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Milk polar lipids reduce lipid cardiovascular risk factors in overweight postmenopausal women: towards a gut sphingomyelin-cholesterol interplay

Cécile Vors 1 Laurie Joumard-Cubizolles 2 Manon Lecomte 1 Emmanuel Combe 1 Lemlih Ouchchane 3, 4 Jocelyne Drai 1, 5 Ketsia Raynal 6 Florent Joffre 7 Laure Meiller 1, 8 Mélanie Le Barz 1 Patrice Gaborit 6 Aurélie Caille 9 Monique Sothier 10 Carla Domingues-Costa Faria 2 Adeline Blot 11 Aurélie Wauquier 12 Emilie Blond 1 Valérie Sauvinet 1 Genevieve Gesan-Guiziou 13 Jean-Pierre Bodin 14 Philippe Moulin 1, 15 David Cheillan 1, 16 Hubert Vidal 1 Béatrice Morio 1 Eddy Cotte 17, 18 Françoise Morel-Laporte 19 Martine Laville 1 Annick Bernalier 20 Stéphanie Lambert-Porcheron 21 Corinne Malpuech Brugere 2 Marie-Caroline Michalski 1
Abstract : Objective To investigate whether milk polar lipids (PL) impact human intestinal lipid absorption, metabolism, microbiota and associated markers of cardiometabolic health. Design A double-blind, randomised controlled 4-week study involving 58 postmenopausal women was used to assess the chronic effects of milk PL consumption (0, 3 or 5 g-PL/day) on lipid metabolism and gut microbiota. The acute effects of milk PL on intestinal absorption and metabolism of cholesterol were assessed in a randomised controlled crossover study using tracers in ileostomy patients. Results Over 4 weeks, milk PL significantly reduced fasting and postprandial plasma concentrations of cholesterol and surrogate lipid markers of cardiovascular disease risk, including total/high-density lipoprotein-cholesterol and apolipoprotein (Apo) B/ApoA1 ratios. The highest PL dose preferentially induced a decreased number of intestine-derived chylomicron particles. Also, milk PL increased faecal loss of coprostanol, a gut-derived metabolite of cholesterol, but major bacterial populations and faecal short-chain fatty acids were not affected by milk PL, regardless of the dose. Acute ingestion of milk PL by ileostomy patients shows that milk PL decreased cholesterol absorption and increased cholesterol-ileal efflux, which can be explained by the observed co-excretion with milk sphingomyelin in the gut. Conclusion The present data demonstrate for the first time in humans that milk PL can improve the cardiometabolic health by decreasing several lipid cardiovascular markers, notably through a reduced intestinal cholesterol absorption involving specific interactions in the gut, without disturbing the major bacterial phyla of gut microbiota.
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Cécile Vors, Laurie Joumard-Cubizolles, Manon Lecomte, Emmanuel Combe, Lemlih Ouchchane, et al.. Milk polar lipids reduce lipid cardiovascular risk factors in overweight postmenopausal women: towards a gut sphingomyelin-cholesterol interplay. Gut, BMJ Publishing Group, 2020, 69 (3), pp.487-501. ⟨10.1136/gutjnl-2018-318155⟩. ⟨hal-02154680⟩

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