Showing posts with label dairy. Show all posts
Showing posts with label dairy. Show all posts

Wednesday, November 4, 2015

Milk Fat Globule Membranes Power Up Strength Gains by Improving the Wiring of Subjects' Muscles | Plus: Its Proven Health, EPO & Immune-Boosting Effects Won't Hurt Either

At the moment it is by no means clear which type of athlete / gymrat would benefit from milk fat globule membrane supplementation and which wouldn't. It's after all well possible that the effects Soga et al. observed in rookies wouldn't occur in adv. trainees or professional athletes.
After the study on nucleotide supplements the Satako Soga's latest paper on the dietary supplementation with milk fat globule membrane is #2 on the list of studies with promising new ergogenics in less than a month. In view of the fact that the last year has been devoid of any true innovations, this is a welcome diversion from writing about whey (or other protein powders), creatine, beta alanine and baking soda, as well as the occasional study on HMB for me.

In spite of the fact that this is a follow up on previous rodent studies from the same researchers, I must warn you not to to expect too much of MFGMs, yet. More data and studies with more realistic resistance training + supplementation protocols from independent labs are warranted before MFGMs may eventually appear next to the previously mentioned top dogs on a list of "waredownloadsoft Recommended Supplements".
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But hey, let's keep the skepticism for the bottom line and take a look at what the scientists from the Kao Corporation did with their fourteen Japanese subjects. The men, who were aged 31–48 years and did not participate in regular strength training before the study, took 1 g of the  structural membranes of milk which are usually covering the triglyceride globules that are dispersed as emulsified bodies in milk or 1g of an identically looking whole milk powder as a placebo in tablet form for 4-weeks (composition see Table 1).
Table 1: Composition of MFGM and whole milk powder (Soga. 2015)
"On the exercise training enforcement days [i.e. the days on which the subjects were required to train], the subjects were instructed to take the tablet within 1 h before training. On the other days, the subjects were instructed to consume the tablet at the time of their choice during their daily routines.
The MFGM was prepared from buttermilk by filtering and centrifugation. The MFGM and whole milk powder compositions were analyzed at Japan Food Research Laboratories (Tokyo, Japan)" (Soga. 2015).
The exercise routine the subjects from both groups had to follow consisted of two workouts per week. The workouts had to be performed on nonconsecutive days for 4 weeks using StrengthErgo 240 stationary cycling exercise machines (Mitsubishi Electric Corporation, Tokyo, Japan). On these machines, the subjects completed 3 sets of 15 % maximal voluntary contraction (MVC) cycle exercises for 60 s and 7 sets of 20 % MVC cycle exercises for 40 s at 50 rpm.
Preliminary rodent studies show that sign. increases in swimming time to exhaustion occur with as little as the equivalent of 1g/day of MFMG (Haramizu. 2014a) - The dose-dependency of the effects suggest that it may be worth taking more than 1g/day for humans, too.
What's the optimal dosage? It is way too early to answer this question with confidence, but the dosage in Soga's study was selected based on the results of previous rodent studies, where the equivalent of the 1 g the subjects consumed in the study at hand turned out to be the minimal effective dosage. In view of the fact that you will find the same amount of MFGM in just 600 ml of full fat milk, I am yet inclined to believe that it may be worth checking if dose-escalations would not yield even better and still side-effect free increases in strength gains and/or increases in endurance performance and fatty acid oxidation as they were observed in previous rodent studies (Haramizu. 2014a). Furthermore, preliminary data from a 4-week safety evaluation by Hari et al. (2015) shows that even 6.5 g/day are without side-effects in healthy humans.
Physical function tests and surface electromyography (EMG) were conducted at baseline and at the end of the study period. In addition, some hemotological parameters were tested of which - surprise - the data in Figure 1 tells you that MFGMs have a small, but statistically significant "EPO-effect" and are thus capable of raising both the red blood cell and hemoglobin content - an effect that has been observed in rodents too (Haramizu. 2014b) and may be ascribed to the incorporation of MFGM phospholipids into red blood cells which would in turn be less vulnerable to exercise-related or other stressors. Whatever the reason for these changes may be, they are certainly in line with the previously mentioned (see red box) increase in fatty acid oxidation during endurance exercise that may be facilitated by an RBC and hemoglogin related increase in oxygen transport.
Figure 1: The significant increase in red blood cell and hemoglogin content could explain the previously observed increases in endurance performance and fatty acid oxidation in Haramizu et al. (2014a). The buffered decrease in white blood cell may not be statistically significant, but may still indicate beneficial effects on the immune system (Soga. 2015).
Both the increase in RBC and hemoglobin, as well as the buffering of the albeit non-significant decline in white blood cells in the placebo group, which may be a response to the exercise-induced stress and evidence of an immune-boosting effect of MFGM supplementation during any potentially exercise induced immune suppression, do yet need further investigation before they can be explained mechanistically.

