chain Sciences, University of Reading, Reading, United Kingdom.
出版信息
Am J Clin Nutr. 2020 Apr 1;111(4):739-748. doi: 10.1093/ajcn/nqz344.
BACKGROUND
Modifying dairy fat composition by increasing the MUFA content is a potential strategy to reduce dietary SFA intake for cardiovascular disease (CVD) prevention in the population.
OBJECTIVES
To determine the effects of consuming SFA-reduced, MUFA-enriched (modified) dairy products, compared with conventional dairy products (control), on the fasting cholesterol profile (primary outcome), endothelial function assessed by flow-mediated dilatation (FMD; key secondary outcome), and other cardiometabolic risk markers.
METHODS
A double-blind, randomized, controlled crossover 12-wk intervention was conducted. Participants with a 1.5-fold higher (moderate) CVD risk than the population mean replaced habitual dairy products with study products (milk, cheese, and butter) to achieve a high-fat, high-dairy isoenergetic daily dietary exchange [38% of total energy intake (%TE) from fat: control (dietary target: 19%TE SFA; 11%TE MUFA) and modified (16%TE SFA; 14%TE MUFA) diet].
RESULTS
Fifty-four participants (57.4% men; mean ± SEM age: 52 ± 3 y; BMI: 25.8 ± 0.5 kg/m2) completed the study. The modified diet attenuated the rise in fasting LDL cholesterol observed with the control diet (0.03 ± 0.06 mmol/L and 0.19 ± 0.05 mmol/L, respectively; P = 0.03). Relative to baseline, the %FMD response increased after the modified diet (0.35% ± 0.15%), whereas a decrease was observed after the control diet (-0.51% ± 0.15%; P< 0.0001). In addition, fasting plasma nitrite concentrations increased after the modified diet, yet decreased after the control diet (0.02 ± 0.01 μmol/L and -0.03 ± 0.02 μmol/L, respectively; P = 0.01).
CONCLUSIONS
In adults at moderate CVD risk, consumption of a high-fat diet containing SFA-reduced, MUFA-enriched dairy products for 12 wk showed beneficial effects on fasting LDL cholesterol and endothelial function compared with conventional dairy products. Our findings indicate that fatty acid modification of dairy products may have potential as a public health strategy aimed at CVD risk reduction. This trial was registered at clinicaltrials.gov as NCT02089035.
背景
通过增加 MUFA 含量来改变乳脂组成是减少人群中 SFA 摄入量以预防心血管疾病（CVD）的一种潜在策略。
目的
确定与常规乳制品（对照）相比，食用 SFA 减少、MUFA 富集（改良）乳制品对空腹胆固醇谱（主要终点）、血流介导的扩张（FMD）评估的内皮功能（关键次要终点）和其他心血管代谢风险标志物的影响。
方法
进行了一项为期 12 周的双盲、随机、对照交叉干预研究。参与者的 CVD 风险比人群平均水平高出 1.5 倍，他们用研究产品（牛奶、奶酪和黄油）代替习惯性乳制品，以实现高脂肪、高乳制品的等能量日常饮食交换[总能量摄入的 38%来自脂肪：对照（饮食目标：19%TE SFA；11%TE MUFA）和改良（16%TE SFA；14%TE MUFA）饮食]。
结果
54 名参与者（57.4%为男性；平均±SEM 年龄：52±3 岁；BMI：25.8±0.5 kg/m2）完成了研究。与对照饮食相比，改良饮食降低了空腹 LDL 胆固醇的升高（分别为 0.03±0.06 mmol/L 和 0.19±0.05 mmol/L；P=0.03）。与基线相比，改良饮食后 FMD 反应百分比增加（0.35%±0.15%），而对照饮食后则减少（-0.51%±0.15%；P<0.0001）。此外，改良饮食后血浆硝酸盐浓度升高，而对照饮食后降低（分别为 0.02±0.01 μmol/L 和-0.03±0.02 μmol/L；P=0.01）。
结论
在患有中度 CVD 风险的成年人中，12 周内食用富含 MUFA、SFA 减少的高脂肪乳制品与常规乳制品相比，对空腹 LDL 胆固醇和内皮功能有有益影响。我们的研究结果表明，乳制品的脂肪酸修饰可能具有作为降低 CVD 风险的公共卫生策略的潜力。该试验在 clinicaltrials.gov 上注册为 NCT02089035。
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