Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-15T03:35:28.397Z Has data issue: false hasContentIssue false

Hypolipidaemic and anti-atherosclerotic effects of lupin proteins in a rabbit model

Published online by Cambridge University Press:  01 October 2008

Marta Marchesi
Affiliation:
Department of Pharmacological Sciences, University of Milan, via Balzaretti 9, Milan20133, Italy
Cinzia Parolini
Affiliation:
Department of Pharmacological Sciences, University of Milan, via Balzaretti 9, Milan20133, Italy
Erika Diani
Affiliation:
Department of Pharmacological Sciences, University of Milan, via Balzaretti 9, Milan20133, Italy
Elena Rigamonti
Affiliation:
Department of Pharmacological Sciences, University of Milan, via Balzaretti 9, Milan20133, Italy
Lorena Cornelli
Affiliation:
Department of Pharmacological Sciences, University of Milan, via Balzaretti 9, Milan20133, Italy
Anna Arnoldi
Affiliation:
Department of Agri-Food Molecular Sciences, University of Milan, Milan, Italy
Cesare R. Sirtori
Affiliation:
Department of Pharmacological Sciences, University of Milan, via Balzaretti 9, Milan20133, Italy
Giulia Chiesa*
Affiliation:
Department of Pharmacological Sciences, University of Milan, via Balzaretti 9, Milan20133, Italy
*
*Corresponding author: Dr Giulia Chiesa, fax +39 02 50318284, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

The biological activities of a protein isolate from lupin (Lupinus albus) were studied in a rabbit model of atherosclerosis. Focal plaque development was induced at both common carotid arteries by perivascular injury. After surgery, animals were fed three different diets for 90 d, all with 1 % cholesterol, 15 % SFA and 20 % protein; the protein source was casein (CAS), lupin proteins (LUP) or 50 % CAS+50 % LUP (CAS+LUP). Lower cholesterolaemia was detected in the LUP v. the CAS group at 60 and 90 d of treatment ( − 40·3 and − 33·5 %, respectively; P < 0·05). Cryosection analyses of the carotids indicated a significant reduction in focal lesion progression in the LUP v. the CAS group ( − 37·4 %; P < 0·05). In summary, in a rabbit model of atherosclerosis, a protein isolate from L. albus reduced cholesterolaemia and exerted a remarkable protective activity against atherosclerosis progression.

Type
Short Communication
Copyright
Copyright © The Authors 2008

The growing use of legume proteins in human nutrition for their nutraceutical properties(Reference Sirtori, Eberini and Arnoldi1Reference Arnoldi and Arnoldi4) has recently suggested detailed investigations on the possible clinical use of lupin proteins. Lupin beans are characterised by a lower content of antinutrients v. other legumes(Reference Muzquiz, Pedrosa, Cuadrado, Ayet, Burbano, Brenes, Jasman, Hill, Huisman and van der Poel5) and by an almost total absence of phyto-oestrogens(Reference Katagiri, Ibrahim and Tahara6, Reference Sirtori, Lovati, Manzoni, Castiglioni, Duranti, Magni, Morandi, D'Agostina and Arnoldi7). This last feature, on the one hand, may avoid potential problems that have been recently indicated for these hormone-like components(Reference Sirtori, Arnoldi and Johnson8); on the other, it allows a direct evaluation of the activity of ‘proteins’, independent of other components. Lupin protein isolates are nutritionally satisfactory(Reference Caligari, Chiesa, Johnson, Camisassi, Gilio, Marchesi, Parolini, Rubio and Sirtori9, Reference Sujak, Kotlarz and Strobel10) and have a neutral flavour(Reference D'Agostina, Antonioni, Resta, Arnoldi, Bez, Knauf and Wasche11), thus allowing the production of food items with optimal sensory characteristics(Reference Arnoldi, Resta, Brambilla, Boschin, D'Agostina, Sirtori and O'Kane12).

A previous study from our group(Reference Sirtori, Lovati, Manzoni, Castiglioni, Duranti, Magni, Morandi, D'Agostina and Arnoldi7) investigated the potential hypolipidaemic effect of a total protein extract from Lupinus albus. When given to rats fed a classical cholesterol–cholic acid regimen, lupin proteins significantly reduced both plasma cholesterol and TAG levels v. control animals. The cholesterol reduction appeared to be associated with a mechanism shared with soya proteins, i.e. a direct up regulatory activity on LDL receptors(Reference Lovati, Gianazza and Sirtori13Reference Duranti, Lovati, Dani, Barbiroli, Scarafoni, Castiglioni, Ponzone and Morazzoni15).

