Fermented dairy foods intake and risk of cardiovascular diseases: A meta-analysis of cohort studies

Abstract

Since the associations of fermented dairy foods intake with risk of cardiovascular diseases (CVD) remained inconsistent, we carried out this meta-analysis on all published cohort studies to estimate the overall effect. We searched the PubMed and CNKI (China National Knowledge Infrastructure) databases for all articles within a range of published years from 1980 to 2018 on the association between fermented dairy foods intake and CVD risk. Finally, 10 studies met the inclusion criteria for this study, with 385,122 participants, 1,392 Myocardial infarction, 4,490 coronary heart disease (CHD), 7,078 stroke, and 51,707 uncategorized CVD cases. Overall, statistical evidence of significantly decreased CVD risk was found to be associated with fermented dairy foods intake (OR = 0.83, 95% CI = 0.76–0.91). In subgroup analysis, cheese and yogurt consumptions were associated with decreased CVD risk (OR = 0.87, 95% CI = 0.80–0.94 for cheese and OR = 0. 78, 95% CI = 0.67–0.89 for yogurt). Our meta-analysis indicated that fermented dairy foods intake was associated with decreased CVD risk.     

Milk, milk products, and disease free health: an updated overview

The cow and its milk have been held sacred in the world since the dawn of human civilization. Indian ancient Vedic texts describe the virtues of milk and dairy products, as is authenticated by modern scientific principles and proofs. Therefore, milk has been considered as one of the most natural and highly nutritive part of a daily balanced diet. Currently, the integration of advanced scientific knowledge with traditional information is gaining incredible momentum toward developing the concept of potential therapeutic foods. Furthermore, new advances toward understanding the therapeutic roles of milk and milk products have also given a new impetus for unraveling the age old secrets of milk. At present, the best-known examples of therapeutic foods are fermented milk products containing health promoting probiotic bacteria. In the present article, we have tried to review the various aspects of the therapeutic nature of milk and fermented dairy products in a highly up-dated manner, and offer an in-depth insight into the development of targeted therapeutic future foods as per the requirements of consumers.     

Nutritional and healthful aspects of cultured and culture-containing dairy foods

Nutritional and therapeutic qualities of fermented dairy products are reviewed. Partial hydrolysis of milk constituents (proteins, fats, and lactose) in yogurt, cheese, and other cultured dary foods appears to contribute to their increased digestibility. Lactase and other constituent enzymes of various culturing organisms should contribute to assimilation of lactose by lactose intolerant individuals. Several lactic cultures synthesize certain B-vitamins in fermented dairy products. In contrast, directly acidified dairy products do not exhibit such enhancement in B-vitamins. The hypocholestremic effect of milk is enhanced by fermentation or inclusion of lactic cultures. Lactobacillus acidophilus, Lactobacillus bulgaricus and other lactic organisms produce antimicrobial agents and natural antibiotics. However, production of natural antibacterial substances by different strains of the same species vary widely. These metabolites in cultured dairy products may be responsible for increased shelf life of the foods by inhibiting a wide spectrum of food spoilage organisms. Also, consumption of cultured products containing such natural antibacterial substances may provide the consumer with protection against disease organisms. Unfermented milk containing a specific culture or strain may be consumed to invest organisms for projected beneficial effects.     

Production,Consumption, and Pricing of Milk and Its Components,

Production and consumption of milk fat, milk protein, and lactose were compared for 1970, 1975, 1979, and 1983 to determine whether production and consumption were balanced and, if not, to determine how balance might be achieved. Ratios of these components in milk produced remained virtually constant from 1970 to 1983. However, increased cheese consumption during this period resulted in increased per capita consumption of fat and protein despite reduced consumption of these components in other dairy products. Because lactose is not in cheese, lactose consumption declined. Because of these changes, imbalances of production and consumption of milk components now exist and are due almost entirely to too much lactose being produced. Because of small variation of lactose percentage, this imbalance could be reduced by increased fat and protein percentages. Milk pricing should encourage this by emphasizing fat and protein (not solids-not-fat). Fat and protein differentials should differ from market to market and should be based on utilization. Milk pricing is reviewed, and a procedure for determining blend differentials is outlined.     

