Dairy intake revisited - associations between dairy intake and lifestyle related cardio-metabolic risk factors in a high milk consuming population

Association between cheese consumption but not other dairy products and lower obesity risk in adults

INTRODUCTION

Some studies have associated dairy consumption with a lower risk of obesity. However, these studies are concentrated in developed countries with high dairy consumption. In developing countries, the evidence is scarce. This study aimed to evaluate the association between the consumption of different types of dairy products and obesity in Chilean adults.

MATERIALS AND METHODS

A cross-sectional study, stratified by sex and age, was carried out using a validated online survey to assess the consumption of dairy products among adults living in Chile. Dairy product consumption was then classified into tertiles. Obesity was determined based on self-reported body mass index (BMI) ≥ 30 kg/m2. Logistic regression models were used to assess the association between dairy consumption and obesity, adjusting for several confounding variables.

RESULTS

In total, 2008 participants were included in the analyses. Forty-seven percent, 39% and 14% belonged to the <35 years, 35-60 years, and ≥60-year groups, respectively. 55% were female, 86% had a low-medium socioeconomic level. Cow-derived cheese, milk, and yogurt were the most commonly consumed dairy products. Obese participants had a lower total consumption of dairy products (17.1%) than normal-weight subjects (25.7%, p<0.05). Higher cheese intake was significantly associated with a lower obesity risk (ORadj: 0.70; 95%CI 0.51-0.96, p<0.05). Other types of dairy products and total consumption of dairy products were not significantly associated.

DISCUSSION AND CONCLUSIONS

Habitual cheese consumption, but not other dairy products, was associated with a lower risk of obesity in this sample of Chilean adults.

Dairy products and hypertension: Cross-sectional and prospective associations

BACKGROUND

The association between dairy intake and prevalence or incidence of hypertension remains controversial. We aimed to investigate the association between intake of different dairy products and prevalence and incidence of hypertension in a community-dwelling sample.

METHODS

Three cross-sectional studies (2009-12, 2014-17 and 2018-21) and one prospective study (2009-12 to 2018-21) were conducted in Lausanne, Switzerland. Dietary intake was assessed via a validated food frequency questionnaire. Dairy consumption was compared between participants with and without prevalent or incident hypertension.

RESULTS

For the cross-sectional analyses, data from 4437 (2009-12, 54.0% women, 57.7 ± 10.5 years), 2925 (2014-17, 53.4% women, 62.5 ± 10.0 years), and 2144 (2018-21; 53.3% women, 65.5 ± 9.6 years) participants were used. No consistent differences between participants with and without hypertension were found for all dairy products (total dairy, milk, yogurt, cheese, low-fat dairy, and full-fat dairy) although participants with hypertension tended to consume less cheese (51 ± 1 vs. 55 ± 1, p = 0.014, 52 ± 1 vs. 56 ± 1, p = 0.053, and 54 ± 1 vs. 56 ± 1 g/day for 2009-12, 2014-17 and 2018-21, respectively). For the prospective study, data from 2303 participants (60.8% women, 53.9 ± 9.0 years) were used. Irrespective of the dairy product considered, no association was found between quartiles of dairy consumption and development of hypertension. Similar findings were obtained after stratifying on dietary quality.

CONCLUSION

In this population-based study, no association was found between the consumption of different dairy products and the prevalence or incidence of hypertension.

Full-fat dairy products and cardiometabolic health outcomes: Does the dairy-fat matrix matter?