No further research is needed, though, to state that all other blood markers. These included AST + ALT (liver health), glucose and triglycerides + cholesterol, neither of which was affected by the supplement. The latter cannot be said of the increase in leg extension strength before and after the intervention and the EMG activity which showed highly significant inter-group differences.
Do I even have to supplement? I mean, I can just drink 600ml of full fat milk, right? I don't doubt that you can do just that. The problem is that the milk you can drink will probably be pasturized - a process of which Cano-Ruiz et al. (1997) have shown that it will induce significant and potentially functionally relevant differences in the composition of the milk fat globule membrane. Whether the supplement that was used at the study at hand was made during the production of buttermilk before or after pasteurization is not clear. If we assume it was made after pasteurization, though, you could in fact hope for similar results from pasteurized whole milk. Otherwise, the milk would have to be raw (even if it is, though it cannot be guaranteed that the same amount of MFGMs from milk will have identical effects).
In fact, the differences in Figure 2 are pronounced enough to ask the question: Were they induced by the supplementation alone or did the pathetic training regimen have an effect here, as well? As I am going to point out in the bottom line one paragraph below, we will need studies with more realistic training programs to answer this question in a way that's relevant for trainees like you and me. In the mean time, however, there is no debating "that the daily intake of 1 g MFGM combined with regular, twice weekly exercise improved skeletal muscle strength (leg extension) in middle-aged adults, despite a lack of change in muscle mass" (Soga. 2015).
Figure 2: The MFGM supplementation lead to significant increases in leg extension strength, of which the increase in EMG activity (likewise sign.) suggests that they were mediated by neuronal changes (Soga. 2015).
The same goes for the increase in RMS of surface EMG, which indicates that the dietary provision of MFGM increased the average (RMS = root mean square) motor unit activity during muscle contraction and may thus mechanistically explain why the subjects got stronger even though they didn't make substantial gains in muscle mass: The supplement helped them to "make the most" of the muscle they had. This hypothesis is in line with results from rodent studies which
"[...] revealed that dietary MFGM combined with regular exercise improved muscle strength in adult mice primarily by stimulating the pathway involving “nervous system development” in the skeletal muscle (Haramizu. 2014b). This pathway includes functional annotations such as formation of synapses, growth of neurites, or development of NMJ. Dietary MFGM combined with exercise increased skeletal muscle expression of docking protein-7 (Dok-7) and muscle-specific receptor tyrosine kinase in mice, both of which play a critical role in NMJ [neuromuscular junction] formation. Defects in NMJ function causes muscle weakness in neuromuscular disorders, and Dok-7 gene therapy improves NMJ formation and rescues the motor activity" (Soga. 2015).
And still, even at the risk that I may sound like a broken record, I have to repeat that without future research it is impossible to tell (a) whether the assumptions we've made about the increase in red blood cell count are accurate and, maybe even more importantly, (b) who, i.e. which type of athlete, will benefit most from using MFGM supplements.
MFGMs can do much more! It's not like this was the first study on MFGMs. It's just the first study on exercise performance in humans. In rodents performance incre- ments (see red box), as well as increases in RBC and EMG have long been established. In older women MFGMs have been shown to improve or fully reverse frailty (Kim. 2015). As hinted at in the conclusion, the addition of MFGMs to infant formulas will also narrow the gap in cognitive development and lipid composition (+future VCD risk) between breastfed and formula-fed infants (Timby. 2014a,b).

Other purported benefits include anti-cancer effects (Lemonnier. 2003) stress protection, the potential to reduce the risk of Alzheimer's (Spitsberg. 2005) and increase gastrointestinal intergrity (Snow. 2010), and beneficial effects on blood lipids (Noh. 2004) and cardio-vascular health where some researchers expect beneficial, while others fear detrimental effects (Riccio. 2004; Spitsberg. 2005; Singh. 2006). Since most of these effects have been observed in vitro or in rodent studies, it is yet by no means clear which of them would occur in response to MFGM supplementation.
Bottom line: As I already pointed out in the introduction, it is way too early to celebrate MFGMs as "the next big thing" or the supplemental reincarnation of the "a gallon of milk per day" protocol which would have provided its followers a highly significant 6g+ dose of MFGM on a daily basis.

The reason(s) we need further research are simple. Firstly, we need independent validation of the results that were generated by scientists who work for a company that produces milk fat globule membranes. Secondly, studies in trained individuals in whom the purportedly mechanistically involved improvements in the neuronal wiring of the muscle may be significantly less pronounced, as well as studies involving more realistic resistance training and endurance training protocols to confirm the beneficial effects that were observed in this study and the rodent study by Haramizu et al. which found significant increases in maximal endurence (see red box) are required to be able to tell for whom MFGM supplements will be beneficial. And third- and lastly, experiments with different dosing protocols (timing and amount) are necessary to determine the optimal dosing schemes - preferably for different types of exercises.

