Effects of Saturated Fatty Acids from Butter and Cheese on High‐density Lipoprotein (HDL)‐Mediated Cholesterol Efflux Capacity
Authors: Brassard Didier , Arsenault Benoît , Boyer Marjorie , Bernic Daniela , Tessier‐Grenier Maude , Tremblay Angelo , Jones Peter , Levy Emile , Couture Patrick , Lamarche Benoît 
Published: November 2023

OBJECTIVEThe association between dietary saturated fat (SFA) intake and cardiovascular disease risk remains controversial. Emerging data suggest that SFA from different sources may show different association with cardiovascular and cardiometabolic risk. The objective of this study was to examine how SFA from cheese (CHEESE) influences HDL‐mediated cholesterol efflux capacity (CEC), a key anti‐atherogenic property of HDL, compared with a low fat/high carbohydrate diet (CHO), a diet rich in SFA from butter (BUTTER) and diets either high in monounsaturated (MUFA) or polyunsaturated fatty acids (PUFA).METHODSA total of 46 men and women with abdominal obesity and with relatively low HDL cholesterol (HDL‐C) completed this randomized crossover controlled trial consisting of 5 predetermined isoenergetic diets of 4 weeks each (Table 1): 1) CHEESE, 2) BUTTER, 3) MUFA, 4) PUFA, 5) CHO. All foods were provided to participants during each experimental diet. CEC was assessed with radiolabelled J774 macrophages using apolipoprotein B depleted serum samples taken from participants at the end of each dietary phase. HDL lipid composition (gas chromatography) and HDL particle size distribution (polyacrylamide gradient gel electrophoresis) were also assessed.RESULTSAll higher fat diets increased HDL‐C concentrations compared to CHO (all p<0.001). BUTTER and CHEESE increased low‐density lipoprotein cholesterol (LDL‐C) concentrations more than CHO, MUFA and PUFA diets, particularly among individuals with high baseline LDL‐C (all p<0.001). LDL‐C concentrations tended to be greater after BUTTER than after CHEESE (p=0.07). BUTTER, PUFA and CHEESE significantly increased large HDL2b levels compared to CHO (all p≤0.01). BUTTER also increased HDL2b levels more than MUFA (p=0.04). There was no difference in HDL‐mediated CEC between CHEESE and CHO (p=NS). BUTTER significantly increased HDL‐mediated CEC compared to CHEESE and CHO (both p<0.05). MUFA also increased CEC compared to CHEESE and CHO (both p<0.05). PUFA had no significant effect on HDL CEC compared to the others diets (p=NS). The increase in LDL‐C after BUTTER (vs. CHO) was significantly correlated with concurrent increase in CEC in men (r=0.44, p=0.04), but not in women (r=0.27, p=0.20).CONCLUSIONSThese results provide evidence of a matrix effect modulating the effects of dairy SFA on HDL characteristics and function, with greater changes seen with SFA from butter than with SFA from cheese in men and women with abdominal obesity and with relatively low HDL‐C levels. The increase in HDL‐mediated CEC seen with SFA from butter parallels the increase in LDL‐C among men, but not among women. Additional studies assessing other HDL functions will provide further insights on how the food source may modify the effects of SFA on cardiometabolic risk.Support or Funding InformationDairy Research Cluster Initiative (Dairy Farmers of Canada, Agriculture and Agri‐Food Canada, the Canadian Dairy Network and the Canadian Dairy Commission) and the National Dairy Council.
Macronutrients (% energy), calcium, sodium and fibers content of experimental diets

CHEESE
BUTTER
MUFA
PUFA
CHO

Lipids (%)
32.0
32.0
32.0
32.0
25.0

SFA (%)
12.6
12.4
5.8
5.8
5.8

MUFA (%)
12.5
12.3
19.6
12.6
12.6

PUFA (%)
4.8
4.8
4.8
11.5
4.8

Carbohydrates (%)
51.9
52.0
51.9
51.9
58.9

Proteins (%)
16.0
16.0
16.0
16.0
16.0

Calcium (mg/2500 kcal)
1261
811
812
812
842

Sodium (mg/2500 kcal)
2482
2480
2479
2479
2485

Fibers (g/2500 kcal)
31
31
31
31
31