Reducing dairy fat intake is a common dietary guideline to limit energy and saturated fatty acid intake for the promotion of cardiometabolic health. However, research utilizing a holistic, food-based approach to assess the consumption of the fat found in dairy, a broad and diverse food group, may provide new insight into these guidelines. Dairy fat is comprised of a diverse assembly of fatty acids, triacylglycerols, sterols, and phospholipids, all uniquely packaged in a milk fat globule. The physical structure of this milk fat globule and its membrane is modified through different processing methods, resulting in distinctive dairy-fat matrices across each dairy product. The objectives of this narrative review were to first define and compare the dairy-fat matrix in terms of its unique composition, physical structure, and fat content across common dairy products (cow's milk, yogurt, cheese, and butter). With this information, we examined observational studies and randomized controlled trials published within the last 10 years (2013-2023) to assess the individual effects of the dairy-fat matrix in milk, yogurt, cheese, and butter on cardiometabolic health and evaluate the implications for nutrition guidance. Searches conducted on Ovid MEDLINE and PubMed® utilizing search terms for cardiometabolic health, both broadly and regarding specific disease outcomes and risk factors, yielded 59 studies that were analyzed and included in this review. Importantly, this review stratifies by both dairy product and fat content. Though the results were heterogeneous, most studies reported no association between intake of these individual regular-fat dairy products and cardiometabolic outcome measures, thus, the current body of evidence suggests that regular-fat dairy product consumption may be incorporated within overall healthy eating patterns. Research suggests that there may be a beneficial effect of regular-fat milk and yogurt intake on outcome measures related to body weight and composition, and an effect of regular-fat cheese intake on outcome measures related to blood lipids, but more research is necessary to define the directionality of this relationship. Lastly, we identify methodological research gaps and propose future research directions to bolster the current evidence base available for ascertaining the role of dairy fat in a healthy diet.

Associations between ultraprocessed and minimally processed snacks consumption and overweight/obesity among college students in South Florida

OBJECTIVE

Evaluate the association between ultraprocessed and minimally processed snack consumption and overweight/obesity among college students.

PARTICIPANTS

College students.

METHODS

Cross-sectional study. Participants completed an online survey with questions on socio-demographics, beverages and snacks consumption, and weight status. ANCOVA and logistic regression was used; analyses were adjusted for age, sex, race/ethnicity, physical activity, and sleep duration.

RESULTS

A total of 435 students completed all questions in the survey. Most students were female (73.3%), Hispanics (61.1%), had a mean age of 24.7-year old and 40% had overweight/obesity. Those with overweight/obesity also had higher odds of consuming soft drinks in higher frequency and quantity than those without overweight/obesity (p < .05). Never consuming unsweetened yogurt/cheese and lower frequency and consumption of fruits were associated with higher odds of overweight/obesity (p < .05).

CONCLUSION

Higher frequency and consumption of soft drinks while lower frequency and consumption of unsweetened yogurt/cottage cheese and fruits were associated with overweight/obesity.

Dairy products and constituents: a review of their effects on obesity and related metabolic diseases

Obesity has become a global public health problem that seriously affects the quality of life. As an important part of human diet, dairy products contain a large number of nutrients that are essential for maintaining human health, such as proteins, peptides, lipids, vitamins, and minerals. A growing number of epidemiological investigations provide strong evidence on dairy interventions for weight loss in overweight/obese populations. Therefore, this paper outlines the relationship between the consumption of different dairy products and obesity and related metabolic diseases. In addition, we dive into the mechanisms related to the regulation of glucose and lipid metabolism by functional components in dairy products and the interaction with gut microbes. Lastly, the role of dairy products on obesity of children and adolescents is revisited. We conclude that whole dairy products exert more beneficial effect than single milk constituent on alleviating obesity and that dairy matrix has important implications for metabolic health.

Association of milk consumption with management and incidence of hypertension among South Korean adults: A prospective analysis of the health examinees study cohort

BACKGROUND AND AIMS

Studies have revealed a positive relationship between milk consumption and hypertension. However, few researchers have investigated the association between milk consumption and changes in blood pressure (BP) in South Korean adults. Therefore, we examined the association between milk intake and the management and risk of hypertension in South Korean adults.

METHODS AND RESULTS

Participants were selected from the Health Examinees study. The definition of hypertension was based on the guidelines of the Korean Society of Hypertension. The participants were divided into three groups according to changes between baseline and follow-up BP data. Milk consumption was assessed using food frequency questionnaires. In both men and women, the higher milk consumption group had increased odds of trends of BP improvement (OR: 1.249, 95% CI: 1.043-1.496, p for trend: 0.2271 in men; OR: 1.147, 95% CI: 1.014-1.297, p for trend: 0.0293 in women) and decreased odds of trends of worsening (OR: 0.861, 95% CI: 0.756-0.980, p for trend: <0.0001 in men, OR: 0.866, 95% CI: 0.794-0.943, p for trend: 0.0010 in women) compared to those of the non-consumption group. In the prospective study, milk intake was inversely associated with hypertension risk (HR: 0.900, 95% CI: 0.811-0.999, p for trend: 0.0076 in men; HR: 0.879, 95% CI: 0.814-0.949, p for trend: 0.0002 in women).