With that being said, MFGMs are still one of the more promising newcomers, lately. Their effects are after all not restricted to performance enhancing in the narrow(er) sense, but extend into the realms of general health and fitness (see box on the right hand side of this bottom line). In conjunction with their potential use as additives to baby formula, where they have already been shown to improve risk markers of future cardiometabolic disease and the babies' cognitive development to an extent that marginalizes the benefits of breast-feeding in these areas, make them one of the hottest candidates on my personal "still insufficient evidence, but promising"-list of supplement to keep an eye on | Comment on Facebook!
References:
  • Cano-Ruiz, M. E., and R. L. Richter. "Effect of homogenization pressure on the milk fat globule membrane proteins." Journal of Dairy Science 80.11 (1997): 2732-2739.
  • Haramizu, Satoshi, et al. "Dietary milk fat globule membrane improves endurance capacity in mice." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 307.8 (2014): R1009-R1017.
  • Haramizu, Satoshi, et al. "Habitual exercise plus dietary supplementation with milk fat globule membrane improves muscle function deficits via neuromuscular development in senescence-accelerated mice." SpringerPlus 3 (2014): 339.
  • Kim, Hunkyung, et al. "Effects of Exercise and Milk Fat Globule Membrane (MFGM) Supplementation on Body Composition, Physical Function, and Hematological Parameters in Community-Dwelling Frail Japanese Women: A Randomized Double Blind, Placebo-Controlled, Follow-Up Trial." PloS one 6.10.2 (2015): e0116256.
  • Lemonnier, Lori A., et al. "Sphingomyelin in the suppression of colon tumors: prevention versus intervention." Archives of Biochemistry and Biophysics 419.2 (2003): 129-138.
  • Riccio, Paolo. "The proteins of the milk fat globule membrane in the balance." Trends in food science & technology 15.9 (2004): 458-461.
  • Singh, Harjinder. "The milk fat globule membrane—A biophysical system for food applications." Current Opinion in Colloid & Interface Science 11.2 (2006): 154-163.
  • Snow, D. R., et al. "Membrane-rich milk fat diet provides protection against gastrointestinal leakiness in mice treated with lipopolysaccharide." Journal of dairy science 94.5 (2011): 2201-2212.
  • Soga, Satoko, Noriyasu Ota, and Akira Shimotoyodome. "Dietary milk fat globule membrane supplementation combined with regular exercise improves skeletal muscle strength in healthy adults: a randomized double-blind, placebo-controlled, crossover trial." Nutrition Journal 14.1 (2015): 85.
  • Spitsberg, V. L. "Invited review: Bovine milk fat globule membrane as a potential nutraceutical." Journal of dairy science 88.7 (2005): 2289-2294.
  • Timby, Niklas, et al. "Neurodevelopment, nutrition, and growth until 12 mo of age in infants fed a low-energy, low-protein formula supplemented with bovine milk fat globule membranes: a randomized controlled trial." The American journal of clinical nutrition 99.4 (2014a): 860-868.
  • Timby, Niklas, et al. "Cardiovascular risk markers until 12 mo of age in infants fed a formula supplemented with bovine milk fat globule membranes." Pediatric research 76.4 (2014b): 394-400.
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Yogurts, Cheeses & Beyond - A Comprehensive Review of the Potential Health Benefits of Fermented Dairy Products