Invited review: Potential effects of short- and long-term intake of fermented dairy products on prevention and control of type 2 diabetes mellitus

The consumption of fermented dairy products has been linked with lowering the risk of type 2 diabetes mellitus (T2DM), but studies have yet to demonstrate a definite association. We evaluated evidence from a cross-sectional analysis of longitudinal studies and human and animal experimental trials to further understand the current knowledge linking short- and long-term consumption of fermented dairy products to T2DM. Most cohort studies revealed a protective effect of fermented dairy products on T2DM development, with yogurt noted as the most consistent food item protecting against the disease. Human experimental trials and animal studies revealed improvements in biomarkers of glycemic control with short-term monitored intake of fermented dairy products from various sources. Therefore, fermented dairy products may offer protection against the development and may have therapeutic benefits for individuals with T2DM. This could influence on dietary recommendations and the development of functional foods aiming to minimize the risk of T2DM.     

Major advances in concentrated and dry milk products, cheese, and milk fat-based spreads

Advances in dairy foods and dairy foods processing since 1981 have influenced consumers and processors of dairy products. Consumer benefits include dairy products with enhanced nutrition and product functionality for specific applications. Processors convert raw milk to finished product with improved efficiencies and have developed processing technologies to improve traditional products and to introduce new products for expanding the dairy foods market. Membrane processing evolved from a laboratory technique to a major industrial process for milk and whey processing. Ultra-filtration and reverse osmosis have been used extensively in fractionation of milk and whey components. Advances in cheese manufacturing methods have included mechanization of the making process. Membrane processing has allowed uniform composition of the cheese milk and starter cultures have become more predictable. Cheese vats have become larger and enclosed as well as computer controlled. Researchers have learned to control many of the functional properties of cheese by understanding the role of fat and calcium distribution, as bound or unbound, in the cheese matrix. Processed cheese (cheese, foods, spreads, and products) maintain their importance in the industry as many product types can be produced to meet market needs and provide stable products for an extended shelf life. Cheese delivers concentrated nutrients of milk and bio-active peptides to consumers. The technologies for the production of concentrated and dried milk and whey products have not changed greatly in the last 25 yr. The size and efficiencies of the equipment have increased. Use of reverse osmosis in place of vacuum condensing has been proposed. Modifying the fatty acid composition of milkfat to alter the nutritional and functional properties of dairy spread has been a focus of research in the last 2 decades. Conjugated linoleic acid, which can be increased in milkfat by alteration of the cow's diet, has been reported to have anticancer, anti-atherogenic, antidiabetic, and antiobesity effects for human health. Separating milk fat into fractions has been accomplished to provide specific fractions to improve butter spreadability, modulate chocolate meltability, and provide texture for low-fat cheeses.     

Effect of proteolysis during Cheddar cheese aging on the detection of milk protein residues by ELISA

Cow milk is a common allergenic food, and cow milk-derived cheese retains an appreciable level of allergenicity. The specific and sensitive detection of milk protein residues in foods is needed to protect milk-allergic consumers from exposure to undeclared milk protein residues contained in foods made with milk or milk-derived ingredients or made on shared equipment or in shared facilities with milk or milk-derived ingredients. However, during cheese ripening, milk proteins are degraded by chymosin and milk-derived and bacterial proteases. Commercial allergen-detection methods are not validated for the detection of residues in fermented or hydrolyzed products. The objective of this research was to evaluate commercially available milk ELISA kits for their capability to detect milk protein residues in aged Cheddar cheese. Cheddar cheese was manufactured at a local dairy plant and was aged at 5°C for 24 mo, with samples removed at various time points throughout aging. Milk protein residues and protein profiles were measured using 4 commercial milk ELISA kits and sodium dodecyl sulfate-PAGE. The ELISA data revealed a 90% loss of milk protein residue signal between the youngest and oldest Cheddar cheese samples (0.5 and 24 mo, respectively). Sodium dodecyl sulfate-PAGE analysis showed protein degradation throughout aging, with the highest level of proteolysis observed at 24 mo. Results suggest that current commercial milk ELISA methods can detect milk protein residues in young Cheddar cheese, but the detection signal dramatically decreases during aging. The 4 evaluated ELISA kits were not capable of detecting trace levels of milk protein residues in aged cheese. Reliable detection of allergen residues in fermented food products is critical for upholding allergen-control programs, maintaining product safety, and protecting allergic consumers. Furthermore, this research suggests a novel use of ELISA kits to monitor protein degradation as an indication of cheese ripening.     