CONCLUSION

Increased intake of milk was inversely related to the risk of increased BP, with a decreased risk of hypertension events.

The independent and combined effects of single-child status and ideal lifestyle on clustered cardio-metabolic risk factors among Chinese children and adolescents

Background

Cardio-metabolic risk factors (CMRFs) represent the accumulation of metabolic abnormalities, significantly increasing the likelihood of cardiovascular diseases. Although studies assessed the independent association of single-child status and lifestyle risk factors with components of CMRFs or clustered CMRFs, little has been known about the combined effect of single-child status and lifestyles on clustered CMRFs as well as sex differences.

Materials and methods

Data was collected from a cross-sectional survey conducted in September 2013 in China. A total of 13,859 children and adolescents aged 7–18 years with blood samples were included. Anthropometric measurements and serum biochemical indexes were collected to assess clustered CMRFs, while questionnaires were used to obtain single-child status, lifestyle information, and characteristics of children and their parents. Mixed effect logistic regression was applied to analyze the independent and the combined effects of single-child status and ideal lifestyle category on clustered CMRFs.

Results

The prevalence of clustered CMRFs was 3.4%, with a higher prevalence in boys (4.0%) than girls (2.7%). Children and adolescents with clustered CMRFs had a higher proportion of single children (76.6 vs. 69.7%) and unfavorable lifestyles (62.1 vs. 29.2%) compared with their peers with non-clustered CMRFs. Both single children (OR = 1.67, 95% CI: 1.32–2.11) and unfavorable lifestyles (OR = 9.03, 95% CI: 6.26–13.02) were associated with an increased risk of clustered CMRFs. The risk of clustered CMRFs increased significantly (OR = 12.79, 95% CI: 6.67–24.52) when single children and an unfavorable lifestyle were combined, which was almost neutralized (OR = 1.33, 95% CI: 0.63–2.82) when single children adhered to a favorable lifestyle. However, no sex differences were observed in this study.

Conclusion

Single children with unfavorable lifestyles were associated with an obvious risk of clustered CMRFs, which might be partially offset by expanding family size (the number of siblings) or establishing a favorable lifestyle. A birth-friendly social environment as well as a family environment with a favorable lifestyle are encouraged in China.

Relationship between Dietary Habits and Control of Lipid Profiles in Patients with Dyslipidemia Using Pravastatin

We investigated the association between dietary habits, evaluated using the modified Mini Dietary Assessment Index for Koreans (MDA), and lipid control among patients aged ≥20 years who had used pravastatin for dyslipidemia for 6 months. Participants were administered questionnaires regarding sociodemographic characteristics and lifestyle factors. Odds ratios and 95% confidence intervals for the control of low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and total cholesterol (TC) at 6 months for each category of the modified MDA items were calculated through multivariate logistic regression analysis. The odds for controlled LDL-C was higher among those who consumed cholesterol-rich foods <1 time/week (3.27, 1.25–8.57) than for those who did so ≥4 times/week. The odds for controlled TG was higher among those who always consumed dairy products (2.96, 1.36–6.44), ate protein-rich foods three times/day (2.94, 1.06–8.10), and had a regular eating schedule (3.02, 1.30–7.00) than among those who did not have any of these. The odds for controlled TC was higher among those with a regular eating schedule (3.47, 1.55–7.76) than among their counterparts. Patients with dyslipidemia should consume less cholesterols, consume more dairy and protein-rich foods, and follow a regular eating schedule to control lipid profiles.

Dairy Product Consumption and Cardiovascular Health: a Systematic Review and Meta-Analysis of Prospective Cohort Studies

