Abstract
Cardiovascular diseases (CVDs) are the number one cause of mortality worldwide. Low-density lipoprotein (LDL) cholesterol is a well-known risk factor of CVD which increases after the intake of saturated fatty acids (SFA). Cheese is a dietary product commonly consumed in Western countries and known to contain high amounts of SFA. However, cheese also contributes with several nutrients in the diet such as essential amino acids and calcium.
The aim of this thesis was to examine the effect of cheese intake on CVD risk through evidence from both observational, intervention and explorative studies.
By reviewing results from published observational studies it was concluded that cheese does not seem to increase CVD risk, despite of the high SFA content of most cheeses. A human cross-over intervention study was conducted with the purpose of investigating the effect of hard cheese intake on risk markers of CVD compared to butter intake with an equal fat content. It was found that cheese intake lowered total cholesterol, LDL cholesterol and high-density lipoprotein (HDL) cholesterol concentrations and increased glucose concentrations when compared to butter.
Additionally, butter intake resulted in higher total cholesterol and LDL cholesterol when compared to habitual diet whereas no difference was observed between cheese intake and habitual diet.
Calcium has been suggested to increase fecal fat and bile acid excretions which could explain the lower cholesterol concentrations with cheese intake. Although calcium intake and fecal calcium excretions increased with cheese intake in our study, we found no difference in fecal fat or fecal bile acid excretions when comparing cheese intake with butter intake. A non-targeted metabolomics approach was employed to identify metabolites deriving from cheese intake in urine samples. Several metabolites where identified most likely deriving from the high amino acid content of cheese. While many of them were suggested to be related to total cholesterol concentrations, the biological mechanisms explaining the effect of cheese intake on cholesterol concentrations remains unresolved.
In conclusion, results from this PhD thesis suggest that cheese may not increase CVD risk. Furthermore, cheese decr ses total cholesterol and LDL cholesterol concentrations when compared to butter intake of equal fat content. However, cheese may also decrease HDL cholesterol and increase fasting glucose concentrations when compared to butter which should be further investigated. Moreover, cheese intake results in many urinary metabolites. Their use as markers of cheese intake and any possible biological link to cholesterol concentrations in humans needs further considerations.
The aim of this thesis was to examine the effect of cheese intake on CVD risk through evidence from both observational, intervention and explorative studies.
By reviewing results from published observational studies it was concluded that cheese does not seem to increase CVD risk, despite of the high SFA content of most cheeses. A human cross-over intervention study was conducted with the purpose of investigating the effect of hard cheese intake on risk markers of CVD compared to butter intake with an equal fat content. It was found that cheese intake lowered total cholesterol, LDL cholesterol and high-density lipoprotein (HDL) cholesterol concentrations and increased glucose concentrations when compared to butter.
Additionally, butter intake resulted in higher total cholesterol and LDL cholesterol when compared to habitual diet whereas no difference was observed between cheese intake and habitual diet.
Calcium has been suggested to increase fecal fat and bile acid excretions which could explain the lower cholesterol concentrations with cheese intake. Although calcium intake and fecal calcium excretions increased with cheese intake in our study, we found no difference in fecal fat or fecal bile acid excretions when comparing cheese intake with butter intake. A non-targeted metabolomics approach was employed to identify metabolites deriving from cheese intake in urine samples. Several metabolites where identified most likely deriving from the high amino acid content of cheese. While many of them were suggested to be related to total cholesterol concentrations, the biological mechanisms explaining the effect of cheese intake on cholesterol concentrations remains unresolved.
In conclusion, results from this PhD thesis suggest that cheese may not increase CVD risk. Furthermore, cheese decr ses total cholesterol and LDL cholesterol concentrations when compared to butter intake of equal fat content. However, cheese may also decrease HDL cholesterol and increase fasting glucose concentrations when compared to butter which should be further investigated. Moreover, cheese intake results in many urinary metabolites. Their use as markers of cheese intake and any possible biological link to cholesterol concentrations in humans needs further considerations.
| Original language | English |
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| Publisher | Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen |
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| Number of pages | 70 |
| ISBN (Print) | 978-87-7611-678-1 |
| Publication status | Published - 2013 |