Based on recent data by our group(Reference Castiglioni, Manzoni, D'Uva, Spiezie, Monteggia, Chiesa, Sirtori and Lovati16) and others(Reference Adams, Golden, Williams, Franke, Register and Kaplan17, Reference Walker, Adams, Franke and Register18) suggesting an anti-atherosclerotic effect of soya proteins, also characterised by a cholesterol-lowering activity(Reference Sirtori, Eberini and Arnoldi1, Reference Lovati, Gianazza and Sirtori13, Reference Duranti, Lovati, Dani, Barbiroli, Scarafoni, Castiglioni, Ponzone and Morazzoni15), the impact on atherosclerosis progression of a diet containing L. albus proteins was tested in a rabbit model of focal lipid-rich soft plaques, generated at the common carotid arteries(Reference Chiesa, Di Mario and Colombo19).

Materials and methods

Lupin protein preparation

A total protein isolate from L. albus seeds was manufactured by the Fraunhofer Gesellschaft, Fraunhofer-Institute (Freising, Germany), by an extraction and precipitation process followed by spray drying(Reference D'Agostina, Antonioni, Resta, Arnoldi, Bez, Knauf and Wasche11). The protein percentage was 91·21 % DM. A detailed description of the composition and a proteomic investigation of this protein isolate have been previously reported(Reference D'Agostina, Antonioni, Resta, Arnoldi, Bez, Knauf and Wasche11, Reference Wait, Gianazza, Brambilla, Eberini, Morandi, Arnoldi and Sirtori20).

Animals, diets and experimental protocols

Procedures involving animals and their care were conducted in compliance with national and European Union laws and policies.

Arterial plaque formation at the common carotid artery was induced in male New Zealand White rabbits by perivascular injury, as described previously(Reference Chiesa, Di Mario and Colombo19, Reference Chiesa, Monteggia and Marchesi21). Rabbits were divided into three groups of six rabbits, balanced for body weight. After surgery, rabbits were fed a 1 % cholesterol and 15 % SFA diet for 90 d, the protein source (20 % in each diet) being either casein (CAS), 50 % CAS+50 % total protein isolate from L. albus (CAS+LUP) or total protein isolate from L. albus (LUP).

Fasting blood samples were taken before and after 30, 60 and 90 d of dietary treatments for plasma total cholesterol, TAG and HDL-cholesterol measurements, by a Roche Diagnostics Cobas autoanalyser (Nutley, NJ, USA). After 90 d diet, animals were anaesthetised with xylazine/ketamine and then killed. Injured arteries were excised, embedded in optimal cutting temperature compound for cryosections under liquid N2 and stored at − 80°C, until analyses. Plaque volume was evaluated by measuring cross-sectional areas of the intima every 0·25 mm within the area of plaque accumulation using an image analysis system (ImageJ 1.37v; National Institutes of Health, Bethesda, MD, USA) interfaced to a Zeiss Axioscope microscope (Carl Zeiss, Oberkochen, Germany). Selected sections were incubated as described(Reference Chiesa, Di Mario and Colombo19) with mouse monoclonal antibodies directed against rabbit smooth muscle α-actin (HHF35; DAKO Corp., Glostrup, Denmark) and rabbit macrophages (RAM-11; DAKO Corp.). Sections were also stained with Oil red O to identify lipid accumulation within the plaque(Reference Chiesa, Di Mario and Colombo19, Reference Chiesa, Monteggia and Marchesi21). Quantification of the percentage of plaque area covered by lipids or macrophages (i.e. with positive staining for Oil red O or for the anti-RAM-11 antibody, respectively) was performed by using a Nikon Coolpix 950 digital camera interfaced with a Zeiss Axioscope microscope (Carl Zeiss), followed by computer-assisted planimetry.

Statistical analyses

Data are expressed as mean values and standard deviations. Group differences were tested for statistical significance by multivariate ANOVA (repeated measures), followed by the Tukey post hoc test; a value of P < 0·05 was considered statistically significant. The statistical analysis was performed using SYSTAT software (version 5.2; Systat Software, Inc., San Jose, CA, USA).

