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Guidelines for Endothelial Testing

Fatty acid-modified dairy vs. conventional dairy and endothelial function (full-text)

Am J Clin Nutr 2022 Jan 10; nqab428. 
Effect of fat reformulated dairy food consumption on postprandial flow-mediated dilatation and cardiometabolic risk biomarkers compared with conventional dairy: a randomized, controlled trial
Oonagh Markey 1, Dafni Vasilopoulou 1, Kirsty E Kliem 2 3, Colette C Fagan 1 3, Alistair S Grandison 1, Rachel Sutton 1, David J Humphries 1 3, Susan Todd 4, Kim G Jackson 1 3, David I Givens 3, Julie A Lovegrove 1 3
  • 1 Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom.
  • 2 Animal, Dairy, and Food Chain Sciences, University of Reading, Reading, United Kingdom.
  • 3 Institute for Food, Nutrition, and Health, University of Reading, Reading, United Kingdom.
  • 4 Department of Mathematics and Statistics, University of Reading, Reading, United Kingdom.
Background: Longer-term consumption of saturated fatty acid (SFA)-reduced, monounsaturated fatty acid (MUFA)-enriched dairy products have been reported to improve fasting flow-mediated vasodilation (FMD). Yet, their impact on endothelial function in the postprandial state warrants investigation.
Objectives: To compare the impact of a fatty acid (FA)-modified with a conventional (control) dairy diet on the postprandial %FMD (primary outcome) and systemic cardiometabolic responses to representative meals, and retrospectively explore whether treatment effects differ by apolipoprotein (APO)E or endothelial nitric oxide synthase (eNOS) Glu298Asp gene polymorphisms.
Methods: In a crossover-design randomized controlled study, 52 adults with moderate cardiovascular disease risk consumed dairy products [38% total energy intake (%TE) from fat: FA-modified (target: 16%TE SFAs; 14%TE MUFAs) or control (19%TE SFAs; 11%TE MUFAs)] for 12-wk, separated by an 8-wk washout. Blood sampling and FMD measurements (0-480 min) were performed pre- and post-intervention after sequential mixed meals that were representative of the assigned dairy diets (0 min; ∼50 g fat; 330 min; ∼30 g fat).
Results: Relative to pre-intervention (∆), the FA-modified dairy diet and meals (treatment) attenuated the increase in the incremental AUC (iAUC), but not AUC, for the %FMD response observed with the conventional treatment (-135 ± 69 vs + 199 ± 82% x min; P = 0.005). The ∆ iAUC, but not AUC, for the apoB response decreased after FA-modified yet increased after the conventional treatment (-4 ± 3 vs + 3 ± 3 mg/mL × min; P = 0.004). The ∆ iAUC decreased for total plasma SFAs (P = 0.003) and trans 18:1 (P < 0.0001) and increased for cis-MUFAs (P < 0.0001) following conventional, relative to the FA-modified treatment. No treatment x APOE- or eNOS-genotype interactions were evident for any outcome.
Conclusions: This study provides novel insights into the longer-term effects of FA-modified dairy food consumption on postprandial cardiometabolic responses.
© The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.
Fig.1 ) Nutritional composition of the sequential high-fat mixed test breakfast (0 min) and lunch meals (330 min) that incorporated the fatty acid–modified or conventional (control) dairy products
1Values are total energy and macronutrient quantities of each test meal according to modified and control diet. CHO, carbohydrate; FA, fatty acid; TFA, trans fatty acid.
2Measurement of energy, total fat, protein, and carbohydrate content of the dairy product samples was conducted in duplicate by SGS UK Ltd. (Ealing, London; ISO 17,025 accredited laboratory).
3Lipids extracted from the dairy product samples were analyzed in triplicate for FA composition by GC–flame ionization detection using a standardized procedure, as described previously.
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