Yogurt does not have to be served this way to be healthy, but I bet many of your friends and relatives would be amazed and much more likely to pass on the cream cake or tiramisu if the option was an appetizing dessert like that.
In a world where being vegan is "the new sexy" and eating animal products "the new smoking", dairy has lost much of its former appeal. I mean, we all remember how the literal "glass of milk" has been marketed as a daily health booster, right? Well, times have changed and that despite the fact that an impartial review of the evidence suggests more benefits than downsides to dairy consumption. Specifically fermented dairy, first and foremost yogurt, but also cheese can, and in the case of yogurt maybe even should be part of your of your diet. And that's not just because both are an often forgotten, but essential part hailed "Mediterranean diet" (Vasilopoulou. 2013). The same diet of which recent studies say that it's associated w/ a -30% reduced CVD risk (Estruch. 2013).
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How's that? Well, cheese may be full of saturated fat and cholesterol. In controlled trials, however, even high fat cheese has - in contrast to butter, for example (Hjerpsted. 2011) - no or even beneficial effects on the total and LDL cholesterol levels of otherwise healthy individuals. In addition, real dairy cheese has been found to have neutral effects on body weight when it is consumed as part of an otherwise healthy diet. Some traditional types of cheese even share the anti-hypertensive effects of yogurt, which is still the real star among the fermented dairy products. A star that has been shown to prevent weight gain, reduce cholesterol and more meaningful makers of heart disease risk, to improve glycemia, and to prevent the development and/or progression of type II diabetes in both experimental and observational studies (Tholstrup. 2006; Nestel. 2008; Mozaffarian. 2011, Tapsell. 2015).
Figure 1: A study comparing the effects of getting 13% of one's total daily fat intake from cheese vs. butter on the blood lipids in healthy men and women shows increases in TC and LDL only with butter (Hjerpsted. 2013). In contrast to the total and LDL cholesterol levels, the total / HDL cholesterol ratio wasn't affected sign. by butter though. You can thus expect both forms of high fat dairy having negligible cholesterol mediated effects on the heart health of healthy indiv.
In short, the existing scientific evidence leaves little doubt that yogurt is, maybe next to whey (learn why), the star among the dairy based health foods. Part of its beneficial effects are probably mediated by its ability to improve integrity of our digestive tracts and thus to prevent the influx of pro-inflammatory, obesogenic, and pro-atherogenic endotoxins into the bloodstream. With it being available for almost 10,000 years, yogurt is thus the first and oldest "functional food" to act on the recently discovered link between "leaky gut", obesity and cardiovascular disease (Lam. 2011).
Figure 2: Proposed mechanisms by which yogurt consumption exerts beneficial health effects (Marette. 2015)
Some scientists like Marette & Picard-Deland even go so far as to argue that an early introduction of yoghurt into the diets of children is vital to establish a microbial community that supports long-term health. And while Taspell et al. are right to highlight that "[m]ore research is needed" (Tapsell. 2015). There's little doubt that "yogurt can deliver essential nutrients with high bioavailability and relatively low energy density" (ibid).
If the caloric content is controlled, the consumption of a high amount of dairy products (both fermented and non-fermented) is associated w/ sign. greater weight and fat loss - specifically unhealthy trunk fat (Zemel. 2015).
Simply adding yogurt or fermented dairy on top of an unhealthy diet is not going to cut it: People often fail to understand that "superfoods", no matter how "super" they are, can't work their weight loss or health magic if they are simply added on top of one's habitual diets. It is thus not surprising that the addition of yogurt and other fermented dairy products to the Western diet will not yield any significant health benefits if it does not replaces other, less healthier foods. If the energy intake is controlled for, as it was the case in a 2004 study by Zemel et al. higher dairy intakes are however - independent of their calcium content - associated w/ sign. greater weight & fat loss (s. left Figure)
The fact pertinent trials still show ambiguous results, when it comes to the effects of yogurt on body weight and composition (Chen. 2012) is mostly a results of the study designs which usually require subjects to simply increase their intake of dairy products, in general, or yogurt, in particular. As Taspell (2015) points out in a recent review this is a problem "if the energy content of the diet is not managed, particularly with high-fat varieties and with added ingredients such as sugar" (ibid). If it is managed, as in habitual consumers, though, high(er) yogurt intakes have been shown to be associated...
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    with higher scores for the Dietary Guidelines Adherence Index (DGAI) and higher intakes of key micronutrients, as well as significantly higher potassium and fiber intakes - two nutrients the average Westerner usually doesn't get enough of (Wang. 2013)
  • with reduced weight gain in a large US cohort study that tracked the food intake and weight development of 22 557 men and 98 320 women for four years; with R = -0.89 the correlation is similar to the one for the recommended amount of physical activity vs. being sedentary and thus nothing you should ignore as being practically irrelevant
  • with reduced inflammation as measured by C-reactive protein, IL-6 and TNF-a in the ATTICA study that involved 3042 healthy Greek adults for whom only 8 servings of dairy products, in general (full fat and low fat!), were linked with already significant reductions in inflammation; since a greater proportion of the cohort reported consumption of fermented dairy foods such as feta cheese (93%), hard yellow cheese (92%) and low-fat yogurt (50%) compared to low-fat milk (46%), we can yet safely assume that many of these anti-inflammatory benefits were actually due to fermented dairy products
  • with reduced type II diabetes risk (-12% or both yogurt and cheese) in the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct Study (Sluijs. 2012);
    Table 1: HRs for risk of type 2 diabetes associated with the substitution of yoghurt (137 ga) for snacks and desserts: EPIC-Norfolk study (n=4,127 | O'Connor. 2014)
    with 28% reduced diabetes risk the results of the EPIC-Norfolk cohort study in the UK were even more impressive (O’Connor. 2014); as you can see in Table 1 the results of this study do yet also underline that the benefits will occur only if yogurt replaces other, less healthier ingredients of ones diet.
Other studies detected significantly lower common carotid artery intima-media thickness (CCA-IMT) in older, female Australian yogurt enthusiasts who consumed only 100g of common yogurt per day (CCA-IMTadj = -0.023 mm, P< 0·003 | Ivey. 2011). And as far as cheeses are concerned evidence from studies like Struijk et al. (2013) which found significant negative associations between cheese intake and the 2h-post prandial glucose levels, a marker that's highly predictive of one's future diabetes risk (Struijk. 2013) and a much better indicator of diabetes-related CVD risk than fasting glucose (Lithell. 2001), would suggest that the existing link between higher cheese intakes and diabetes may be mediated by the complex food matrices in which cheese appears in the Western diet: Cheeseburger, pizza, etc. In the standard Western diet, cheese is always added on top of other (usual junk) foods, which is much in contrast to the way it is consumed in the initially reference Mediterranean diet. 
Kids who drink more milk, tend to be leaner... and that despite (?) the fact that this stuff comes out of an animal and is full of bad cholesterol and fat - outrageous? Not exactly... more!
Does it have to be yogurt with patented probiotics? While some studies like Asemi et al. show benefits of one or several of the myriad of patented yogurt strains, most of the existing evidence suggests that regular yogurt which will also contain sign. amounts of "good" bacteria will have effects that are very similar to those of the expensive "functional foods". I mean, there's a reason yogurt and other fermented dairy foods have been part of the human diet ever since 10 000–5000 BC when we first domesticated milk-producing animals (cows, sheep, and goats, as well as yaks, horses, buffalo, and camels | Moreno. 2012).

For certain parts of the population (like people with high cholesterol, for example), certain starter cultures may yet have sign. advantages - which of the various currently available cultures will have the greatest health impact does yet still have to be elucidated. Next to the starter cultures, the protein content of the end product may be another important thing to keep in mind. Douglas et al. (2013), for example were able to show that Greek yogurt with 24g of protein per 250ml serving has a significantly higher satiety effect than yogurt with lower protein content.
Now this wouldn't be a waredownloadsoft article if it would rely exclusively on observational evidence. It is thus important to point out that Nestel's 2013 three-week crossover study comparing the effects of dairy foods categorized as low-fat (milk/yogurt), fermented (yogurt/cheese) or non-fermented (butter/cream/ice cream) confirmed that the concentrations of inflammatory markers like IL-6 were significantly lower on the fermented dairy diet than on the non-fermented dairy diet (P < 0.05).
Table 2: While everyone appears to believe that eating cheese was consistently associated with increased CVD risk, the majority of the existing studies shows no sign. association between cheese consumption and cardiovascular disease - especially when the data is adjusted for other dietary factors (summary from Elwood. 2010).
Clinical trials like Nikooyeh, et al. (2011) or Neyestani (2012) show improvements in glycemia, inflammation and adiponectin in type II diabetics and suggest that yogurt may be an ideal vehicle to increase our daily vitamin D3 intakes (by fortification).

