Role of Functional Fortified Dairy Products in Cardiometabolic Health: A Systematic Review and Meta-analyses of Randomized Clinical Trials

There is insufficient evidence on the role of functional fortified dairy products in improving health and in preventing risk factors associated with noncommunicable chronic diseases. This systematic review was conducted to summarize effects of the consumption of fortified dairy products on biomarkers of cardiometabolic risk. MEDLINE and SCOPUS databases were used to perform searches to include studies published up to 30 April 2018. Randomized clinical trials with human subjects consuming dairy products fortified with phytosterols, FAs, vitamins or minerals and relating this consumption with cardiometabolic health were included in this review. Risk of bias assessment according to Cochrane guidelines was performed to determine the quality of the trials. Forty-one studies were finally selected for this synthesis; the selected studies tested dairy products fortified with the following nutrients and bioactive components: phytosterols (n=31), FAs (n=8), and vitamin D (n=2). We found that the consumption of phytosterol-fortified dairy, led to an overall LDL cholesterol reduction of -0.36 (-0.41,-0.31) mmol/L, P < 0.001; this decrease was mainly related to the dosage. Likewise, consumption of omega-3 FA-fortified dairy products resulted in a plasma LDL cholesterol reduction of -0.18 (-0.27,-0.09) mmol/L as well as a decrease of -0.18 (-0.32,-0.05) mmol/L in triacylglycerols ( TG). Performing meta-analyses of the consumption of dairy products fortified with vitamin D or FAs other than omega-3 FAs and biomarkers of cardiometabolic risk was not possible because of the few available publications. Our results indicate that consumption of dairy products fortified with phytosterols and omega-3 FAs can lead to a reduction of LDL cholesterol and consumption of fortified dairy products fortified with omega-3 FAs can reduce TG concentration. However, more studies with homogeneous designs are needed to determine the advantages of using dairy products as fortification vehicles to prevent cardiometabolic risk.