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Stearic acid, trans fatty acids, and dairy fat: effects on serum and lipoprotein lipids, apolipoproteins, lipoprotein(a), and lipid transfer proteins in healthy subjects.

To compare the effects on serum lipoproteins of stearic acid, trans fatty acids, and dairy fat, 80 healthy subjects consumed a dairy fat-based (baseline) diet for 5 wk, then an experimental diet high in either trans fatty acids (8.7% of energy; n = 40) or stearic acid (9.3% of energy; n = 40) for another 5 wk. All diets provided 32.2-33.9% of energy as fat, 14.6-15.8% as saturated plus trans fatty acids, 11.4-12.5% as cis-monounsaturated fatty acids, 2.9-3.5% as polyunsaturated fatty acids, and 200-221 mg cholesterol/10 MJ. Compared with the dairy fat diet, stearic acid and trans fatty acids decreased serum total cholesterol concentrations similarly (by 13% and 12%, respectively, P < 0.001) but the trans fatty acid diet decreased HDL cholesterol (17%) and apolipoprotein (apo) A-I (15%) significantly more than did the stearic acid diet (11% and 12%, respectively). Stearic acid but not trans fatty acids reduced concentrations of LDL cholesterol and apo B significantly (P < 0.001). The trans fatty acid diet increased the ratio of LDL to HDL cholesterol (19%) and of apo B to apo A-I (16%) more than did the dairy fat diet (P < 0.001) but the stearic acid diet had no effect. Lipoprotein(a) concentrations increased with both experimental diets, significantly more with trans fatty acids (30%) than with stearic acid (10%). In conclusion, high amounts of trans fatty acids had more adverse effects on lipoproteins than did equal amounts of stearic acid and dairy fat. Stearic acid reduced LDL cholesterol, did not affect the ratio of LDL to HDL cholesterol, and increased lipoprotein(a), although to a lesser extent than did trans fatty acids. Dietary fats low in both saturated fatty acids and trans fatty acids should be favored.

Adult↗

Health effects of trans fatty acids.

trans Fatty acids are formed during the process of partial hydrogenation in which liquid vegetable oils are converted to margarine and vegetable shortening. Concern has existed that this process may have adverse consequences because natural essential fatty acids are destroyed and the new artificial isomers are structurally similar to saturated fats, lack the essential metabolic activity of the parent compounds, and inhibit the enzymatic desaturation of linoleic and linolenic acid. In the past 5 y a series of metabolic studies has provided unequivocal evidence that trans fatty acids increase plasma concentrations of low-density-lipoprotein cholesterol and reduce concentrations of high-density-lipoprotein (HDL) cholesterol relative to the parent natural fat. In these same studies, trans fatty acids increased the plasma ratio of total to HDL cholesterol nearly twofold compared with saturated fats. On the basis of these metabolic effects and the known relation of blood lipid concentrations to risk of coronary artery disease, we estimate conservatively that 30,000 premature deaths/y in the United States are attributable to consumption of trans fatty acids. Epidemiologic studies, although not conclusive on their own, are consistent with adverse effects of this magnitude or even larger. Because there are no known nutritional benefits of trans fatty acids and clear adverse metabolic consequences exist, prudent public policy would dictate that their consumption be minimized and that information on the trans fatty acid content of foods be available to consumers.

Cholesterol↗

Impact of processing on formation of trans fatty acids.

Trans fatty acids are formed during hydrogenation which is done to improve the functionality and oxidative stability of oils. Several process conditions affect the content of trans fatty acids in hydrogenated oil. There is conflicting evidence as to whether intake of trans fatty acids, in foods such as margarine, affects the types and levels of cholesterol produced in the blood. Epidemiological studies have shown associated increases in total cholesterol and low density lipoproteins, as well as decreased levels of high density lipo-proteins in the blood. It is unknown whether these effects are related directly to trans fatty acids or to the decrease of unsaturated fatty acids in the diet. This chapter will cover the recent nutritional status of trans fatty acids and the effect of processing on the levels of trans fatty acids in foods.

Adult↗

Risk of preeclampsia in relation to elaidic acid (trans fatty acid) in maternal erythrocytes.

