Cardiovascular health

Preventing cardiometabolic disease: new insights into the role of fermented dairy foods

Preventing cardiometabolic disease: new insights into the role of fermented dairy foods

A wealth of research is shedding light on how fermented dairy foods such as yogurt and cheese may be associated with reduced risk of cardiometabolic disease, including cardiovascular diseases (CVDs), stroke, and type 2 diabetes, according to the authors of this review.

Official dietary recommendations for dairy foods tend to be based on the impact of single nutrients or types of product on health – for example, advising low-fat products to avoid weight gain or reduce saturated fat to lower the risk of heart disease. But now a much more complicated picture is emerging of the many ways in which dairy foods may be associated with reduced risk of cardiometabolic disease, a term that encompasses cardiovascular and metabolic conditions such as insulin resistance and type 2 diabetes.  The authors of this review of lab-based research, animal studies and human trials argue that both well-known and lesser-known components of dairy foods, as well as processing methods such as fermentation, can affect biological pathways and through them lead to benefits for cardiometabolic health.

Potential cardiometabolic benefits of dairy proteins are emerging

Cow’s milk proteins, mainly casein and whey, have been associated with improving cardiometabolic health, for example by helping to maintain the correct balance of blood glucose and insulin levels, at least in animals.

This may be linked to specific amino acids and/or naturally occurring bioactive peptides released during fermentation.

Traditional dietary guidelines obscure the potential benefits of dairy fats on cardiometabolic disease

High blood levels of dairy fatty acids are consistently associated with a reduced incidence of diabetes and possibly coronary heart disease and stroke in cohort studies.

The authors say that the traditional emphasis on saturated fats and high levels of LDL-cholesterol in dietary guidelines has obscured the potentially positive effects of dairy-derived saturated fatty acids on, for example, HDL-cholesterol.

This emphasis also downplays the potential benefits of other types of fatty acids and lipid components that make up most of the fat content of milk. These include a variety of saturated, monounsaturated and polyunsaturated fatty acids, as well as bioactive compounds found in the Milk Fat Globule Membrane (MFGM) that surrounds fat droplets in milk.

Benefits may also come from fat-soluble vitamins D, K, and K2, produced from dairy fats during fermentation.

Probiotics in fermented dairy products may help prevent cardiometabolic disease by promoting changes in gut microbiota

Probiotics in fermented dairy products may help prevent cardiometabolic disease by promoting changes in gut microbiota Click To Tweet

The review shines a spotlight on growing evidence of the links between probiotics in fermented dairy products, such as yogurt, and changes in the gut microbiota.

This interaction between probiotics and the gut microbiota may confer a protective effect of dairy fermented food against weight gain, obesity and metabolic conditions such as diabetes.

The potential role of fermentation and vitamin K2 in cardiometabolic risk is a promising new area of research

The authors draw links between vitamin-K2-producing bacteria, used in the production of fermented dairy products, and the potential to reduce the risk of cardiometabolic diseases. This represents a promising area for further research.

Yogurt is associated with reduced cardiometabolic conditions, such as long-term weight gain and diabetes

The associations between dairy intake and reduced risk of overweight, heart disease and diabetes may depend more on the type of product than its fat content, say the authors:

  • Yogurt, for instance, seems consistently to be associated with reduced long-term weight gain – even when sweetened with sugar – compared with low-fat or whole milk.
  • Cheese seems to have a relatively neutral association with weight gain.
  • Both yogurt and cheese are also associated with a lower risk of type 2 diabetes, adding further strength to the evidence that fermentation may be a key factor in cardiometabolic health.

Find out more: read the original article

Source: Mozaffarian D, Wu JHY. Flavonoids, dairy foods, and cardiovascular and metabolic health. a review of emerging biologic pathways. Circ Res 2018;122:369-384.

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