Dairy, Saturated Fat and Cardiometabolic Disease Anne Mullen, BSc, PhD, FHEA, RD Director of Nutrition at The Dairy Council February 2016 Email: a.mullen@dairycouncil.org.uk Tel: 020 7025 0560 Web: www.milk.co.uk Twitter: TheDairyCouncil 210 High Holborn, London WC1V 7EP
Overview Introduction to TDC/AHDB Dairy research work Dairy, Saturated Fat & Cardiometabolic Health Context Evidence Outlook
Who we are Non-profit making organisation with a remit to address human health and disease issues relating to dairy Staffed by registered dietitians and registered nutritionists Provide information on the health benefits of dairy to consumers, healthcare professionals, media and industry Engage with opinion formers in clinical and public health Liaise with international health and nutrition bodies Facilitate dairy and human nutrition research in partnership with organisations such as AHDB Dairy [cardiovascular disease, obesity, hormones, healthy ageing, environmental sustainability]
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SATURATED FAT ADVICE UNCLEAR BBC News, 17 th March 2014 NO LINK FOUND BETWEEN SATURATED FAT AND HEART DISEASE The Telegraph, 18 th March 2014 A DAIRY FAT SIGNIFICANTLY REDUCES HEART DISEASE RISK Mail Online, 17 th March 2014 SPREAD THE WORD - BUTTER IS BACK IN FAVOUR. BUT FOR HOW LONG? The Telegraph, 10 th February 2015
Cardiometabolic disease Cardiovascular Disease: Hypertension Stroke Atherosclerosis Coronary Heart Disease Arteriosclerosis Peripheral Arterial Disease Metabolic Syndrome: Obesity Insulin Resistance Type 2 Diabetes CHD leading cause of death in the UK 1 in six men and 1 in 10 women die from CHD; socioeconomic, geographical, ethnic divides UK CHD death rates above EU average Over 2.7million people have diabetes in England NHS 14bn/yr on treating T2DM mostly on avoidable complications T2DM a major risk factor for CHD
Cardiometabolic disease some dairy
Cardiometabolic disease Assumption 1: Dietary Fat is associated with Cardiometabolic Disease
Kromhaut (1999) Seven Countries Study Classic diet-heart hypothesis
Kromhaut (1999) Seven Countries Study
Siri-Tarino et al (2010) Saturated Fat, CHD/Stroke CHD & SFA RR 1.07 no association Stroke & SFA RR 0.81 no association
Coronary outcomes and. SFA: no association MUFA: no association n-3 LC PUFA: -ve association n-6 PUFA: no association TFA: +ve association Chowdhury et al (2014)
De Souza et al (2015)
Cardiometabolic disease Assumption 1: Dietary Fat is associated with Cardiometabolic Disease eminence-based rather than evidence-based
not all saturated fatty acids are created equal Chowdhury et al (2014)
Ronald P Mensink et al. Am J Clin Nutr 2003;77:1146-1155 2003 by American Society for Nutrition
Cardiometabolic disease Assumption 1: Dietary Fat is associated with Cardiometabolic Disease Risk Factors but not Clinical Outcomes; Not all saturated fats behave the same
Cardiometabolic disease Assumption 1: Dietary Fat is associated with Cardiometabolic Disease Risk Factors but not Clinical Outcomes; Not all saturated fats behave the same Assumption 2: Dairy is a source of saturated fat, therefore.
Soedamah-Muthu et al (2011) Milk and CVD RR 0.94 association
Soedamah-Muthu et al (2011) Milk and CHD RR 1.00 no association
Soedamah-Muthu et al (2011) Milk and Stroke RR 0.87 no significant association
Soedamah-Muthu et al (2012) Dairy and Hypertension RR 0.97 association
Dairy and T2DM Chen et al (2014)
Yogurt and T2DM Chen et al (2014)
Cardiometabolic disease Assumption 1: Dietary Fat is associated with Cardiometabolic Disease Risk Factors but not Clinical Outcomes; Not all saturated fats behave the same Assumption 2: Dairy is a source of saturated fat.but it is a source of diverse fats, not necessarily in high amounts, and contains other nutrients and a matrix that may moderate cardioprotective effects
Cardiometabolic disease some dairy
Challenges Understanding saturated fat/fatty acids and their role in cardiometabolic health Setting appropriate dietary guidelines for saturated fat/fatty acids Understanding the components of dairy that moderate cardiometabolic risk/promote cardiometabolic health Setting appropriate dietary guidelines for milk and dairy
Challenges Understanding saturated fat/fatty acids and their role in cardiometabolic health Setting appropriate dietary guidelines for saturated fat/fatty acids Understanding the components of dairy that moderate cardiometabolic risk/promote cardiometabolic health Setting appropriate dietary guidelines for milk and dairy
Challenges Setting appropriate dietary guidelines for saturated fat/fatty acids France: has increased saturated fat guidelines to 12%, with 8% intake for those considered deleterious when consumed in excess SACN panel assembled to review evidence for UK Sub-challenge: ensure the evidence is reviewed & published Setting appropriate dietary guidelines for milk and dairy Sub-challenge: Consumer, HCP & public health work
Translation: HCP & consumer factsheet Evidence: 3 regional conferences Evidence: 2 review papers for publication Translation: press coverage, social media
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