Other researchers have been able to show that the consumption of a yogurt snack in the afternoon has potent beneficial effects on appetite control and eating initiation in healthy women (Ortinau. 2013; Douglas. 2013). Similar, yet in many cases more pronounced benefits have been observed in animal studies - studies that also indicate that yogurt exerts, next to its metabolic effects, direct inhibitory effects on colon cancer development and progression, too (de LeBlanc. 2004). All that doesn't negate the need for "[m]ore randomised controlled trials" but as Tapsell highlights in her recent review "the picture [which shows fermented dairy as a health food] is becoming clearer" (Tapsell. 2015). 
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So what? While it is obvious that yogurt and other fermented dairy products alone won't solve the Western diabesity crisis. It is unquestionably noteworthy that only 6% of the population in the US or Brazil, where the diabesity epidemic has really been taking off lately, consume yogurt on a daily basis.

As Fisberg et al. (2013) highlight in their review of the history of yogurt, this "represents a missed opportunity to contribute to a healthy lifestyle, as yogurt provides a good to excellent source of highly bioavailable protein and an excellent source of calcium as well as a source of probiotics that may provide a range of health benefits" (Fisberg. 2013).

One thing you must not forget, though, is that all the beneficial effects of yogurt and other fermented dairy products can take full effect only if they are integrated into an overall healthy diet. If you do it like my grandma and add one of those overpriced probiotic drinks to your otherwise pro-inflammatory breakfast, you may upset your knowledgeable grandson, but won't do much for your metabolic and overall health | Comment on Facebook!
References:
  • Asemi, Zatollah, et al. "Effects of daily consumption of probiotic yoghurt on inflammatory factors in pregnant women: a randomized controlled trial." Pakistan journal of biological sciences: PJBS 14.8 (2011): 476-482.
  • Chen, Mu, et al. "Effects of dairy intake on body weight and fat: a meta-analysis of randomized controlled trials." The American journal of clinical nutrition 96.4 (2012): 735-747.
  • de LeBlanc, Alejandra de Moreno, and Gabriela Perdigón. "Yogurt feeding inhibits promotion and progression of experimental colorectal cancer." American Journal of Case Reports 10.4 (2004): BR96-BR104.
  • Douglas, Steve M., et al. "Low, moderate, or high protein yogurt snacks on appetite control and subsequent eating in healthy women." Appetite 60 (2013): 117-122.
  • Elwood, Peter C., et al. "The consumption of milk and dairy foods and the incidence of vascular disease and diabetes: an overview of the evidence." Lipids 45.10 (2010): 925-939.
  • Estruch, Ramón, et al. "Primary prevention of cardiovascular disease with a Mediterranean diet." New England Journal of Medicine 368.14 (2013): 1279-1290.
  • Fisberg, Mauro, and Rachel Machado. "History of yogurt and current patterns of consumption." Nutrition reviews 73.suppl 1 (2015): 4-7.
  • Hjerpsted, Julie, Eva Leedo, and Tine Tholstrup. "Cheese intake in large amounts lowers LDL-cholesterol concentrations compared with butter intake of equal fat content." The American journal of clinical nutrition 94.6 (2011): 1479-1484.
  • Lam, Yan Y., et al. "Role of the gut in visceral fat inflammation and metabolic disorders." Obesity 19.11 (2011): 2113-2120.
  • Lithell, H., and B. Zethelius. "Glucose Tolerance and Cardiovascular Mortality." Arch. Intern. Med. 161 (2001): 397.
  • Marette, André, and Eliane Picard-Deland. "Yogurt consumption and impact on health: focus on children and cardiometabolic risk." The American journal of clinical nutrition 99.5 (2014): 1243S-1247S.
  • Moreno, Aznar LA, et al. "[Scientific evidence about the role of yogurt and other fermented milks in the healthy diet for the Spanish population]." Nutricion hospitalaria 28.6 (2012): 2039-2089.
  • Mozaffarian, Dariush, et al. "Changes in diet and lifestyle and long-term weight gain in women and men." New England Journal of Medicine 364.25 (2011): 2392-2404.
  • Nestel, Paul J. "Effects of dairy fats within different foods on plasma lipids." Journal of the American College of Nutrition 27.6 (2008): 735S-740S.
  • Nestel, Paul J., et al. "Effects of low-fat or full-fat fermented and non-fermented dairy foods on selected cardiovascular biomarkers in overweight adults." British Journal of Nutrition 110.12 (2013): 2242-2249.
  • Neyestani, Tirang R., et al. "Improvement of vitamin D status via daily intake of fortified yogurt drink either with or without extra calcium ameliorates systemic inflammatory biomarkers, including adipokines, in the subjects with type 2 diabetes." The Journal of Clinical Endocrinology & Metabolism 97.6 (2012): 2005-2011.
  • Nikooyeh, Bahareh, et al. "Daily consumption of vitamin D–or vitamin D+ calcium–fortified yogurt drink improved glycemic control in patients with type 2 diabetes: a randomized clinical trial." The American journal of clinical nutrition 93.4 (2011): 764-771.
  • O’Connor, Laura M., et al. "Dietary dairy product intake and incident type 2 diabetes: a prospective study using dietary data from a 7-day food diary." Diabetologia 57.5 (2014): 909-917.
  • Ortinau, Laura C., et al. "The effects of increased dietary protein yogurt snack in the afternoon on appetite control and eating initiation in healthy women." Nutr J 12.71 (2013): 10-1186.
  • Panagiotakos, Demosthenes B., et al. "Dairy products consumption is associated with decreased levels of inflammatory markers related to cardiovascular disease in apparently healthy adults: the ATTICA study." Journal of the American College of Nutrition 29.4 (2010): 357-364.
  • Sluijs, Ivonne, et al. "The amount and type of dairy product intake and incident type 2 diabetes: results from the EPIC-InterAct Study." The American journal of clinical nutrition 96.2 (2012): 382-390.
  • Struijk, E. A., et al. "Dairy product intake in relation to glucose regulation indices and risk of type 2 diabetes." Nutrition, Metabolism and Cardiovascular Diseases 23.9 (2013): 822-828.
  • Tapsell, Linda C. "Fermented dairy food and CVD risk." British Journal of Nutrition 113.S2 (2015): S131-S135. 
  • Tholstrup, Tine. "Dairy products and cardiovascular disease." Current opinion in lipidology 17.1 (2006): 1-10.
  • Vasilopoulou, Effie, Vardis Dilis, and Antonia Trichopoulou. "Nutrition claims: a potentially important tool for the endorsement of Greek Mediterranean traditional foods." Mediterranean Journal of Nutrition and Metabolism 6.2 (2013): 105-111.
  • Wang, Huifen, et al. "Yogurt consumption is associated with better diet quality and metabolic profile in American men and women." Nutrition Research 33.1 (2013): 18-26.
  • Zemel, Michael B., et al. "Calcium and dairy acceleration of weight and fat loss during energy restriction in obese adults." Obesity research 12.4 (2004): 582-590.
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Non-Adherence and Design Problems: Two Reasons Why Recent Diet Study May Fail to Show Benefits of High(er) Protein + Dairy Intakes in Overfat (>37%) Women