OBJECTIVE: Trans fatty acids, formed by the partial hydrogenation of vegetable oils, are associated with increases in plasma concentrations of cholesterol, triglyceride, lipoprotein (a), and coronary heart disease risk. Trans fatty acids may also increase platelet aggregation and alter eicosanoid biosynthesis. We studied the relation between maternal dietary intake of trans fatty acids and risk of preeclampsia. METHODS: Maternal intake of elaidic acid, one of the most abundant dietary trans fatty acids and other fatty acids were estimated using gas-liquid chromatography on erythrocytes from 22 women with preeclampsia and 40 normotensive controls. Fatty acids were expressed as the percentage of total fatty acids in erythrocytes. Logistic regression procedures were used to estimate odds ratios and 95% confidence intervals. RESULTS: Mean levels of elaidic acid were 28% higher among preeclamptics (0.43 +/- 0.12) as compared with controls (0.31 +/- 0.12; p < 0.001). After adjusting for confounding factors, women with the highest levels of elaidic acid (median = 0.47) were 7.4 times (odds ratio = 7.4; 95% confidence interval 1.4-39.7) more likely to have had their pregnancy complicated by preeclampsia as compared with those women with the lowest levels (median 0.24). Risk of preeclampsia appeared to increase with increasing levels of elaidic acid (p value for linear trend = 0.05). CONCLUSION: These cross-sectional data suggest that diets high in elaidic acid may be associated with an increased risk of preeclampsia. This hypothesis should be examined in larger longitudinal studies.

Cross-Sectional Studies↗

Dietary trans fatty acid.

Trans fatty acids are unsaturated fatty acids that contain at least one double bond in the trans configuration. In the diet they occur at relatively low levels in meat and dairy products as a by-product of fermentation in ruminant animals or in hydrogenated fats as a consequence of the hydrogenation process. In general, dietary hydrogenated fat/trans fatty acids have been reported to increase LDL cholesterol levels relative to oil in the natural state or cis fatty acids. In contrast, dietary hydrogenated fat/trans fatty acids have been reported have to have little effect or decrease HDL cholesterol levels, the later observation restricted to relatively high intakes of trans fatty acids. These two effects result in higher, therefore less favorable, total or LDL cholesterol/HDL cholesterol ratios. Significant increases in Lp(a) levels have been reported after consumption of diets relatively high in trans fatty acids compared with either unsaturated or saturated fatty acids. However, the magnitude of the change is for the most part small and the physiological significance of this observation has yet to be resolved. Data related to the mechanism by which hydrogenated fat/trans fatty acids alter serum lipid levels and other risk factors for cardiovascular disease are in the nascent stages. At this time it would appear prudent that public health recommendations should be aimed at encouraging the moderate consumption of products low in saturated fat or minimally hydrogenated. Trans fatty acids intake should not be stressed at the expense of saturated fat but should augment it.

Cardiovascular Diseases↗

Replacement of dietary saturated fatty acids by trans fatty acids lowers serum HDL cholesterol and impairs endothelial function in healthy men and women.

We tested whether trans fatty acids and saturated fatty acids had different effects on flow-mediated vasodilation (FMD), a risk marker of coronary heart disease (CHD). Consumption of trans fatty acids is related to increased risk of CHD, probably through effects on lipoproteins. Trans fatty acids differ from most saturated fatty acids because they decrease serum high-density lipoprotein (HDL) cholesterol, and this may increase the risk of CHD. We fed 29 volunteers 2 controlled diets in a 2x4-week randomized crossover design. The "Trans-diet" contained 9.2 energy percent of trans fatty acids; these were replaced by saturated fatty acids in the "Sat-diet." Mean serum HDL cholesterol after the Trans-diet was 0.39 mmol/L (14.8 mg/dL), or 21% lower than after the Sat-diet (95% CI 0.28 to 0.50 mmol/L). Serum low density lipoprotein and triglyceride concentrations were stable. FMD+SD was 4.4+/-2.3% after the Trans-diet and 6.2+/-3.0% after the Sat-diet (difference -1.8%, 95% CI -3.2 to -0.4). Replacement of dietary saturated fatty acids by trans fatty acids impaired FMD of the brachial artery, which suggests increased risk of CHD. Further studies are needed to test whether the decrease in serum HDL cholesterol caused the impairment of FMD.

Adult↗

Gas chromatographic analysis of infant formulas for total fatty acids, including trans fatty acids.