The association between dairy product consumption and cardiovascular health remains highly debated. We quantitatively synthesized prospective cohort evidence on the associations between dairy consumption and risk of hypertension (HTN), coronary heart disease (CHD) and stroke. We systematically searched PubMed, Embase, and Web of Science through August 1st, 2020 to retrieve prospective cohort studies that reported on dairy consumption and risk of HTN, CHD or stroke. We used random-effects models to calculate the pooled relative risk (RR) and 95% confidence interval (CI) for the highest vs the lowest category of intake and for 1 serving/day increase in consumption. We rated the quality of evidence using NutriGrade. Fifty-five studies were included. Total dairy consumption was associated with a lower risk of HTN (RR for highest vs lowest level of intake: 0.91, 95% CI: 0.86-0.95, I2 = 73.5%; RR for 1 serving/day increase: 0.96, 95% CI: 0.94-0.97, I2 = 66.5%), CHD (highest vs lowest level of intake: 0.96, 95% CI: 0.92-1.00, I2 = 46.6%; 1 serving/day increase: 0.98, 95% CI: 0.95-1.00, I2 = 56.7%), and stroke (highest vs lowest level of intake: 0.90, 95% CI: 0.85-0.96, I2 = 60.8%; 1 serving/day increase: 0.96, 95% CI: 0.93-0.99, I2 = 74.7%). Despite moderate to considerable heterogeneity, these associations remained consistent across multiple subgroups. Evidence on the relationship between total dairy and risk of HTN and CHD were of moderate quality and of low quality for stroke. Low-fat dairy consumption was associated with lower risk of HTN and stroke, and high-fat dairy with a lower risk of stroke. Milk, cheese, or yogurt consumption showed inconsistent associations with the cardiovascular outcomes in high vs. low intake and dose-response meta-analyses. Total dairy consumption was associated with a modestly lower risk of hypertension, CHD and stroke. Moderate to considerable heterogeneity was observed in the estimates and the overall quality of the evidence was low to moderate.

Dairy products consumption and the risk of hypertension in adults: An updated systematic review and dose-response meta-analysis of prospective cohort studies

AIMS

With an increase in the number of published prospective cohort studies, we sought to summarize the relationship between dairy products consumption and the risk of hypertension (HTN).

DATA SYNTHESIS

We searched PubMed, Web of Science, Embase, Science direct, and Scopus. Pooled RRs and 95% CIs were calculated using a random effects model. The certainty of the evidence was assessed by Grading of Recommendations Assessment, Development and Evaluation (GRADE). Sixteen studies were included in the current meta-analysis. We found an inverse association between total dairy products (RR = 0.90; 95% CI: 0.87, 0.94; n = 16), low-fat dairy products (RR = 0.86; 95% CI: 0.77, 0.96; n = 8), milk (RR = 0.94; 95% CI: 0.90, 0.99; n = 11), and fermented dairy (RR = 0.95; 95% CI: 0.91, 0.99; n = 8) consumption and the risk of HTN. However, in subgroup analysis, despite a significant association for total dairy products in women, Americans, longer and larger studies, and self-reported HTN, no associations were found in males, Europeans, or Asians, and studies which followed participants for <10 years or had <3000 participants or measured HTN. Dose-response analysis revealed a non-linear association between total dairy products and milk consumption and the risk of HTN, but a linear association for low-fat dairy products.

CONCLUSIONS

Higher dairy products consumption was associated with reduced risk of HTN. This association was dependent on sex, geographical region of study, and the stage of HTN. However, the certainty of the evidence was graded either as low or very low.

Associations of Dairy Intake with Circulating Biomarkers of Inflammation, Insulin Response, and Dyslipidemia among Postmenopausal Women

BACKGROUND

Cardiometabolic diseases are prevalent in aging Americans. Although some studies have implicated greater intake of dairy products, it is not clear how dairy intake is related to biomarkers of cardiometabolic health.

OBJECTIVE

Our aim was to test the hypothesis that associations of dairy foods with biomarkers of lipid metabolism, insulin-like growth factor signaling, and chronic inflammation may provide clues to understanding how dairy can influence cardiometabolic health.

DESIGN

This was a cross-sectional study in the Women's Health Initiative using baseline food frequency questionnaire data to calculate dairy intake.

PARTICIPANTS/SETTING

Participants were 35,352 postmenopausal women aged 50 to 79 years at 40 clinical centers in the United States.

MAIN OUTCOME MEASURES

Baseline (1993-1998) concentrations of 20 circulating biomarkers were measured.

STATISTICAL ANALYSES

Multivariable-adjusted linear regression was used to estimate percent difference in biomarker concentrations per serving of total dairy and individual foods (milk, cheese, yogurt, butter, and low-fat varieties).