Results

Effect on plasma lipids of a total protein isolate from Lupinus albus in rabbits

The presence in each diet of 1 % cholesterol and 15 % coconut fat determined a marked increase in total cholesterol levels in all groups (Table 1). However, whereas in CAS and CAS+LUP animals total cholesterol concentrations increased progressively up to 60 d, reaching values close to 19 000 mg/l that were maintained until killing (90 d), in LUP-fed rabbits cholesterolaemia did not undergo marked variations after 30 d of treatment and reached a maximum of 12 500 mg/l at 90 d. As a consequence of the different responses to the dietary treatments, a significantly lower mean plasma cholesterolaemia was observed in LUP compared with CAS animals after both 60 and 90 d of experimental diet (Table 1). No significant variations were observed for HDL-cholesterol levels (Table 1).

Table 1 Lipid levels in rabbits fed diets containing 20 % casein (CAS), 10 % CAS+10 % isolate from Lupinus albus (CAS+LUP) or 20 % isolate from L. albus (LUP) as the protein source

(Mean values and standard deviations for six rabbits per group)*

a,b,c Mean values within a column with unlike superscript letters were significantly different (P < 0·05; ANOVA).

* For details of diets and procedures, see Materials and methods.

Mean value was significantly different from that of the CAS-fed animals at 60 d (P < 0·05).

Mean value was significantly different from that of the CAS-fed animals at 90 d (P < 0·05).

A marked increase in TAG levels was observed after each dietary treatment, with no significant differences among groups (Table 1). However, whereas in the CAS group a progressive rise of TAG levels was observed, in LUP-fed rabbits triacylglycerolaemia significantly increased only after 90 d dietary treatment.

Effect on atherosclerosis development

The diet based on lupin proteins significantly affected atherosclerosis development (Fig. 1); at the end of the dietary treatments, plaque volume was significantly reduced in LUP compared with CAS rabbits (P < 0·05) (Fig. 1 (a)). Rabbits fed CAS+LUP displayed an intermediate plaque size between CAS and LUP animals, but statistical significance v. either comparator was not reached.

Fig. 1 Histological analysis of rabbit carotid plaques. (a) Carotid plaque volume evaluated in rabbits after perivascular injury followed by 90 d of high-fat, high-cholesterol diet containing 20 % casein (CAS), 10 % CAS+10 % isolate from Lupinus albus (CAS+LUP) or 20 % isolate from L. albus (LUP) as the protein source. Data are mean values (six rabbits per group), with standard deviations represented by vertical bars. * Mean value was significantly different from that of the CAS-fed group (P < 0·05). (b) Oil red O staining of carotid sections from rabbits fed high-fat, high-cholesterol diets containing 20 % casein (CAS) or 20 % isolate from L. albus (LUP) as protein source (magnification × 50). ↔ , Plaque formation.

As previously described in this animal model fed the same diet(Reference Castiglioni, Manzoni, D'Uva, Spiezie, Monteggia, Chiesa, Sirtori and Lovati16), CAS rabbits developed plaques characterised by a neointimal formation devoid of smooth muscle cells and mostly constituted by macrophages and extracellular lipids. Compared with CAS animals, atherosclerotic plaques of LUP rabbits displayed a reduced macrophage ( − 23·4 %) and lipid accumulation ( − 36·2 %), this latter reaching statistical significance (P < 0·05) (Fig. 1 (b)).