Twelve powdered and 13 liquid infant formulas were analyzed by using an extension of AOAC Official Method 996.01 for fat analysis in cereal products. Samples were hydrolyzed with 8 N HCl and extracted with ethyl and petroleum ethers. Fatty acid methyl esters were prepared by refluxing the mixed ether extracts with methanolic sodium hydroxide in the presence of 14% boron trifluoride in methanol. The extracts were analyzed by gas chromatography. In powdered formulas, saturated fatty acid (SFA) content (mean +/- SD; n = 12) was 41.05 +/- 3.94%, monounsaturated fatty acid (MUFA) content was 36.97 +/- 3.38%, polyunsaturated fatty acid (PUFA) content was 20.07 +/- 3.08%, and total trans fatty acid content was 1.30 +/- 1.27%. In liquid formulas, SFA content (mean +/- SD; n = 13) was 42.29 +/- 2.98%, MUFA content was 36.05 +/- 2.47%, PUFA content was 20.65 +/- 2.40%, and total trans fatty acid content was 0.88 +/- 0.54%. Total fat content in powdered formulas ranged from 4.4 to 5.5 g/100 kcal and linoleic acid content ranged from 868 to 1166 mg/100 kcal. In liquid formulas, total fat content ranged from 4.1 to 5.1 g/100 kcal and linoleic acid content ranged from 820 to 1100 mg/100 kcal. There were no significant differences between powdered and liquid infant formulas in concentrations of total fat, SFA, MUFA, PUFA, or trans fatty acids.

Algorithms↗

Different quantities and quality of fat in milk products given to young children: effects on long chain polyunsaturated fatty acids and trans fatty acids in plasma.

UNLABELLED: In this study we compared plasma contents of long-chain polyunsaturated fatty acids (LC-PUFAs) and trans fatty acids in triglycerides (TG), phospholipids (PL) and cholesterolesters (CE) in young children fed milk diets containing different amounts of linoleic (LA) and alpha-linolenic acid (ALA). Because the diets differed in vitamin A and E content, plasma concentrations of vitamin A and E were also studied. Thirty-seven 1-y-old children were randomly assigned to one of four feeding groups: (1) low-fat milk (LF) (1.0 g cow's milk fat/dL); (2) standard-fat milk (SF) (3.5 g cow's milk fat/dL); (3) partially vegetable fat milk (PVF) (3.5 g fat/dL; 50% vegetable fat from rapeseed oil, 50% milk fat); and (4) full vegetable fat milk (FVF) (3.5 g fat/dL; 100% vegetable fat from palm-, coconut- and soybean oil). We found higher amounts of plasma LA in the FVF group than in the LF and SF groups (p < 0.001) and higher amounts of ALA in the PVF group than in the SF (p < 0.001 in TGs, p < 0.05 in CEs) and LF (p < 0.01 in PLs and CEs, p < 0.05 in TGs) groups. However, amounts of plasma arachidonic acid (AA) were similar between groups as well as the amounts of docosahexaenoic acid (DHA) in CEs and PLs. Total trans FAs were lower in CEs in the PVF and FVF groups than in the SF group (p < 0.05 SF vs PVF; p < 0.01 SF vs FVF). Plasma concentrations of alpha-tocopherol were higher in the FVF group than in the other groups (p < 0.05 FVF vs SF, p < 0.01 FVF vs SF and PVF). CONCLUSION: Children consuming milk diets containing high amounts of vegetable fat present with higher plasma LA and ALA without any effects on amounts of plasma LC-PUFA. The plasma LC-PUFA status is not adversely affected by a low-fat milk diet. AHA and DHA in plasma are not affected by the diets studied, presumably because 15-mo-old children may be able to compensate for dietary influences through endogenous LC-PUFA metabolism.

Animals↗

Upper limits of nutrients in infant formulas: polyunsaturated fatty acids and trans fatty acids.

As upper limits for standard infant formulas, it is suggested that n-6 fatty acids not exceed 20% of total fatty acids or 10% of total energy; that alpha-linolenic acid not exceed 3% and eicosapentaenoic and docosahexaenoic acid not exceed 1% of total fatty acids; or that the sum of these n-3 fatty acids not exceed 2% of total energy. Trans fatty acids are not recommended for use in standard infant formulas. The rationale for these recommendations is presented in each case.

