The impact of sex and the cheese matrix on cholesterol metabolism in middle-aged adults.

Abstract

BACKGROUND AND AIMS: Cheese has been shown to lower total and LDL cholesterol concentrations, despite being a source of saturated fat. The dairy matrix is purported to be responsible for this effect. There is increasing recognition of sexual dimorphism in the development and progression of cardiovascular disease (CVD), in addition to sex-related differences in response to nutrition interventions. This analysis aims to explore the effect of sex on the cholesterol-lowering effect of cheese compared to butter. METHODS: The present study is secondary analysis of pooled data from two parallel-arm randomised controlled trials (RCT) with similar protocols, where participants (n 197, 41.6 % male) received either 120g cheese (n 104) or deconstructed cheese (49g butter, 30g calcium caseinate and a calcium supplement, n 93) for 6 weeks. Each arm provided ∼40g fat per day. RESULTS: In the group as a whole, cheese was found to lower total and LDL cholesterol, compared to deconstructed cheese. No sex × treatment interactions were observed although, within-sex analysis found men and women to respond differently. Within males, cholesterol concentrations decreased in response to dairy fat. Within the female group cheese lowered total and LDL cholesterol concentrations, whereas deconstructed cheese was found to increase the same lipid markers. CONCLUSIONS: Cheese was found to lower cholesterol concentrations in the cohort as a whole, while men and women were found to respond differently to dairy fat. Females appear to respond more favourably to cheese compared to deconstructed cheese. These findings indicate the cheese matrix may have a stronger effect in females and thus may play a role in personalised nutrition.