Dairy fat in cheese raises LDL cholesterol less than that in butter in mildly hypercholesterolaemic subjects

Objective: To determine whether dairy fat in cheese raises low-density lipoprotein (LDL) cholesterol as much as in butter, since epidemiology suggests a different impact on cardiovascular disease. Design: A randomised crossover trial testing the daily consumption of 40 g dairy fat as butter or as matured cheddar cheese, each of 4 weeks duration, was preceded by and separated by 2-week periods when dietary fat was less saturated. Setting: Free-living volunteers. Subjects: A total of 14 men and five women of mean age 56 +/- 8 y, with mean total cholesterol of 5.6 +/- 0.8 mmol/l. Main outcome measures: Plasma cholesterol, LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), triacylglycerol and glucose. Results: Saturated fat intake was significantly lower during the run-in than during the cheese and butter periods. Mean lipid values did not differ significantly between the cheese and run-in periods, but total cholesterol and LDL-C were significantly higher with butter: total cholesterol (mmol/l): butter 6.1 +/- 0.7; run- in 5.6 +/- 0.8 ( P<0.05; ANOVA with Bonferroni adjustment); vs cheese 5.8 +/- 0.6 (P>0.05); median LDL-C (mmol/l): butter 3.9 (3.5 - 4.1) vs run- in 3.4 (3.0 - 4.1) (P<0.05; Tukey test); vs cheese 3.7 (3.3 - 3.9) (P>0.05). Among 13 subjects whose initial LDL-C was >4 mmol/l, the difference between butter (4.4 +/- 0.3 mmol/l) and cheese (3.9 +/- 0.3 mmol/l) was significant ( P = 0.014). HDL-C was highest with butter and triacylglycerol with cheese ( neither was significant). Conclusion: A total of 40 g dairy fat eaten daily for 4 weeks as butter, but not as cheese, raised total and LDL cholesterol significantly compared with a diet containing significantly less saturated fat. Dietary advice regarding cheese consumption may require modification.