Milk Derived Antimicrobial Bioactive Peptides: A Review

In recent decades, bioactive peptides have attracted increasing interest as health promoting functional foods. A variety of naturally formed bioactive peptides have been found in fermented dairy products such as yogurt, sour milk, and cheese. Initially these peptides are inactive within the sequence of the parent protein molecule and can be generated by gastrointestinal digestion of milk, fermentation of milk with proteolytic starter cultures, and/or hydrolysis by proteolytic enzymes. Milk derived peptides exert a number of health beneficial activities, even upon oral administration. Bioactive peptides have a great impact on major body systems including the digestive, nervous, endocrine, cardiovascular, diabetes type II, obesity, and immune systems. Antimicrobial peptides are also an important ingredient of innate immunity, especially at mucosal surfaces such as lungs and small intestine that are constantly exposed to a range of potential pathogens. Therefore, it plays an important role in boosting natural immune protection by reducing the risk of chronic diseases. Bioactive peptides are considered as potent drugs with well-defined pharmacological residues and also used to formulate health-enhancing nutraceuticals.     

Exposure Assessment to Salmonella by Consumption of Informally Marketed Milk and Gouda Cheese in Musanze Town,Rwanda

This study assesses the exposure to Salmonella by consumption of boiled milk and Gouda cheese in Musanze town, Rwanda. A consumer survey (n = 90) revealed that among milk buyers in milk shops, 40.0% were also buying boiled milk for their families resulting in consumption by 136 consumers, mainly adults aging between 19-29 years (32.3%). Among those interviewed consumers in households, 66.7% were re-boiling the milk and 33.3% were storing it refrigerated before consumption. Gouda cheese is usually sold in supermarkets belonging to the formal market. A cheese portion with a weight of 62.5 g is mainly consumed (80.0%, n=370), and the weekly consumption frequency is most in practice (38.1%). A probabilistic exposure model was built up by taking into account prevalence data of Salmonella contamination in boiled milk and Gouda cheese in Rwanda, assumed concentration data of Salmonella, information of the milk chain gathered by observation, and collected consumption data and consumer behavior information. Finally, the risk of infection per day and per year were calculated for different categories of consumers. It appears that even though Salmonella is eliminated by milk boiling, the risk of infection still persists due to post-contamination in the milk shops (8.4% of consumers infected per year), but is decreased by additional boiling in households to 4.9% (children) and 4.6% (adults) per year. For cheese consumption, the risk of infection was lowered by multiple food safety interventions for cheese producers such as trainings on food hygiene and provision of modern equipments improving thus the situation from before to after 2012 by 30.0%% per year in case of adults. Those calculations demonstrate clearly that the additional efforts to reduce the occurrence of Salmonella in the Rwandan dairy chain will benefit the Rwandan population and decrease the burden of food borne disease.     

蛋白质组学在乳及乳制品特性研究中的应用

蛋白质组学工具可用于考察蛋白质的多样性.随着越来越多的细菌基因组网络资源的日益丰富,可以利用蛋白质组学技术来筛选各种发酵食品中的微生物所表达的蛋白质,提供全面而动态的研究.综述了蛋白质组学技术的发展,及其在乳蛋白质以及乳酸菌蛋白质表达研究中的应用.以奶酪为例,介绍了蛋白质组学在复杂食品基质中的应用.     