Discussion

In the present study, lupin proteins inhibited the cholesterol rise induced by a lipid-rich diet, confirming results previously obtained in rats(Reference Sirtori, Lovati, Manzoni, Castiglioni, Duranti, Magni, Morandi, D'Agostina and Arnoldi7). No significant differences were instead observed for triacylglycerolaemia among groups. It should be noted, however, that, differently from the CAS group, the increase of TAG levels in the LUP-fed rabbits occurred only at the end of the dietary treatment (90 d). It may be speculated that the long duration of the high-fat, high-cholesterol dietary challenge required for the development of atherosclerotic plaques may have overcome a possible hypotriacylglycerolaemic effect of lupin proteins in this model. Similarly, the aggressive dietary treatment required to induce atherosclerotic plaque formation may have hidden a possible hypolipidaemic effect played by lupin proteins in the CAS+LUP group. The main objective of the present study was, however, the investigation of the impact of lupin proteins on atherosclerosis progression. To investigate this issue, an appropriate animal model was selected, i.e. the rabbit that, differently from the rat, is highly susceptible to atherosclerosis development. In this animal model, perivascular manipulation at the common carotid arteries, followed by a hyperlipidaemic diet, induces the formation of focal plaques, mostly constituted by extracellular lipids and macrophages(Reference Chiesa, Di Mario and Colombo19), thus reflecting the main features of the human arterial plaques, defined as unstable, frequently associated with acute ischaemic events(Reference Virmani, Kolodgie, Burke, Farb and Schwartz22). This same rabbit model has proven to be sensitive to local interventions with recombinant apolipoproteins(Reference Chiesa, Monteggia and Marchesi21), as well as to dietary treatments(Reference Castiglioni, Manzoni, D'Uva, Spiezie, Monteggia, Chiesa, Sirtori and Lovati16).

The diet exclusively based on L. albus proteins clearly reduced atherosclerosis progression, possibly as a consequence of the observed hypocholesterolaemic activity. The reduction of circulating atherogenic lipoproteins by lupin proteins could easily explain the lower lipid accumulation within carotid plaques of the LUP compared with the CAS group. In the CAS+LUP group, where no hypocholesterolaemic effect was observed, plaque volume was not statistically different from that observed in the CAS rabbits. However, the CAS+LUP group displayed a trend toward a lower extent of atheromas compared with the CAS group, suggesting that the anti-atherogenic activity exerted by lupin proteins may be partially explained by other mechanisms, in addition to the observed reduction of cholesterolaemia. This issue will be the object of future investigations.

While there is evidence for a vascular protective effect of soya proteins(Reference Castiglioni, Manzoni, D'Uva, Spiezie, Monteggia, Chiesa, Sirtori and Lovati16Reference Walker, Adams, Franke and Register18), no data are available on lupin proteins, except for those related to the hypolipidaemic activity(Reference Sirtori, Lovati, Manzoni, Castiglioni, Duranti, Magni, Morandi, D'Agostina and Arnoldi7, Reference Martins, Riottot, de Abreu, Viegas-Crespo, Lanca, Almeida, Freire and Bento23). Differently from soya, a relevant characteristic of lupin is the total absence of isoflavones(Reference Katagiri, Ibrahim and Tahara6, Reference Sirtori, Lovati, Manzoni, Castiglioni, Duranti, Magni, Morandi, D'Agostina and Arnoldi7), which permits us to conclude that the observed vascular protective properties should certainly be ascribed to the protein component.

When the nutraceutical properties of a food are due to the proteins, it becomes very important to assess their quality and integrity. A proteomic analysis of the protein isolate from L. albus used in the present study was recently reported(Reference Wait, Gianazza, Brambilla, Eberini, Morandi, Arnoldi and Sirtori20). The results show that the protein isolate had undergone limited damage, demonstrating that the manufacturing process had been very mild, different from the case of commercial soya protein isolates(Reference Gianazza, Eberini, Arnoldi, Wait and Sirtori24).

Interestingly, in a recent study, L. albus proteins were given as a beverage to subjects with moderate hypercholesterolaemia in an amount corresponding to a daily intake of approximately 35 g(Reference Naruszewicz, Nowicka, Klosiewicz-Latoszek, Arnoldi and Sirtori25). This dietary supplementation significantly reduced both cholesterolaemia and blood pressure, suggesting that the beneficial effects of lupin proteins observed in animal studies(Reference Sirtori, Lovati, Manzoni, Castiglioni, Duranti, Magni, Morandi, D'Agostina and Arnoldi7, Reference Pilvi, Jauhiainen, Cheng, Mervaala, Vapaatalo and Korpela26), including the present study, may occur also in humans. While these preliminary clinical data will require confirmation in appropriate controlled investigations, the results of the present study suggest the potential positive impact of lupin proteins on atherosclerosis prevention and treatment.

Acknowledgements

We are indebted to the Fraunhofer Gesellschaft, Fraunhofer-Institute (IVV) (Freising, Germany) which provided the protein isolate from L. albus.