RESULTS

Lower triglyceride concentrations were associated with greater intake of total dairy (-0.8% [95% CI -1.2% to -0.3%]), mainly driven by full-fat varieties. Individual dairy foods had specific associations with circulating lipid components. For example, greater total milk intake was associated with lower concentrations of total cholesterol (-0.4% [95% CI -0.7% to -0.2%]) and high-density lipoprotein cholesterol (-0.5% [95% CI -0.9% to -0.1%]), whereas greater butter intake was associated with higher total cholesterol (0.6% [95% CI 0.2% to 1.0%]) and high-density lipoprotein cholesterol (1.6% [95% CI 1.1% to 2.0%]) concentrations. In contrast, higher total yogurt intake was associated with lower total cholesterol (-1.1% [95% CI -2.0% to -0.2%]) and higher high-density lipoprotein cholesterol (1.8% [95% CI 0.5% to 3.1%]). Greater total dairy intake (regardless of fat content), total cheese, full-fat cheese, and yogurt were consistently associated with lower concentrations of glucose, insulin, and C-reactive protein. However, milk and butter were not associated with these biomarkers.

CONCLUSIONS

Higher dairy intake, except butter, was associated with a favorable profile of lipids, insulin response, and inflammatory biomarkers, regardless of fat content. Yet, specific dairy foods might influence these markers uniquely. Findings do not support a putative role of dairy in cardiometabolic diseases observed in some previous studies.

Dietary Intake Assessment of Pre-Packed Graviera Cheese in Greece and Nutritional Characterization Using the Nutri-Score Front of Pack Label Scheme

Gravieras are 'gruyere' type hard cheeses with a variety of different products and the second highest consumption in Greece. In this study, we present a dietary intake assessment and a nutritional characterization of pre-packed graviera products sold in the Greek market using Nutri-Score Front of Pack Label (FoPL). The nutrient contents of 92 pre-packed graviera products were combined with daily individual consumption data extracted from the Hellenic National Nutrition Health Survey (n = 93), attempting to evaluate the contribution of graviera's consumption to the Greek diet. The analysis of nutrients' intake as a Reference Intake (RI) percentage ranked saturated fat first on the nutrients' intake list, with RI percentage ranging from 36.1 to 109.2% for the 95th percentile of consumption. The respective % RI for energy, total fat, carbohydrates, sugars, proteins and salt ranged from 12.7-20.7%, 21.6-50.4%, 0-3.1%, 0-6.1%, 37-57.1% and 6.3-42%. Nutri-Score classified 1% of the products to C-light orange class, 62% to D-orange and 37% to E-dark orange, while no products were classified to A-dark green or B-green classes. The comparison between the Nutri-Score classification and the nutrients' intake assessment, also separately conducted within the classes, showed a higher salt intake after the consumption of products classified as D-orange and E-dark orange.

Vitamin D status affects the relationship between lipid profile and high-sensitivity C-reactive protein

Background

The biological pathways through which vitamin D is involved in the regulation of systemic inflammation remain largely unknown.

Objective

The objective of this study was to evaluate the role of vitamin D status on the relationship between lipid profile and high-sensitivity C-reactive protein (hs-CRP) in pregnant women.

Design

Serum 25-hydroxyvitamin D (25(OH)D), hs-CRP, and indicators of lipid profiles (total cholesterol, TC; triglyceride, TG; high-density lipoprotein cholesterol, HDL-C; low-density lipoprotein cholesterol, LDL-C), were measured in 2479 pregnant women during the second trimester. Potential confounding including maternal sociodemographic characteristics, perinatal health status, diet, and lifestyle was prospectively collected. Multiple regression models and cubic models were used to evaluate the associations.

Results

There was a significant non-linear relationship between lipid profile (TC, TG, HDL-C, LDL-C) and hs-CRP (P < 0.05). Increased serum 25(OH)D was significantly associated with decreasing TC, TG, HDL-C, LDL-C, and hs-CRP levels. Compared with medium levels of lipids group, pregnant women with higher levels of TC or TG have higher levels of hs-CRP, and pregnant women with lower levels of TC, HDL-C or LDL-C also have higher levels of hs-CRP in the vitamin D deficient group, and there was a significant correlation between low levels of TG and decreased hs-CRP (adjusted β for TG: -0.063, 95%CI: − 0.120,-0.007) in the non-vitamin D deficient group. Mediators that had appreciable shares of the associations between 25(OH)D and hs-CRP was TG (10.2% of the association; β = − 0.011; total indirect effect: 95% CI: − 0.019, − 0.002). The cubic model suggested that a steep increase in the adjusted regression coefficient of lipid with hs-CRP up to 50 nmol/L of 25(OH)D, and the highest adjusted regression coefficients were observed in pregnant women with 25(OH)D above 50 nmol/L.