Invited review: effects of milk ration on solid feed intake, weaning, and performance in dairy heifers

A feeding regimen that allows a smooth transition from milk to solid feed is vital for successful heifer-rearing programs. In the past, research efforts have focused on the development of feeding methods that allow early weaning, perhaps because the risk of disease is highest during the milk feeding stage. To encourage early intake of calf starter, conventional feeding programs have limited the supply of milk (often to 10% of BW at birth). However, dairy calves provided free access to milk will typically consume more than twice this amount. We critically review the available literature examining the relationship between milk feeding method, solid feed consumption, and rumen development in young dairy calves and identify areas where new work is required. We conclude that milk-fed dairy calves can safely ingest milk at approximately 20% of body weight (BW)/d, and greater milk consumption supports greater BW gain, improved feed efficiency, reduced incidence of disease, and greater opportunity to express natural behaviors, which in combination suggest improved welfare. Method of weaning greatly influences feed consumption, rumen development, and growth check in calves provided higher amounts of milk. Gradual weaning encourages starter intake during the preweaning period, and both weaning age and duration of weaning influence this consumption. Increased solid feed consumption during the weaning process contributes to rumen development, permitting higher starter intake and BW gain after weaning. Growth factors in milk may also enhance the growth and maturation of the gastrointestinal tract, but more research is required to understand the role of these factors. Greater nutrient supply through increased amount of milk appears to improve immune function and long-term performance of heifer calves; for example, reducing the age at first breeding and increasing first-lactation milk yield, but more research is needed to confirm these effects.     

Major scientific advances with dairy foods in nutrition and health

A large body of scientific evidence collected in recent decades demonstrates that an adequate intake of calcium and other nutrients from dairy foods reduces the risk of osteoporosis by increasing bone acquisition during growth, slowing age-related bone loss, and reducing osteoporotic fractures. These results have culminated in the new (2005) Dietary Guidelines for Americans that now recommend 3 servings of milk products per day to reduce the risk of low bone mass and contribute important amounts of many nutrients that may have additional health attributes beyond bone health. A number of animal, observational, and clinical studies have shown that dairy food consumption can help reduce the risk of hypertension. Clinical trials indicate that the consumption of recommended levels of dairy products, as part of a healthy diet, can contribute to lower blood pressure in individuals with normal and elevated blood pressure. Emerging data also indicate that specific peptides associated with casein and whey proteins can significantly lower blood pressure. In addition, a growing body of evidence has provided support for a beneficial effect of dairy foods on body weight and fat loss. Clinical studies have demonstrated that during caloric restriction, body weight and body fat loss occurs when adequate calcium is provided by supplements and that this effect is further augmented by an equivalent amount of calcium supplied from dairy foods. Several studies support a role for calcium, vitamin D, and dairy foods against colon cancer. Additionally, conjugated linoleic acid, a fatty acid found naturally in dairy fat, confers a wide range of anticarcinogenic benefits in experimental animal models and is especially consistent for protection against breast cancer.     

Fermented dairy products: knowledge and consumption.

PURPOSE: Much has been published on the nutritional and health benefits of fermented dairy products, especially those containing probiotic microorganisms. However, consumers may not be familiar with the term "fermented dairy products," and therefore may not take full advantage of them. University students' knowledge and consumption patterns of fermented dairy products were assessed. METHODS: University students (n=223) completed a survey consisting of a section on demographics and another on knowledge and consumption patterns. RESULTS: The majority of respondents (62%) were not familiar with the term "fermented dairy products." Most respondents consumed yogourt a few times a week (40%) or a few times a month (30%). Almost all respondents (92%) were unable to identify the difference between regular and probiotic yogourt. Most respondents (93%) had not heard of acidophilus milk, but the majority (65%) would be willing to try it. Most respondents were unsure whether sour cream (65%), yogourt beverages (74%), and cheddar cheese (61%) were fermented dairy products. Sixty percent of respondents never consumed yogourt drinks. CONCLUSIONS: Education is needed about fermented dairy products, especially probiotics, and their nutritional and health benefits. Such education may increase their acceptability and consumption.     

Application of proteomics to the characterisation of milk and dairy products

The use of proteomic tools allows a global and dynamic view of proteins that are expressed by bacteria. As an increasing number of bacterial genomes is currently available for homology searches, it is now possible to use such techniques to screen proteins expressed by microorganisms used in various fermented foods. Proteomic tools are also useful to investigate protein heterogeneity in protein-rich foods. In this paper the use of proteomic tools for the characterisation of milk proteins and in the study of protein expression of lactic acid bacteria used for manufacture of dairy products is reviewed; particular attention is given applied to advances in proteomic techniques available. The particular case of proteomics applied to cheese as an example of a complex food matrix [a mixture of animal (milk) and microbial proteins] is discussed, focusing on a novel strategy that allows the study of the enzymatic machinery found in situ in cheese.     