Don't expect weight loss wonders from high(er) protein and dairy intakes, but especially when the energy intake is not controlled both can have benefits the study at hand could not detect.
What's better a calorie reduced diet with the suggested amount of protein or one with a slightly higher amount of protein and extra low-fat dairy in it, when it comes to shedding the exuberant body fat off the hips, abs and buttocks of 104 overweight / obese (or with a body fat content of 37%+ "overfat") premenopausal women?

That's probably not exactly the way the scientists from the Utah State University, the Pennsylvania State University, the University of Illinois and the FB Technical Center (Shlisky. 2015) would phrase their research question, but in the end, their 24-week three-phase randomized weight loss intervention comes tried to answer exactly this question.
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Sex-Differences in Fat Oxidation - Reviewed
To learn more about the impact of higher protein intakes (30% vs. 20% of total energy intakes) and the purported "magic" of diets that are high in low fat dairy (in particular yogurt), Julie D. Shlisky and her colleagues had their subjects go through a three-phase weight loss intervention with
  • the JumpStart phase (weeks 0–2), being intended to kickstart the subjects' weight loss on a ~35% energy deficit, phase (2), 
  • the Weightloss phase (weeks 3–12; total of 12 weeks), during which the subjects were supposed to adhere to a 1,500-1,700kcal diet which came close to a 25-30% energy deficit compared to their baseline energy intakes, and
  • the Weightloss Maintenance phase, (weeks 13–24; total of 12 weeks), over the course of which the subjects had to stick to a dietitian designed "energy-balanced" diet which had still ~20% less energy than the subjects baseline diet (see Figure 4, right)
If you look at the tabular overview of what the subjects eat (I won't reprint 4 pages from the full text here) you can easily get confused and think that there were five different groups, eventually it does yet all come down to two groups, the intervention (INT) and comparison (COM) groups and their different diets during the previously explained phases of the study.
Figure 1: Macronutrient compositions of the prescribed diets in the intervention and comparison group (Shlisky. 2015).
In that, the most significant inter-group difference were (a) the macronutrient composition with 30% PRO, 25% FAT, 45% CHO in the intervention group (INT) and 16-17% PRO, 24-25% FAT, 59% CHO in the comparison group (COM).
Figure 2: Total intake (g) of carbohydrates, proteins and fats during the 12 week weight loss and maintenance phases (Shlisky. 2015)
"[w]eekly educational sessions were held for both INT and COM groups throughout the 6- month study and included lessons on basic nutrition knowledge, exchange patterns of eating, portion size and control, purchasing and preparing food and modifying recipes as well as motivational lessons on outcome expectations, selfregulation and monitoring, problem- solving, lifestyle modification, emotion eating and motivation for walking" (Shlisky. 2015) 
In addition, the subjects were told to consume 5 servings per day (with a focus on low fat yogurt) in the intervention and 3 servings of dairy (excluding yogurt) in the comparison group, as well as to finally get their behind off the couch for a total of ~8,000-10,000 steps per day (that was ~30-40 minutes of walking per day).
Thorpe et al. were able to show that high(er) protein intakes from dairy will decrease calcium loss and preserve bone mass (WB = whole body; LS = lumbar spine) while dieting. Don't fall for the "protein is bad for your bones" lie!
What does previous research tell us? If you look at previous research by Bowen (2004 & 2005), Josse (2011), Thorpe (2008) and Zemel (2004), there is significant evidence that high(er) protein intakes will augment fat loss and lean mass retention while increased dairy intakes may benefit bone mass and metabolic markers in men, women, young and old. In particular, when they are consumed alongside true exercise regimen, high(er) protein intakes have been proven have additive effects on body comp. during weight loss (8.8kg vs. 5.5kg fat loss in 16wks | Layman. 2005).