This investigation was supported by a grant from the European Commission, Fifth Framework Programme, Quality of Life and Management of Living Resources Programme, Healthy Profood QLRT 2001-2235. There are no conflicts of interest. All authors contributed to the design of the study and/or analysis and interpretation of the data.

References

1Sirtori, CR, Eberini, I & Arnoldi, A (2007) Hypocholesterolaemic effects of soya proteins: results of recent studies are predictable from the Anderson meta-analysis data. Br J Nutr 97, 816822.Google Scholar
2Anderson, JW & Major, AW (2002) Pulses and lipaemia, short- and long-term effect: potential in the prevention of cardiovascular disease. Br J Nutr 88, Suppl. 3, S263S271.Google Scholar
3Duranti, M (2006) Grain legume proteins and nutraceutical properties. Fitoterapia 77, 6782.Google Scholar
4Arnoldi, A (2004) Grain legumes as a source of food ingredients for the prevention of cardiovascular disease. In Functional Foods, Diet, Cardiovascular Disease and Diabetes, pp. 422447 [Arnoldi, A, editor]. Cambridge, UK: Woodhead Publishing Ltd.Google Scholar
5Muzquiz, M, Pedrosa, MM, Cuadrado, C, Ayet, G, Burbano, C & Brenes, A (1998) Variation of alkaloids, alkaloid esters, phytic acid, and phytase activity in germinated seed of Lupinus albus and L. luteus. In Recent Advances of Research in Antinutritional Factors in Legume Seeds and Rape Seeds, pp. 387390 [Jasman, AJM, Hill, GD, Huisman, J and van der Poel, AFB, editors]. Wageningen, The Netherlands: Wageningen Press.Google Scholar
6Katagiri, Y, Ibrahim, RK & Tahara, S (2000) HPLC analysis of white lupin isoflavonoids. Biosci Biotechnol Biochem 64, 11181125.Google Scholar
7Sirtori, CR, Lovati, MR, Manzoni, C, Castiglioni, S, Duranti, M, Magni, C, Morandi, S, D'Agostina, A & Arnoldi, A (2004) Proteins of white lupin seed, a naturally isoflavone-poor legume, reduce cholesterolemia in rats and increase LDL receptor activity in HepG2 cells. J Nutr 134, 1823.Google Scholar
8Sirtori, CR, Arnoldi, A & Johnson, SK (2005) Phytoestrogens: end of a tale? Ann Med 37, 423438.Google Scholar
9Caligari, S, Chiesa, G, Johnson, SK, Camisassi, D, Gilio, D, Marchesi, M, Parolini, C, Rubio, LA & Sirtori, CR (2006) Lupin (Lupinus albus) protein isolate (L-ISO) has adequate nutritional value and reduces large intestinal weight in rats after restricted and ad libitum feeding. Ann Nutr Metab 50, 528537.Google Scholar
10Sujak, A, Kotlarz, A & Strobel, W (2006) Compositional and nutritional evaluation of several lupin seeds. Food Chem 98, 711719.Google Scholar
11D'Agostina, A, Antonioni, C, Resta, D, Arnoldi, A, Bez, J, Knauf, U & Wasche, A (2006) Optimization of a pilot-scale process for producing lupin protein isolates with valuable technological properties and minimum thermal damage. J Agric Food Chem 54, 9298.Google Scholar
12Arnoldi, A, Resta, D, Brambilla, F, Boschin, G, D'Agostina, A, Sirtori, E & O'Kane, F (2007) Parameters for the evaluation of the thermal damage and nutraceutical potential of lupin-based ingredients and food products. Mol Nutr Food Res 51, 431436.Google Scholar
13Lovati, MR, Gianazza, E & Sirtori, CR (1998) Soybean protein products as regulators of liver low-density lipoprotein receptors. I. Identification of active β-conglycinin subunits. J Agric Food Chem 46, 24742480.Google Scholar
14Lovati, MR, Manzoni, C, Gianazza, E, Arnoldi, A, Kurowska, E, Carroll, KK & Sirtori, CR (2000) Soy protein peptides regulate cholesterol homeostasis in Hep G2 cells. J Nutr 130, 25432549.Google Scholar
15Duranti, M, Lovati, MR, Dani, V, Barbiroli, A, Scarafoni, A, Castiglioni, S, Ponzone, C & Morazzoni, P (2004) The α′ subunit from soybean 7S globulin lowers plasma lipids and upregulates liver β-VLDL receptors in rats fed a hypercholesterolemic diet. J Nutr 134, 13341339.Google Scholar