Fate of lysostaphin in milk from individual cows through pasteurization and cheesemaking

Transgenic cows secreting over 3 μg of lysostaphin/ mL of milk are protected against mastitis caused by Staphylococcus aureus, but it is unknown if active lysostaphin persists through dairy processing procedures or affects the production of fermented dairy foods. The objective of this study was to determine the fate of lysostaphin as milk was pasteurized and then processed into cheese. Raw milk from transgenic cows was heat treated at 63°C for 30 min, 72°C for 15 s (high temperature, short time), or 140°C for 2 s (UHT). Portions of the high temperature, short-time milk were manufactured into semi-hard cheeses. Aliquots taken at each processing step were assayed to determine the quantity (ELISA) and activity (ability to inhibit S. aureus growth) of lysostaphin. Results indicated that most of the lysostaphin was present in the aqueous portion of the milk and was not affected by pasteurization, although UHT treatment reduced enzyme concentration by 60%. The quantity and activity of the lysostaphin decreased during cheesemaking. Based on the amount of lysostaphin present in the starting cheesemilk, 10 to 15% of the lysostaphin was recovered in the whey, 21 to 55% in the cheese curd at d 1, and 21 to 36% in cheese stored at 4°C for 90 d. Enough of the lysostaphin secreted into milk by transgenic cows survived typical dairy processing conditions to impart potential value as a bioprotective agent against staphylococci in dairy foods.     

Short communication: Survival of the characteristic microbiota in probiotic fermented camel,cow, goat,and sheep milks during refrigerated storage

The objective of this study was to monitor the viability during storage of Lactobacillus acidophilus LA-5 (A), Bifidobacterium animalis ssp. lactis BB-12 (B), and Streptococcus thermophilus CHCC 742/2130 (T) in probiotic cultured dairy foods made from pasteurized camel, cow, goat, and sheep milks fermented by an ABT-type culture. The products manufactured were stored at 4°C for 42 d. Microbiological analyses were performed at weekly intervals. Streptococcus thermophilus CHCC 742/2130 was the most numerous culture component in all 4 products both at the beginning and at the end of storage. The viable counts of streptococci showed no significant decline in fermented camel milk throughout the entire storage period. The initial numbers of Lb. acidophilus LA-5 were over 2 orders of magnitude lower than those of Strep. thermophilus CHCC 742/2130. With the progress of time, a slow and constant decrease was observed in lactobacilli counts; however, the final viability percentages of this organism did not differ significantly in the probiotic fermented milks tested. The cultured dairy foods made from cow, sheep, and goat milks had comparable B. animalis ssp. lactis BB-12 counts on d 0, exceeding by approximately 0.5 log₁₀ cycle those in the camel milk-based product. No significant losses occurred in viability of bifidobacteria in fermented camel, cow, and sheep milks during 6 wk of refrigerated storage. In conclusion, all 4 varieties of milk proved to be suitable raw materials for the manufacture of ABT-type fermented dairy products that were microbiologically safe and beneficial for human consumption. It was suggested that milk from small ruminants be increasingly used to produce probiotic fermented dairy foods. The development of camel milk-based probiotic cultured milks appears to be even more promising because new markets could thus be conquered. It must be emphasized, however, that further microbiological and sensory studies, technology development activities, and market research are needed before such food products can be successfully commercialized.     