Conclusion

Our findings suggest that high levels of vitamin D during pregnancy may improve lipid profile levels and inhibit elevated hs-CRP induced by high lipid metabolism.

Calcium Intake in Children with Eczema and/or Food Allergy: A Prospective Cohort Study

Eczema and food allergy may impact diet. Using data from a cohort of Manitoba children born in 1995, we examined calcium intake, defined as the frequency and quality of calcium products consumed (with the exception of cheese), amongst Manitoba adolescents (12-14 years) with eczema or food allergy in childhood (7-8 years) or adolescence. At both ages, children were assessed by a physician for eczema and food allergy. Adolescents completed food frequency questionnaires. Calcium intake was defined as 1+ vs. <1 weekly. Linear and logistic regression was used as appropriate, with adjustments for confounders. Overall, 468 adolescents were included, of whom 62 (13.3%) had eczema only in childhood, 25 (5.3%) had food allergy only, and 26 (5.6%) had eczema and food allergy. Compared to children without eczema, those with eczema only had poorer calcium intake in adolescence (β -0.44; 95%CI -0.96; 0.00). Girls, but not boys, with eczema in childhood had poorer calcium intake in adolescence than girls without eczema (β -0.84; 95%CI -1.60; -0.08). These patterns persisted even if children experienced transient vs. persistent eczema to adolescence. Similar but non-significant trends were found for food allergy. Childhood eczema is associated with significantly lower calcium intake and consumption in adolescence. These differences persist to adolescence, even if a child "outgrows" their allergic condition.

Red and Processed Meat Consumption and Risk for All-Cause Mortality and Cardiometabolic Outcomes: A Systematic Review and Meta-analysis of Cohort Studies

This article has been corrected. The original version (PDF) is appended to this article as a Supplement.

BACKGROUND

Dietary guidelines generally recommend limiting intake of red and processed meat. However, the quality of evidence implicating red and processed meat in adverse health outcomes remains unclear.

PURPOSE

To evaluate the association between red and processed meat consumption and all-cause mortality, cardiometabolic outcomes, quality of life, and satisfaction with diet among adults.

DATA SOURCES

EMBASE (Elsevier), Cochrane Central Register of Controlled Trials (Wiley), Web of Science (Clarivate Analytics), CINAHL (EBSCO), and ProQuest from inception until July 2018 and MEDLINE from inception until April 2019, without language restrictions, as well as bibliographies of relevant articles.

STUDY SELECTION

Cohort studies with at least 1000 participants that reported an association between unprocessed red or processed meat intake and outcomes of interest.

DATA EXTRACTION

Teams of 2 reviewers independently extracted data and assessed risk of bias. One investigator assessed certainty of evidence, and the senior investigator confirmed the assessments.

DATA SYNTHESIS

Of 61 articles reporting on 55 cohorts with more than 4 million participants, none addressed quality of life or satisfaction with diet. Low-certainty evidence was found that a reduction in unprocessed red meat intake of 3 servings per week is associated with a very small reduction in risk for cardiovascular mortality, stroke, myocardial infarction (MI), and type 2 diabetes. Likewise, low-certainty evidence was found that a reduction in processed meat intake of 3 servings per week is associated with a very small decrease in risk for all-cause mortality, cardiovascular mortality, stroke, MI, and type 2 diabetes.

LIMITATION

Inadequate adjustment for known confounders, residual confounding due to observational design, and recall bias associated with dietary measurement.

CONCLUSION

The magnitude of association between red and processed meat consumption and all-cause mortality and adverse cardiometabolic outcomes is very small, and the evidence is of low certainty.

PRIMARY FUNDING SOURCE

None. (PROSPERO: CRD42017074074).

