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.