Table 3.
Synthesis of results of eligible RCTs on the impact of isoenergetic replacement of cheese with other dairy products on blood lipid markers in the postprandial state
| First author, year (country) | Health status | Study completers, n (%, M/F) | Age (mean or range) | BMI (mean or range) | Study design, duration of washout (d), duration of postprandial period (h) | Dietary intervention arms (n), standardized meal components | Intervention | Comparator | Relevant outcomes | Result | Industrial funding (yes/no) | Overall RoB |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cheese vs. butter | ||||||||||||
| Drouin-Chartier 2017 (Canada) [50] | Healthy | 43 (44/56) | 36.9 y | 24.7 kg/m2 | Crossover, ≥2-wk washout, 8 h | 3 Bread, icing (topping), fruit juice |
Young Cheddar (hard) cheese (32% milk fat): 41.5 g total fat and 33.1 g dairy fat per 1000 kcal serving1 | Salted butter: 41.5 g total fat and 33.2 g dairy fat per 1000 kcal serving1 | TG (PO: triglyceride response at 4 h), NEFA, ApoB-48 | ↔ TG, NEFA or ApoB-48% change in concentrations from baseline to 4 h or percentage difference in iAUC0–8 h between cheese and butter meals | Yes | Some concerns |
| Hansson 2019 (Norway) [49] | Healthy and OW/OB | 47(30/70) | 25–46 y | 23.6 (21.0–25.8) kg/m2 | Crossover, ≥2–5 wk washout period, 6 h | 4 White bread, raspberry jam |
Gräddost (Semi-hard cheese): Full-fat milk- and cream-based cheese: 45.1 g dairy (total) fat per 715 kcal meal | Butter: 44.8 g dairy (total) fat per 629 kcal meal | TG (PO: iAUC0-6h), TC, LDL-C, HDL-C, NEFA | ↔ TG, NEFA, TC or LDL-C iAUC0–6 h between cheese and butter meals | No | Some concerns |
| Cheese vs. cream cheese or homogenized cheese | ||||||||||||
| Drouin-Chartier 2017 (Canada) [50] | Healthy | 43 (44/56) | 36.9 y | 24.7 kg/m2 | Crossover, ≥2-wk washout, 8h | 3 Bread, icing (topping), fruit juice |
Young Cheddar (hard) cheese (32% milk fat): 41.5 g total fat and 33.1 g dairy fat per 1000 kcal serving1 | Cream cheese (31% milkfat, 55% moisture, unripened, homogenized, fresh cheese): 41.5 g total fat and 33.2 g dairy fat per 1000 kcal serving1 | TG (PO: triglyceride response at 4 h), NEFA, ApoB-48 | ↔ TG or NEFA% change in concentrations from baseline to 4 h or % difference in iAUC0–8 h; ↑ 2 h TG concentration after cream cheese vs. Cheddar cheese (P = 0.0004); ↓ 6 h TG response after cream cheese vs. Cheddar cheese (P = 0.0004); ↓ 2 h NEFA concentration after cream cheese vs. Cheddar cheese (P = 0.04); ↓ apoB-48 iAUC0–8 h (P = 0.01) and ↓ apoB-48 response at 4 (P = 0.02) and 6 h (P = 0.0002) after cream cheese vs. Cheddar cheese | Yes | Some concerns |
| Kjølbæk 2021 (Denmark) [15] | Healthy | 21 (100/0) | 19–40 y | 20.0–24.5 kg/m2 | Crossover, ≥2-wk washout period, 8 h | 4 Bread and water (for similar density) |
Matured (8–12 wk) full-fat (50+) Cheddar (hard) cheese: 66.6 g dairy fat (intertwined network of protein and areas of coalesced fat) and 68 g total fat per standardized 4.7 kJ meal | Homogenized Cheddar cheese: 66.6 g dairy fat (loss of protein network and small discrete fat droplets) and 68 g total fat per standardized 4.7 kJ meal | TG and apoB-48 (PO: iAUC0-8h), TC, HDL-C, LDL-C, NEFA, apoB-100 | ↔ iAUC0-8 h or 8 h concentrations for TG, ApoB-48, TC, HDL-C, LDL-C, NEFA or apoB-100 between cheese meals | Yes | Some concerns |
| Cheese vs. whipped cream | ||||||||||||
| Hansson 2019 (Norway) [49] | Healthy and OW/OB | 47(30/70) | 25–46 y | 23.6 (21.0–25.8) kg/m2 | Crossover, 2–5 wk washout period, 6 h | 4 White bread, raspberry jam |
Gräddost (Semi-hard cheese): Full-fat milk- and cream-based cheese: 45.1 g dairy (total) fat per 715 kcal meal | Whipped cream: 45.1 g dairy (total) fat per 652 kcal meal | TG (PO: iAUC0-6h), TC, LDL-C, HDL-C, NEFA | ↔ iAUC0-8 h for TG, NEFA, TC, HDL-C or LDL-C between cheese and whipped cream meals | No | Some concerns |
| Cheese vs. sour cream | ||||||||||||
| Hansson 2019 (Norway) [49] | Healthy and OW/OB | 47(30/70) | 25–46 y | 23.6 (21.0–25.8) kg/m2 | Crossover, 2–5 wk washout period, 6 h | 4 White bread, raspberry jam |
Gräddost (Semi-hard cheese): Full-fat milk- and cream-based cheese: 45.1 g dairy (total) fat per 715 kcal meal | Sour cream: 45.2 g dairy (total) fat per 655 kcal meal | TG (PO: iAUC0-6h), TC, LDL-C, HDL-C, NEFA | ↑ iAUC0-6 h for TG and HDL-C after sour cream vs. cheese meal (P = 0.02 and P = 0.01, respectively) ↔ iAUC0-6 h for NEFA, TC or LDL-C between cheese and sour cream meals |
No | Some concerns |
Abbreviations: apo, apolipoprotein; NEFA, nonesterified fatty acid; OW/OB, overweight/obese; PO, primary outcome; TC, total cholesterol; TG, triacylglycerol;%TE, percent total energy.
1The serving size was adjusted according to individual energy requirements.