pubmed.ncbi.nlm.nih.gov

Role of Functional Fortified Dairy Products in Cardiometabolic Health: A Systematic Review and Meta-analyses of Randomized Clinical Trials - PubMed

  • ️Tue Jan 01 2019

Meta-Analysis

Role of Functional Fortified Dairy Products in Cardiometabolic Health: A Systematic Review and Meta-analyses of Randomized Clinical Trials

María J Soto-Méndez et al. Adv Nutr. 2019.

Abstract

There is insufficient evidence on the role of functional fortified dairy products in improving health and in preventing risk factors associated with noncommunicable chronic diseases. This systematic review was conducted to summarize effects of the consumption of fortified dairy products on biomarkers of cardiometabolic risk. MEDLINE and SCOPUS databases were used to perform searches to include studies published up to 30 April 2018. Randomized clinical trials with human subjects consuming dairy products fortified with phytosterols, FAs, vitamins or minerals and relating this consumption with cardiometabolic health were included in this review. Risk of bias assessment according to Cochrane guidelines was performed to determine the quality of the trials. Forty-one studies were finally selected for this synthesis; the selected studies tested dairy products fortified with the following nutrients and bioactive components: phytosterols (n = 31), FAs (n = 8), and vitamin D (n = 2). We found that the consumption of phytosterol-fortified dairy, led to an overall LDL cholesterol reduction of -0.36 (-0.41, -0.31) mmol/L, P < 0.001; this decrease was mainly related to the dosage. Likewise, consumption of ω-3 FA-fortified dairy products resulted in a plasma LDL cholesterol reduction of -0.18 (-0.27, -0.09) mmol/L as well as a decrease of -0.18 (-0.32, -0.05) mmol/L in triacylglycerols (TG). Performing meta-analyses of the consumption of dairy products fortified with vitamin D or FAs other than ω-3 FAs and biomarkers of cardiometabolic risk was not possible because of the few available publications. Our results indicate that consumption of dairy products fortified with phytosterols and ω-3 FAs can lead to a reduction of LDL cholesterol and consumption of fortified dairy products fortified with ω-3 FAs can reduce TG concentration. However, more studies with homogeneous designs are needed to determine the advantages of using dairy products as fortification vehicles to prevent cardiometabolic risk.

Keywords: biomarker; cardiometabolic health; cardiovascular disease prevention; dairy products; fortified food; functional food; milk.

Copyright © American Society for Nutrition 2019.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart for study selection.

FIGURE 2
FIGURE 2

Effect size and 95% CI for fully adjusted random-effects model evaluating the influence of consumption of dairy products fortified with phytosterols on LDL cholesterol plasma concentrations. Overall effect: Z = − 14.33, P < 0.001; Heterogeneity: I2 = 75.6% (59.12, 81.60), Q = 226.99, df = 45, P < 0.001 (n = 46). Pooled effect estimate is represented by the black diamond. MD, mean difference; RE model, random effect model.

FIGURE 3
FIGURE 3

Effect size and 95% CI for fully adjusted random-effects model evaluating the influence of consumption of milk fortified with phytosterols on LDL cholesterol plasma concentrations. Overall effect: Z = − 6.84, P < 0.001; Heterogeneity: I2 = 79.8% (56.45, 91.71), Q = 67.52, df = 11, P < 0.001 (n = 12). Pooled effect estimate is represented by the black diamond. MD, mean difference; RE model, random effect model.

FIGURE 4
FIGURE 4

Effect size and 95% CI for fully adjusted random-effects model evaluating the influence of consumption of yogurt, yogurt drinks and other fermented milks fortified with phytosterols on LDL cholesterol plasma concentrations. Overall effect: Z = − 9.32, P < 0.001; Heterogeneity: I2 = 79.9% (62.38, 87.53), Q = 148.47, df = 24, P < 0.001(n = 25). Pooled effect estimate is represented by the black diamond. MD, mean difference; RE model, random effect model.

FIGURE 5
FIGURE 5

Effect size and 95% CI for fully adjusted random-effects model evaluating the influence of consumption of cheese [overall effect: Z = − 6.85, P < 0.001; Heterogeneity: I2 = 7.2% (0.0001, 96.95), Q = 1.90, df = 2, P = 0.39 (n = 3)] (A) and butter [overall effect: Z − 10.46, P < 0.001; Heterogeneity: I2 = 0.0% (0, 0), Q = 0.32, df = 5, P = 1.00 (n = 6)] (B) fortified with phytosterols on LDL cholesterol plasma concentrations. Pooled effect estimate is represented by the black diamond. MD, mean difference; RE model, random effect model.

FIGURE 6
FIGURE 6

Effect size and 95% CI for fully adjusted random-effects model evaluating the influence of consumption of dairy products fortified with ω-3 FAs on LDL cholesterol plasma concentrations. Overall effect: Z = − 3.90, P < 0.001; Heterogeneity: I2 = 77.5% (19.32, 99.58), Q = 15.38, df = 4, P < 0.01 (n = 5). Pooled effect estimate is represented by the black diamond. MD, mean difference; RE model, random effect model.

FIGURE 7
FIGURE 7

Effect size and 95% CI for fully adjusted random-effects model evaluating the influence of consumption of dairy products fortified with ω-3 FAs on TG plasma concentrations. Overall effect: Z = − 2.67, P = 0.008; Heterogeneity: I2 = 91.5% (66.40, 98.82), Q = 51.40, df = 4, P < 0.001 (n = 5). Pooled effect estimate is represented by the black diamond. MD, mean difference; RE model, random effect model.

Similar articles

Cited by

References

    1. Hooper L, Abdelhamid A, Moore H, Douthwaite W, Skeaff C, Summerbell C. Effect of reducing total fat intake on body weight: systematic review and meta-analysis of randomised controlled trials and cohort studies. BMJ. 2012;345:e7666. - PMC - PubMed
    1. Mahe G, Carsin M, Zeeny M, De Bosschere J-P. Dietary pattern, a modifiable risk factor that can be easily assessed for atherosclerosis vascular disease prevention in clinical practice. Public Health Nutr. 2011;14:319–26. - PubMed
    1. Jawaldeh A, Al-Jawaldeh H. Fat Intake Reduction Strategies among Children and Adults to Eliminate Obesity and Non-Communicable Diseases in the Eastern Mediterranean Region. Children. 2018;5:89. - PMC - PubMed
    1. Gardener SL, Rainey-Smith SR. The role of nutrition in cognitive function and brain ageing in the elderly. Curr Nutr Rep. 2018;7(3):139–49. - PubMed
    1. World Health Organization (WHO). Healthy Diet. [Internet]. 2015; [cited 7 Jan 2018]. Available from: http://www.who.int/news-room/fact-sheets/detail/healthy-diet.

Publication types

MeSH terms

Substances