Carotenoids and retinoids in Finnish foods: dairy products and eggs

As part of an overall composition study of Finnish foods, the carotenoid and retinoid content of 20 dairy product samples and eggs were determined by HPLC. The total beta-carotene (all-trans beta-carotene plus 15-cis beta-carotene) was quantitated for dairy products. For egg and egg yolk, lutein content was also determined. Only traces of lycopene, cryptoxanthin, and alpha-carotene were present. All-trans retinol and 13-cis retinol were the major retinoids in dairy products. Small amounts of 9-cis, 11-cis, and 9,11-cis retinols were found. High values of both retinol and beta-carotene were found in full fat cheeses and whipping cream: from 179.0 (cheese, Edam-type) to 318.7 micrograms/100 g (whipping cream) and from 86.7 (cheese, Edam-type) to 186.5 micrograms/100 g (whipping cream) for all-trans retinol and total beta-carotene, respectively. The retinol content averaged 16.3, 32.6, and 52.2 and that of beta-carotene 9.6, 16.7, and 3.0 micrograms/100 g in milk (1.9% fat), milk (3.9% fat), and human milk, respectively. The major pigment in eggs and egg yolk was lutein, 619.5 micrograms/100 g in eggs and 1575.8 micrograms/100 g in egg yolk. According to this study, at the present level of consumption in Finland, milk, milk products (excluding butter), and eggs result in a daily intake of about 350 retinol equivalents, and consequently, are a major source of vitamin A.     

Heavy metals and trace elements levels in milk and milk products

Milk and dairy products are an important food in the human diet. The present investigation was carried out to determine concentrations of lead, cadmium, zinc, copper and iron in milk and dairy products and evaluate the potential health risks of metals to humans via consumption of milk and dairy products. A total of 77 samples of milk and dairy products (22 raw milk, 20 kareish cheese, 21 butter and 14 rice pudding) were collected from farms, individual farmers and dairy shops in Beni-Suef governorate, Egypt. Pb, Cd, Zn, Cu and Fe concentrations in milk and dairy products ranged from 0.044–0.751, 0.008–0.179, 0.888–18.316, 0.002–1.692 and 1.3208–45.6198 ppm respectively. Pb concentration in all samples exceeded the maximum permissible limit (0.02 mg/kg) established by codex standard. Pd and Cd intake through milk and dairy products consumption were 1.27 and 0.33 μg/kg bw/day, which represent 35.3 and 39.8 % of the tolerable daily intake. Dairy products are poor sources of iron, copper and zinc, and milk contributes little to the total iron and zinc intake. Target hazard quotient values of less than 1 indicate a relative absence of health risks associated with the consumption of milk and dairy products.     

Consumers' perceptions toward 3 different fermented dairy products: Insights from focus groups,word association,and projective mapping

Yogurts, fermented milk beverages, and fermented milks have great similarity and are widely accepted by Brazilian population, but the factors that influence their choice and consumption are unknown. In this sense, the present study aimed to identify the main aspects involved in consumers' perception of 3 different products, comparing the findings by using the 2 fast qualitative methods, word association and projective mapping, and a standard method, focus group. The tasks were performed by different participants through graphic stimuli (word association and projective mapping) and focus interviews (focus group). Results showed that all the 3 methodologies identified numerous intrinsic and extrinsic factors that influence the consumer choices regarding fermented dairy products. Major dimensions were closely related to the sensory aspects, emotional factors, perception of benefits, and composition, among others. It is noteworthy that the stimuli related to fermented milk beverages evoked rejecting responses, possibly due to the dissociation between information and consumers' expectation. Although minor differences were observed between the number and type of dimensions that were obtained, similar conclusions can be drawn from all 3 sensory methods, which shows the relevance of qualitative and projective methods for investigation of consumers' perception. These findings can help dairy companies to provide subsidies and guidelines for the reformulation of their products, marketing strategies, and improvement in the communication between producers and consumers from different fermented dairy products.     

Lactic Fermentation of Ground Soybean for Use in Imitation Cream Cheese Products

Ground soybean fermented with Lactobacillus casei ssp. rhamnosus (ATCC 39595) was found to contain diacetyl and acetyl-methylcarbinol. The fermented ground soybean showed significantly improved flavor and texture compared to nonfermented material when used to replace nonfat dry milk in an imitation cream cheese product. The flavor improvement was due principally to the presence of diacetyl but the factor(s) responsible for texture improvement was not identified. Didcetyl production by L. casei was enhanced by the addition of sodium acetate or sodium citrate to the ground soybean suspension before fermentation.