Fermented dairy products, diet quality, and cardio-metabolic profile of a Mediterranean cohort at high cardiovascular risk

Authors: MENZ-SANCHEZ, GUILLERMO - UNIVERSITY ROVIRA I VIRGILI; BABIO, NANCY - UNIVERSITY ROVIRA I VIRGILI; MARTINEZ-GONZALEZ, MIGUEL - INSTITUTO DE SALUD CARLOS III; CORELLA, DOLORES - INSTITUTO DE SALUD CARLOS III; SCHRODER, HELMUT - HOSPITAL DEL MAR MEDICAL RESEARCH INSTITUTE; VIOQUE, JESUS - INSTITUTO DE SALUD CARLOS III; ROMAGUERA, DORA - INSTITUTO DE SALUD CARLOS III; MARTINEZ, JULIAN - INSTITUTO DE SALUD CARLOS III; LOPEZ-MIRANDA, JOSE - INSTITUTO DE SALUD CARLOS III; ESTRUCH, RAMON - INSTITUTO DE SALUD CARLOS III; WARNBERG, JULIA - INSTITUTO DE SALUD CARLOS III; BUENO-CAVANILLAS, AURORA - UNIVERSIDAD DE GRANADA; SERRA-MAJEM, LLUIS - UNIVERSITY OF LAS PALMAS DE GRAN CANARIA; TUR, JOSEPH - INSTITUTO DE SALUD CARLOS III; AROS, FERNANDO - INSTITUTO DE SALUD CARLOS III; TINAHONES, FRANCISCO - INSTITUTO DE SALUD CARLOS III; SANCHEZ, VICENTE - UNIVERSITY OF LEON; LAPETRA, JOSE - INSTITUTO DE SALUD CARLOS III; PINTO, XAVIER - HOSPITAL DE LLOBREGAT; VIDAL, JOSEP - UNIVERSITY OF BARCELONA; VASQUEZ, CLOTILDE - INSTITUTO DE SALUD CARLOS III; ORDOVAS, JOSE - JEAN MAYER HUMAN NUTRITION RESEARCH CENTER ON AGING AT TUFTS UNIVERSITY; DELGADO-RODRIGUEZ, MIGUEL - SON ESPASES HOSPITAL; MATIA-MARTIN, PILAR - HEALTH RESEARCH INSTITUTE OF THE SAN CARLOS CLINICAL HOSPITAL; BASORA, JOSEP - INSTITUTO DE SALUD CARLOS III; BUIL-COSIALES, PILAR - INSTITUTO DE SALUD CARLOS III; FERNANDEZ-CARRION, REBECA - INSTITUTO DE SALUD CARLOS III; FITO, MONTSERRAT - INSTITUTO DE SALUD CARLOS III; SALAS-SALVADO, JORDI - UNIVERSITY ROVIRA I VIRGILI

Submitted to: Nutrition, Metabolism and Cardiovascular Diseases
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/11/2018
Publication Date: 5/21/2018
Citation: Menz-Sanchez, G., Babio, N., Martinez-Gonzalez, M.A., Corella, D., Schroder, H., Vioque, J., Romaguera, D., Martinez, J.A., Lopez-Miranda, J., Estruch, R., Warnberg, J., Bueno-Cavanillas, A., Serra-Majem, L., Tur, J.A., Aros, F., Tinahones, F.J., Sanchez, V.M., Lapetra, J., Pinto, X., Vidal, J.C., Vasquez, C., Ordovas, J.M., Delgado-Rodriguez, M., Matia-Martin, P., Basora, J.F., Buil-Cosiales, P., Fernandez-Carrion, R., Fito, M., Salas-Salvado, J. 2018. Fermented dairy products, diet quality, and cardio-metabolic profile of a Mediterranean cohort at high cardiovascular risk. Nutrition, Metabolism and Cardiovascular Diseases. 28(10):1002-1011. https://doi.org/10.1016/j.numecd.2018.05.006.
DOI: https://doi.org/10.1016/j.numecd.2018.05.006

Interpretive Summary: Fermented dairy products (i.e., yogurt, cheese, kefir, sour cream) have been associated with a better diet quality and cardio-metabolic profile. With the current rise on the interest in the healthy aspects of the Mediterranean diet, it will be important to know whether these dairy products add value to this specific dietary pattern. Therefore, this study aimed to assess the diet quality and the associations between the consumption of total fermented dairy products and their subtypes and the prevalence of Metabolic Syndrome (MetS) components in a Mediterranean population at high cardiovascular risk. Analyses were conducted on 6,572 men and women (mean age: 65 years) with overweight or obesity and MetS recruited into the PREDIMED-Plus cohort. Our results show that participants who were high consumers of fermented dairy products reported a higher consumption of fruit, vegetables, fish, nuts, and whole bread and a lower consumption of white bread, alcohol, and cookies. Participants who consumed higher amounts of cheese had a better plasma lipid profile than those with lower consumption. In summary, compared to nonconsumers, participants consuming fermented dairy products reported a better diet quality and, notably, cheese consumers presented a lower prevalence of hypertriglyceridemia and low HDL-cholesterol plasma levels, which are MetS components.

Technical Abstract: BACKGROUND AND AIMS: Fermented dairy products have been associated with a better diet quality and cardio-metabolic profile. However, in Mediterranean populations, these associations have not been well characterized. The aim of this study was to assess the diet quality and the associations between the consumption of total fermented dairy products and their subtypes and the prevalence of Metabolic Syndrome (MetS) components in a Mediterranean population at high cardiovascular risk. METHODS AND RESULTS: Baseline cross-sectional analyses were conducted on 6,572 men and women (mean age: 65 years) with overweight or obesity and MetS recruited into the PREDIMED-Plus cohort. A 143-item Food Frequency Questionnaire (FFQ) was used, and anthropometrical, biochemical, and blood pressure measurements were recorded. Multivariate-adjusted Cox regressions were fitted to analyze the association between quartiles of consumption of fermented dairy products and their subtypes and MetS components to estimate the relative risk (RR) and 95% confidence intervals (95% CIs). Participants who were high consumers of fermented dairy products reported a higher consumption of fruit, vegetables, fish, nuts, and whole bread and a lower consumption of white bread, alcohol, and cookies. Participants in the higher quartile showed a lower prevalence of the low HDL-cholesterol component of the MetS (RR=0.88; 95% CI: 0.78-0.98) than those in the lowest quartile of cheese consumption. Cheese consumption was inversely associated with the prevalence of hypertriglyceridemia. Total fermented dairy products, yogurt, and its types were not associated with any of the MetS components. CONCLUSIONS: Compared to nonconsumers, participants consuming fermented dairy products reported a better diet quality and, particularly, cheese consumers presented a lower prevalence of hypertriglyceridemia and low HDL-cholesterol plasma levels, which are MetS components.