减少乳制品脂肪的摄入是限制能量和饱和脂肪酸摄入以促进心脏代谢健康的常见饮食指南。然而,利用整体的研究,以食物为基础的方法来评估乳制品中脂肪的消耗,一个广泛而多样的食物群体,可能会为这些指南提供新的见解。乳脂由多种脂肪酸组成,三酰基甘油,固醇,和磷脂,都独特地包装在牛奶脂肪球中。通过不同的加工方法对这种乳脂球及其膜的物理结构进行了修饰,在每种乳制品中产生独特的乳制品-脂肪基质。这篇叙述性综述的目的是首先定义和比较乳制品脂肪基质的独特组成,物理结构,和普通乳制品中的脂肪含量(牛奶,酸奶,奶酪,和黄油)。有了这些信息,我们研究了过去10年(2013-2023年)发表的观察性研究和随机对照试验,以评估牛奶中乳制品脂肪基质的个体效应,酸奶,奶酪,和黄油对心脏代谢健康的影响,并评估营养指导的影响。利用心脏代谢健康搜索词对OvidMEDLINE和PubMed®进行搜索,广泛地和具体的疾病结果和风险因素,产生了59项研究,这些研究被分析并包括在这篇综述中。重要的是,这篇综述按乳制品和脂肪含量进行了分层。尽管结果是异质的,大多数研究报告说,这些个体常规脂肪乳制品的摄入量与心脏代谢结果指标之间没有关联,因此,目前的证据表明,常规脂肪乳制品的消费可能被纳入整体健康的饮食模式。研究表明,摄入常规脂肪牛奶和酸奶对与体重和成分有关的结果指标可能有有益的影响,以及常规脂肪奶酪摄入对与血脂相关的结局指标的影响,但是需要更多的研究来定义这种关系的方向性。最后,我们确定了方法学研究的空白,并提出了未来的研究方向,以支持目前可用于确定乳制品脂肪在健康饮食中的作用的证据基础.
Reducing dairy fat intake is a common dietary guideline to limit energy and saturated fatty acid intake for the promotion of cardiometabolic health. However, research utilizing a holistic, food-based approach to assess the consumption of the fat found in dairy, a broad and diverse food group, may provide new insight into these guidelines. Dairy fat is comprised of a diverse assembly of fatty acids, triacylglycerols, sterols, and phospholipids, all uniquely packaged in a milk fat globule. The physical structure of this milk fat globule and its membrane is modified through different processing methods, resulting in distinctive dairy-fat matrices across each dairy product. The objectives of this narrative review were to first define and compare the dairy-fat matrix in terms of its unique composition, physical structure, and fat content across common dairy products (cow\'s milk, yogurt, cheese, and butter). With this information, we examined observational studies and randomized controlled trials published within the last 10 years (2013-2023) to assess the individual effects of the dairy-fat matrix in milk, yogurt, cheese, and butter on cardiometabolic health and evaluate the implications for nutrition guidance. Searches conducted on Ovid MEDLINE and PubMed® utilizing search terms for cardiometabolic health, both broadly and regarding specific disease outcomes and risk factors, yielded 59 studies that were analyzed and included in this review. Importantly, this review stratifies by both dairy product and fat content. Though the results were heterogeneous, most studies reported no association between intake of these individual regular-fat dairy products and cardiometabolic outcome measures, thus, the current body of evidence suggests that regular-fat dairy product consumption may be incorporated within overall healthy eating patterns. Research suggests that there may be a beneficial effect of regular-fat milk and yogurt intake on outcome measures related to body weight and composition, and an effect of regular-fat cheese intake on outcome measures related to blood lipids, but more research is necessary to define the directionality of this relationship. Lastly, we identify methodological research gaps and propose future research directions to bolster the current evidence base available for ascertaining the role of dairy fat in a healthy diet.