Against that background I would be very hesitant to take use the study at hand to argue that you can shed body fat just as effectively on the bogus "recommended diet" (=15-20% protein, 60% carbohydrates and 20-25% fat).
Needless to say that the novelty of the physical activity, of which I'd like to remind you that it had the same volume for both groups, must be taken into consideration when we take a look at the results of the 24-wk study:
Figure 3: Relative changes in markers of body composition after the weight loss and weight maintenance phase; all values expressed as percent difference to the respective pre-values in both groups (Shilsky. 2015).
Now, if you look at the overall effects and inter-group differences in Figure 3, three things are remarkable: Firstly, all subjects lost a significant amount of body weight and body fat without having to starve themselves or spending hours on the elliptical or treadmill. Secondly, there were no inter-group differences, which means that neither the overall increase in protein intake (see Figure 2), nor the increased intake of low-fat dairy and most prominently yogurt (effectively, the difference was only 1 serving per day, because the INT subjects failed to hit their target of five and ate only four servings per day) had beneficial effect on (a) the actual weight and more importantly fat / lean mass loss and (b) the subjects' general ability to keep the weight off during the follow up.
Figure 4: Reduction in energy expenditure (% of baseline) and total step count (activity level) of the subjects in the weight loss and weight maintenance phases of the study (Shlisky. 2015)
If we also take into account the data from Figure 3 which depicts the reduction in energy intake from baseline and the total number of steps participants in both groups took on a daily basis, we could yet conclude that the lower dairy (no yogurt) + lower protein group achieved very similar results with less efforts. There is thus no debating the scientists conclusion that
"[h]ealthy premenopausal women with excess adiposity effectively lost BW and fat mass and improved some metabolic risk factors following an ERD with approximately 20% protein and 3 svg/d of nonfat dairy intake." (Shlisky. 2015)
The increased protein or dairy (in this case mostly yogurt) intake did after all not offer significant benefits, as neither of the existing differences in Figure 3 was statistically significant.
The actual macronutrient ratio during the weight loss and maintenance phase (figure shows averages) was by no means what it was supposed to be. The women ate ~8% less protein than they were supposed to do.
So, there's no benefit to high(er) protein and dairy intakes? No, there isn't - at least in a study with such a questionable design. Did you recognize the culprit? Yes, you're right: What on earth do you expect to happen if you design a "weight maintenance phase" during which the subjects still have to consume an energy reduced diet... I mean, it is well possible that the dietitians equations said that the diet was "energy-balanced". If you compare their intake to the ad-libitum diets of the subjects (=their baseline diet), the women still consumed 18% (HP) and 27% (NP) less energy during the weight maintenance phase - this time with a significant inter-group difference in favor of the high(er) protein high(er) dairy (yogurt) group who consumed more energy during both the weight loss and maintenance phase with identical results.

I am not sure what you think, but I personally would refute any statement about the standard diet recommendation being as efficient as a high(er) protein + high(er) dairy variety based on the study at hand. The increased satiety effect, a potential increase in thermogenesis, etc. - all the purported benefits of high(er) protein intakes couldn't show due to (a) non-adherence (instead of 30%, the subjects in the intervention group consumed only 23% and 20% protein during the weight loss and maintenance phase, respectively, and were thus not far off of the 20% and 18% in the COM group) and (b) the stupid idea not to let the women eat an ad-libitum with a fixed macronutrient ratio during the weight maintenance phase. This is after all a more realistic scenario and one in which real benefits of high(er) protein can show | Comment on Facebook!
References:
  • Bowen, Jane, Manny Noakes, and Peter M. Clifton. "A high dairy protein, high-calcium diet minimizes bone turnover in overweight adults during weight loss." The Journal of nutrition 134.3 (2004): 568-573.
  • Bowen, J., M. Noakes, and P. M. Clifton. "Effect of calcium and dairy foods in high protein, energy-restricted diets on weight loss and metabolic parameters in overweight adults." International journal of obesity 29.8 (2005): 957-965.
  • In particularly in conjunction with exercise, high(er) protein intakes have been proven have additive beneficial effects on body composition during weight loss (Layman. 2005)
  • Josse, Andrea R., et al. "Increased consumption of dairy foods and protein during diet-and exercise-induced weight loss promotes fat mass loss and lean mass gain in overweight and obese premenopausal women." The Journal of nutrition 141.9 (2011): 1626-1634.
  • Shlisky, Julie D., et al. "An energy‐reduced dietary pattern, including moderate protein and increased nonfat dairy intake combined with walking promotes beneficial body composition and metabolic changes in women with excess adiposity: a randomized comparative trial." Food Science & Nutrition (2015).
  • Thorpe, Matthew P., et al. "A diet high in protein, dairy, and calcium attenuates bone loss over twelve months of weight loss and maintenance relative to a conventional high-carbohydrate diet in adults." The Journal of nutrition 138.6 (2008): 1096-1100.
  • Zemel, Michael B., et al. "Calcium and dairy acceleration of weight and fat loss during energy restriction in obese adults." Obesity research 12.4 (2004): 582-590.
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Lactose, Fat & Other Proteins Impair Digestion of Micellar Casein W/Out Modifying Protein Synthesis or Breakdown

It does not necessarily have to be supplemental micellar casein. Quark, for example, is an excellent casein source you can use in "smoothies".
As a waredownloadsoft reader you are well aware of the interactions between casein micelles and the low and high pH milieu of the intestinal tract. They clump and form a mass that is significantly harder to digest than the easily digestible albumin proteins from whey.

