Milk Proteins and Cardiovascular Health - NMRBy 2030 ~ 23.6 million people will die from CVD Way2Go...

Insert footer on Slide Master

Ági A. Fekete PhD student

Milk Proteins and Cardiovascular Health

Supervisors: Prof. Julie Lovegrove Prof. Ian Givens

TSB, DRINC & MRC Event 2014


Milk and dairy products & CVD

• Saturated fatty acids have a detrimental impact on CVD risk factors

• Milk and dairy products are rich in SFA

• Emerging observational studies indicate that the consumption of milk and dairy products are inversely associated with incidence of CVD


By 2030 ~ 23.6 million people will die from CVD

Milk proteins

Fat 1.7%

Protein 3.4%

Carbohydrate 4.7%

Water, minerals & vitamins 90.2 %


In 2008 ~ 17.3 million death in the world


Milk proteins

Bovine milk contains ~32-34g/L protein

αs1 casein 40%

αs2 casein 10%

β casein 24%

κ casein 13%

β-lactoglobulin 11%

α-lactalbumin 2% Casein 80%

Whey 20%



Milk proteins

Weight management Bone health

Mood, memory and stress control

Cardiovascular health

Dental health

Immune defence Digestive health


Protein and health


Protein and health

“Our overall assessment of this paper is that the conclusions and analyses are biased, and flawed. While there is growing consensus that a moderate protein intake between 1.0 and 1.5 g/kg/d may confer health benefits beyond those afforded by the current RDA for protein, we also recognize there are gaps in the current knowledge base and encourage discussion of important contradictory evidence/data...Unfortunately, the article by Levine et al. presents conclusions not supported by their own analyses or the greater literature.”

Prof Donald K Layman, University of Illinois; Prof Arne Astrup, Copenhagen University; Prof Peter M Clifton, University of South Australia; Dr Heather Leidy,

University of Missouri; Dr Douglas Paddon-Jones, University of Texas; Prof Stuart M Phillips, McMaster University


Protein and health


Milk protein Blood Pressure

Is there any link between them?

Milk and blood pressure



Blood pressure (mmHg)

Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure



Prospective studies on milk consumption and BP

Study Population BP in subjects with

highest milk intakes

Ackley et al., 1983

Jorde & Bonas, 2000

Shaper et al., 1991

Vivjer et al., 1992

Ness et al., 2001

Abbott et al.,1996

Iso et al., 1999

Elwood et al., 2004

Djousse, 2006

PREDIMED study 2009

5,050

7,735

1,340

1,265

5,765

3,150

34,486

2,512

4,797

2,290

- 6.3% of SD

- 5.5% of SD

- 8.3% of SD

-10.0% of SD

- 5.5% of SD

- 6.3% of SD

- 7.5% of SD

- 10.0% of SD

- 6.4% of SD

- 10.5% of SD





Weight of evidence: RCTs evaluating the impact of milk proteins on BP

Comprehensive literature review


Ile-Pro-Pro (IPP), Val-Pro-Pro (VPP). LTP are found to possess antihypertensive effect in vitro and in human studies as well.

Meta-analysis

Casein-derived lactotripeptides (LTP)

In the 1990s, Japanese researchers isolated peptides from fermented milk, which is comprised of chains of three amino acids

Ile-Pro-Pro (IPP), Val-Pro-Pro (VPP) found to possess antihypertensive effect in vitro and in human studies




The inclusion criteria of the meta-analysis on LTPs

Study design

• Randomised, placebo controlled trials

Subjects

• Male and female, age 18 or above

Intervention

• Products containing casein-derived lactotripeptides (VPP, IPP)

Types of outcome measure

• Change of SBP and DBP from baseline compared to placebo group

Date of publication

• -2013

Meta-analysis



Meta-analysis

When all possible biases considered:

Small but significant reduction in SBP and non-significant reduction in DBP

Conclusion of the meta-analysis:



Meta-analysis

Estimated effects of population-wide shifts in systolic BP distributions on mortality

Appel L J et al. Hypertension 2006;47:296-308


Human dietary intervention study: Milk proteins on BP and vascular function




Pal and Ellis (2010) Obesity 18, 1354-1359

n=70 overweight subjects were assigned to 54 g whey, casein or glucose ingestion for 12 weeks

Statistically significant difference from baseline *p<0.05

Letters indicate statistically significance between groups *p<0.05

Comparative effects of whey and casein on blood pressure

Impact of milk proteins on BP and vascular function



Impact of milk proteins on BP

Dairy bioactive peptides

-ve

↑BP

Possible mechanism of milk bioactive peptides


Milk protein Vascular function

Is there any link between them?


Vascular function is a CVD risk marker


Vascular function




• The endothelium plays an important role in vascular function.

• Endothelial dysfunction is an imbalance between the production of endothelium-derived relaxing and contracting factors.

• Arterial stiffness is a manifestation of vascular dysfunction.

Vascular function

Vascular function




Pal and Ellis (2010) Obesity 18, 1354-1359

Only whey reduced significantly AI% (measure arterial stiffness)

Statistically significant difference from baseline *p<0.05

Letters indicate statistically significance between groups *p<0.05

n=70 overweight subjects were assigned to 54 g whey, casein or glucose ingestion for 12 weeks

Comparative effects of whey and casein on vascular function

Impact of milk proteins on BP and vascular function



Way2Go study

Way2Go Research: Long-term (chronic) study

Diet diary completion

Visit 1 Visit 2 Visit 3 Visit 4 Visit 5 Visit 6

Wash out period

(4 weeks)

Wash out period

(4 weeks)

Treatment period (8 weeks)

whey or casein or maltodextrin


maltodextrin or whey or casein


casein or maltodextrin or whey

Run-in period

(2 weeks)

Blood draw, 24 h ambulatory blood pressure monitor, vascular testing




Inclusion criteria

• A signed consent form

• Blood pressure: 120/80-159/99

• Age: 30-75 years

• BMI 20-40 kg/m2

• Glucose <7 mmol/l

• Chol <8 mmol/l

• TAG <4 mmol/l

• Normal liver and kidney function

• Haemoglobin (>130 g/l)




Arterial stiffness measures

Pulse wave analysis (PWA)

Applanation tonometry

Digital volume pulse (DVP)

Infra-red light-transmitting

unit




Flow Mediated Dilatation (FMD)

Ultrasound (macrocirculation)

Vascular reactivity measure



Way2Go study

Way2Go Research: Short-term (postprandial) study



Lunch: • Philadelphia cheese + butter sandwich • Study drink

Postprandial study food – a challenge for the cardiovascular system

Breakfast: • 4 shortbread fingers • 2.5 pieces of croissant with butter • Study drink

Nutritional composition

Energy 2.6 MJ

Protein 35.8 g

Carbohydrate 46 g

Fat (SFA) 30 g (14 g)

Nutritional composition

Energy 4.5 MJ

Protein 39.2 g

Carbohydrate 92.1 g

Fat (SFA) 59 g (25 g)

Nutritional composition based on DISRUPT study (Jackson et al., 2010)



Meta-analysis

Conclusion

Consumption of milk and dairy products seem to be beneficial for vascular health

Dairy products should be incorporated into a healthy, balanced diet

More research required to clarify how milk and dairy products exert their beneficial effects on human health

Acknowledgements

Katy Fingleton – placement student

Carlotta Giromini – visiting PhD student

Karen Jenkins – research nurse

Rada Mihaylova – research nurse

Prof. Ian Givens

Prof. Julie Lovegrove

Milk Proteins and Cardiovascular Health - NMRBy 2030 ~ 23.6 million people will die from CVD Way2Go...

Documents

Transcript of Milk Proteins and Cardiovascular Health - NMRBy 2030 ~ 23.6 million people will die from CVD Way2Go...