Fermentation of Milk into Yoghurt and Cheese Leads to Contrasting Lipid and Glyceride Profiles

There is mounting evidence that the consumption of fermented dairy products such as cheese and yoghurt is associated with a reduced risk of type II diabetes. This effect is greater than in fresh milk and differs between cheese and yoghurt. However, the molecular components responsible for the effect are not known. We tested the hypothesis that the lipid and/or glyceride profiles of yoghurts and cheeses are distinct from one another and fresh milk. We developed a novel sample preparation technique for high-fat samples that can be used with Direct Infusion–Mass Spectrometry. We found that the lipid and glyceride profiles of cheddars from the UK, Ireland and France, and hard cheeses from Sweden and Italy were similar to one another but distinct from unfermented dairy products. The lipid and glyceride profile of yoghurts was varied and included types that may be similar to fresh milk. Several odd-chain-containing triglycerides were more abundant, while a variety of others were less abundant, in fermented milk samples. Phosphatidylcholines and phosphatidylethanolamines were more abundant in cheeses, with evidence that the phosphatidylethanomine profile is re-modelled in a way that reflects the bacterial cell envelope. We concluded that a combination of microorganismal metabolism, concentration of the lipid/glyceride fraction and oxidation during fermentation contribute to the observed lipid profile if fermented dairy foods. These differences in the lipid and glyceride profile provide a new avenue for understanding why different fermented dairy foods show a different association with reduced disease risk compared to unfermented dairy.

Association of Lactase Persistence Genotypes (rs4988235) and Ethnicity with Dairy Intake in a Healthy U.S. Population

Lactase persistence (LP) is a trait in which lactose can be digested throughout adulthood, while lactase non-persistence (LNP) can cause lactose intolerance and influence dairy consumption. One single nucleotide polymorphism (SNP ID: rs4988235) is often used as a predictor for dairy intake, since it is responsible for LP in people in European descent, and can occur in other ethnic groups. The objective of this study was to determine whether rs4988235 genotypes and ethnicity influence reported dairy consumption in the United States (U.S.). A food frequency questionnaire (FFQ) and multiple Automated Self-Administered 24-h recalls (ASA24®) were used to measure habitual and recent intake, respectively, of total dairy, cheese, cow's milk, plant-based alternative milk, and yogurt in a multi-ethnic U.S. cohort genotyped for rs4988235. Within Caucasian subjects, LP individuals reported consuming more recent total dairy and habitual total cow's milk intake. For subjects of all ethnicities, LP individuals consumed more cheese (FFQ p = 0.043, ASA24 p = 0.012) and recent total dairy (ASA24 p = 0.005). For both dietary assessments, Caucasians consumed more cheese than all non-Caucasians (FFQ p = 0.036, ASA24 p = 0.002) independent of genotype, as well as more recent intake of yogurt (ASA24 p = 0.042). LP subjects consumed more total cow's milk than LNP, but only when accounting for whether subjects were Caucasian or not (FFQ p = 0.015). Fluid milk and alternative plant-based milk consumption were not associated with genotypes or ethnicity. Our results show that both LP genotype and ethnicity influence the intake of some dairy products in a multi-ethnic U.S. cohort, but the ability of rs4988235 genotypes to predict intake may depend on ethnic background, the specific dairy product, and whether intake is reported on a habitual or recent basis. Therefore, ethnicity and the dietary assessment method should also be considered when determining the suitability of rs4988235 as a proxy for dairy intake.

Dairy Product Intake and Cardiometabolic Diseases in Northern Sweden: A 33-Year Prospective Cohort Study

Dairy products are important constituents of most diets, and their association with adverse health outcomes remains a focus. We characterized dairy food intake and examined associations with the incidence of type 2 diabetes (T2D), myocardial infarction (MI) or stroke among 108,065 Swedish men and women. Hazard ratios (HRs) and 95% CIs were estimated using the multivariable Cox proportional hazards models in a population characterized by high milk tolerance. During a mean follow-up of 14.2 years, 11,641 first-time events occurred. Non-fermented milk intake decreased, whereas butter intake increased over the period. For high intake of non-fermented milk, the HR (95% CI) for developing T2D and MI was 1.17 (1.03, 1.34) and 1.23 (1.10, 1.37), respectively, in men. A greater intake of butter, fermented milk, and cheese tended to be associated with a reduced risk of T2D and/or MI. Non-consumers and those who chose low-fat variants of the targeted dairy products had increased risk for T2D, MI, or stroke compared to those in the non-case group. Generally, effect-sizes were small. This prospective study found that non-fermented milk was associated with an increased risk for developing T2D and MI and that subjects abstaining from dairy products or choosing low-fat variants were at greater risk. However, the overall cardiometabolic risk of non-fermented milk intake was judged as low, since the effect sizes were small.