As discussed in previous articles you can use this property of casein to your advantage, an advantage that makes the combination of whey and casein protein so efficient in terms of its ability to (a) boost protein synthesis (that's what the whey fraction will do) and (b) sustain the elevated protein synthesis (this is what the slowly digesting casein micelles will do).
You can learn more about protein intake at the waredownloadsoft

Protein Timing DOES Matter!

5x More Than the FDA Allows!

Protein requ. of athletes

High EAA protein for fat loss

Fast vs. slow protein

Whey vs. Pea Protein
Even when it's used on its own, though, casein protein is a very useful muscle builder, one of which we didn't know yet whether its efficacy would be impaired by the co-ingestion of the co-factors in milk, i.e. lactose, whey proteins, fat, and minerals would affect the digestion and effects of casein. More specifically, the scientists from the NUTRIM School of Nutrition and Translational Research in Metabolism in Maastricht speculated that the ingestion of casein in a milk matrix would trigger a "more rapid casein digestion and amino acid absorption, greater amino acid availability, greater whole-body protein accretion, and greater postprandial muscle protein synthesis when compared to the ingestion of isolated casein dissolved in water" (Churchward-Venne. 2015).

Table 1: Subject characteristics of healthy older men who ingested 25-g intrinsically labeled casein with or without milk serum | Values are means 6 SEMs, n = 16 (Cas and Cas+Serum). No significant differences were observed between groups. Cas, casein; Cas+Serum (Churchward-Venne. 2015).
To test this hypothesis that could be of great importance for both athletes and older adults, who are at risk of sarcopenic muscle loss, the Dutch researchers recruited thirty-two healthy older men (aged 71 +/- 1 y) and conducted a parallel-group, randomized controlled trial during which the subjects received either 
  • 25 g intrinsically L-[1-13C]-phenylalanine and L-[1-13C]-leucine labeled casein dissolved in bovine milk serum (Cas+Serum | the serum contained ~10.3% lactose, ~0.3% protein, ~0.06% fat, and ~1.1% minerals), or
  • 25 g of the same casein mixed with plain water (Cas)
to assess the effects of the milk matrix on casein protein digestion and absorption kinetics and postprandial muscle protein synthesis.
The problem with casein studies is that most of them use fast digesting, "non-clumping" calcium or sodium caseinates. That's also the case for the dozens of rodent studies that claim that casein was pro-carcinogenic and what-not and it's in contrast to the studies I referred to in the introduction of this article and the study at hand. Speaking of which: I am not sure how realistic the use of milk serum and casein protein is - I mean, I'd have preferred the use of casein alone and casein + meal. This would have been a much more realistic litmus test, because the 25g casein + small quantities of lactose, fat, and other milk proteins mix used in the study at hand is not exactly close to milk or anything else you'd usually eat.
The results of the experiment falsified the scientists' assumption that the addition of a milk matrix to isolated casein would result in a more rapid casein digestion and amino acid absorption, a more rapid increase in plasma amino acid availability, and subsequently greater postprandial whole-body protein accretion as well as skeletal muscle protein synthesis when compared to the ingestion of isolated casein without a milk matrix (i.e., dissolved in water).
Figure 1: Plasma tyrosine (left, top), and leucine (left bottom) concentrations (micromoles per liter), as well as protein breakdown and synthesis (right) during basal postabsorptive conditions and after ingestion of 25-g intrinsically labeled casein with or without milk serum in older men (Churchward-Venne. 2015)
If you look at the data, it is actually rather the opposite that happened: The provision of the "missing" nutrients from milk slows the digestion of casein micelles (it is possible that the total amount of protein that was absorbed is identical, but the 300 min study period does not allow for a confirmation of this hypothesis). The slower protein digestion did yet not have a negative effect on the post-prandial protein synthesis; so, there's certainly no evidence of the increase in protein anabolism Churchward-Venne et al. (2015) expected, but there's no evidence of detrimental effects, either.

Thus, if neither protein breakdown nor synthesis are influenced, the results of the study at hand suggest that another often advertised supplement "quality", i.e. maximal digestion speed, is practically irrelevant  if you get enough protein per serving.
When it Comes to its Satiety Effect, More Protein Doesn't Help More - Athletes Trying to Lose Weight May Fare Better if They Spread Their Intake to Several 20-30g Servings | more
Bottom line: The fact that neither protein breakdown nor synthesis were significantly different clearly indicates that it does not really matter if you consume your micellar casein pure or together with its natural synergists.

Very similar results have previously been observed for the combination of whey protein and micellar casein, where the addition of the slow-digesting casein proteins do not, as some people may expct, reduce the protein-anabolic effects of whey protein - which is, at least in part, why the combination of the two is such an outstanding muscle builder for athletes.

As I already hinted at in the red box, the study I am still waiting or is not the one the Dutch scientists conducted. The study I would like to see is one that test whether there's a difference between the pro-anabolic effects of whey protein alone and whey protein consumed along a complete meal. I don't really expect to see a physiologically relevant difference, but who knows - without experimental verification that's nothing but my personal hypothesis | Comment on FB!
References:
  • Churchward-Venne, Tyler A., et al. "Ingestion of Casein in a Milk Matrix Modulates Dietary Protein Digestion and Absorption Kinetics but Does Not Modulate Postprandial Muscle Protein Synthesis in Older Men." The Journal of Nutrition (2015): jn213710.
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