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A Linoleate-enriched Cheese Product Reduces Low-Density Lipoprotein in Moderately Hypercholesterolemic Adults

Paul A. Davis, PhD; Jean-Francois Platon, PhD; M. Eric Gershwin, MD; Georges M. Halpern, MD; Carl L. Keen, PhD; Donna DiPaolo, MS; Janet Alexander, BS; and Vincent A. Ziboh, PhD
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From the University of California at Davis, Davis, California; Actiotech, Paris, France. Requests for Reprints: Paul A. Davis, PhD, Department of Internal Medicine, TB156, University of California at Davis, Davis, CA 95616. Acknowledgments: The authors thank Rita Tezanos-Pinto, MT, and the Lipid Assay Laboratory staff for their assistance in analyzing the lipoprotein samples; Drs. Stephen Phinney and Anna Tang of the University of California, Davis, CNRU Lipid Metabolism Core Unit for the fatty-acid analysis of the modified-fat cheese product; and Christine Trapp for her expert handling of the study participants with respect to dietary surveys, cheese distribution, and compliance follow-up. Grant Support: In part by University of California, Davis, National Institutes of Health Clinical Nutrition Research Unit (DK 35747) and Sorrento Cheese Company, Buffalo, New York.


Copyright 2004 by the American College of Physicians


Ann Intern Med. 1993;119(7_Part_1):555-559. doi:10.7326/0003-4819-119-7_Part_1-199310010-00002
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Objective: To test the effect of substituting a modified-fat cheese product into the diets of hypercholesterolemic adults.

Design: A 4-month, randomized, double-blind, crossover substitution trial.

Setting: General community outpatient study.

Participants: Twenty-six healthy adult volunteers (17 men, 9 women) with moderate hypercholesterolemia (total cholesterol >5.69 mmol/L but < 7.24 mmol/L).

Intervention: Daily substitution of 100 g of cheese, either partial skim-milk mozzarella or modified-fat (vegetable oil) mozzarella cheese product, into participants' normal diets. Participants consumed an assigned cheese for 2 months, at which time they crossed over to consume the other study cheese.

Main Outcome Measures: Plasma lipid and apolipoprotein levels were measured at baseline and at 2 and 4 months after initiation of the study. Compliance was assessed by body weight and by biweekly dietary records and interviews.

Results: No differences in weight or in the amount or type of calories consumed were found during the study. No statistically significant changes in lipid values resulted from consumption of mozzarella cheese. Modified-fat cheese substitution resulted in a decreased low-density lipoprotein cholesterol level when compared with levels at both baseline ( 0.28 mmol/L; 95% CI, 0.14 to 0.42 mmol/L) and during consumption of the skim-milk mozzarella cheese ( 0.38 mmol/L; 95% CI, 0.2 to 0.70 mmol/L). Findings for total cholesterol were similar. High-density lipoprotein cholesterol, plasma triglyceride, and apolipoprotein A-I and B-100 levels were unaltered. Both sexes responded similarly.

Conclusions: A linoleate-enriched cheese product, in the absence of any other changes in diet or habits, substituted into the normal diets of hypercholesterolemic adults reduced low-density lipoprotein and plasma cholesterol levels.

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