16Castiglioni, S, Manzoni, C, D'Uva, A, Spiezie, R, Monteggia, E, Chiesa, G, Sirtori, CR & Lovati, MR (2003) Soy proteins reduce progression of a focal lesion and lipoprotein oxidiability in rabbits fed a cholesterol-rich diet. Atherosclerosis 171, 163170.CrossRefGoogle ScholarPubMed
17Adams, MR, Golden, DL, Williams, JK, Franke, AA, Register, TC & Kaplan, JR (2005) Soy protein containing isoflavones reduces the size of atherosclerotic plaques without affecting coronary artery reactivity in adult male monkeys. J Nutr 135, 28522856.Google Scholar
18Walker, SE, Adams, MR, Franke, AA & Register, TC (2008) Effects of dietary soy protein on iliac and carotid artery atherosclerosis and gene expression in male monkeys. Atherosclerosis 196, 103113.Google Scholar
19Chiesa, G, Di Mario, C, Colombo, N, et al. (2001) Development of a lipid-rich, soft plaque in rabbits, monitored by histology and intravascular ultrasound. Atherosclerosis 156, 277287.Google Scholar
20Wait, R, Gianazza, E, Brambilla, D, Eberini, I, Morandi, S, Arnoldi, A & Sirtori, CR (2005) Analysis of Lupinus albus storage proteins by two-dimensional electrophoresis and mass spectrometry. J Agric Food Chem 53, 45994606.Google Scholar
21Chiesa, G, Monteggia, E, Marchesi, M, et al. (2002) Recombinant apolipoprotein A-I (Milano) infusion into rabbit carotid artery rapidly removes lipid from fatty streaks. Circ Res 90, 974980.Google Scholar
22Virmani, R, Kolodgie, FD, Burke, AP, Farb, A & Schwartz, SM (2000) Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol 20, 12621275.Google Scholar
23Martins, JM, Riottot, M, de Abreu, MC, Viegas-Crespo, AM, Lanca, MJ, Almeida, JA, Freire, JB & Bento, OP (2005) Cholesterol-lowering effects of dietary blue lupin (Lupinus angustifolius L.) in intact and ileorectal anastomosed pigs. J Lipid Res 46, 15391547.Google Scholar
24Gianazza, E, Eberini, I, Arnoldi, A, Wait, R & Sirtori, CR (2003) A proteomic investigation of isolated soy proteins with variable effects in experimental and clinical studies. J Nutr 133, 914.Google Scholar
25Naruszewicz, M, Nowicka, G, Klosiewicz-Latoszek, L, Arnoldi, A & Sirtori, C (2006) Effect of lupin protein (Lupinus albus) on cardiovascular risk factors in smokers with mild hypercholesterolemia. Circulation 114, 874.Google Scholar
26Pilvi, TK, Jauhiainen, T, Cheng, ZJ, Mervaala, EM, Vapaatalo, H & Korpela, R (2006) Lupin protein attenuates the development of hypertension and normalises the vascular function of NaCl-loaded Goto-Kakizaki rats. J Physiol Pharmacol 57, 167176.Google Scholar
Figure 0

Table 1 Lipid levels in rabbits fed diets containing 20 % casein (CAS), 10 % CAS+10 % isolate from Lupinus albus (CAS+LUP) or 20 % isolate from L. albus (LUP) as the protein source(Mean values and standard deviations for six rabbits per group)*

Figure 1

Fig. 1 Histological analysis of rabbit carotid plaques. (a) Carotid plaque volume evaluated in rabbits after perivascular injury followed by 90 d of high-fat, high-cholesterol diet containing 20 % casein (CAS), 10 % CAS+10 % isolate from Lupinus albus (CAS+LUP) or 20 % isolate from L. albus (LUP) as the protein source. Data are mean values (six rabbits per group), with standard deviations represented by vertical bars. * Mean value was significantly different from that of the CAS-fed group (P < 0·05). (b) Oil red O staining of carotid sections from rabbits fed high-fat, high-cholesterol diets containing 20 % casein (CAS) or 20 % isolate from L. albus (LUP) as protein source (magnification × 50). ↔ , Plaque formation.