Fatty Acids↗

Effect of butter, mono- and polyunsaturated fatty acid-enriched butter, trans fatty acid margarine, and zero trans fatty acid margarine on serum lipids and lipoproteins in healthy men.

The effect of diets containing 50% of fat calories from butter, butter enriched with mono- and polyunsaturated fatty acids, and margarines with and without trans fatty acids on the serum lipids of 38 healthy men in a free-living condition have been determined. Serum lipid responses to the high level of individual dietary fats were unexpectedly small. The butter diet produced a small, but significant rise (5%) in the total serum cholesterol and low density lipoprotein (LDL)-cholesterol, relative to all other diets. Enrichment of butter with either olive oil (50/50) or sunflower oil (50/50) failed to reduce serum lipid levels below habitual diet values. Hard margarine, containing 29% trans fatty acids, caused a decrease in apolipoprotein A-I and B levels, but did not change total serum cholesterol or LDL-cholesterol levels, relative to habitual diet values. A soft margarine, high in linoleate, with no trans fatty acids reduced total cholesterol, LDL-cholesterol, and apolipoprotein B significantly, relative to all diets. Soft margarine high density lipoprotein (HDL)-cholesterol levels remained unchanged, but apolipoprotein A-I values were decreased relative to habitual and butter diets. The quantities of saturated fatty acids and the sum of monounsaturated and polyunsaturated fatty acids consumed on the hard and soft margarines were equal; therefore, the different response of serum cholesterol and LDL-cholesterol between these two diets is attributable to the trans fatty acids in the hard margarine. The data indicate that trans fatty acids are not metabolically equivalent to the natural cis isomers and that they affect the serum lipid profile adversely.

Adult↗

Trans fatty acids, insulin resistance, and type 2 diabetes.

Type 2 diabetes, a growing global health problem, has a complex etiology involving many interactions between genetic and environmental factors. Essential to the development of the disease is insulin resistance of the peripheral tissues. Insulin resistance may be partly modified by the specific types of dietary fatty acids. Trans fatty acids (TFAs), created through the transformation of polyunsaturated fatty acids from their natural cis form to the trans form, are abundant in the Western diet. TFAs take on similar properties as saturated fats, and appear to be more atherogenic. High intakes of saturated fats may promote insulin resistance. It is therefore reasonable to hypothesize that high intakes of TFAs would have similar, or stronger, effects. In this review, all current evidence on the topic of TFAs, insulin resistance, and type 2 diabetes is summarized and interpreted. Although there is some support from observational and experimental studies for the hypothesis that high intakes of TFAs may increase the risk for type 2 diabetes, inconsistencies across studies and methodological problems make it premature to draw definitive conclusions at this time. More experimental research in humans is needed to further address this question.

Adult↗

Effect of feeding systems on omega-3 fatty acids, conjugated linoleic acid and trans fatty acids in Australian beef cuts: potential impact on human health.

The influence of feeding systems on the levels of functional lipids and other fatty acid concentrations in Australian beef was examined. Rump, strip loin and blade cuts obtained from grass feeding, short-term grain feeding (80 days; STGF) and long-term grain feedlot rations (150-200 days; LTFL) were used in the present study. The typical Australian feedlot ration contains more than 50% barley and/or sorghum and balanced with whole cottonseed and protein meals were used as feed for STGF and LTFL regimens. Meat cuts from 18 cattle for each feeding regimen were trimmed of visible fat and connective tissue and then minced (300 g lean beef); replicate samples of 7 g were used for fatty acid (FA) analysis. There was a significantly higher level of total omega-3 (n-3) and long chain n-3 FA in grass-fed beef (P< 0.0001) than the grain-fed groups regardless of cut types. Cuts from STGF beef had significantly reduced levels of n-3 FA and conjugated linoleic acid (CLA) and similar levels of saturated, monounsaturated and n-6 FA compared with grass feeding (P < 0.001). Cuts from LTFL beef had higher levels of saturated, monounsaturated,n-6 FA and trans 18:1 than similar cuts from the other two groups (P<0.01), indicating that increased length of grain feeding was associated with more fat deposited in the carcass. There was a step-wise increase in trans 18:1 content from grass to STGF to LTGF, suggesting grain feeding elevates trans FA in beef, probably because of increased intake of 18:2n-6. Only grass-fed beef reached the target of more than 30mg of long chain n-3 FA/100 g muscle as recommended by Food Standard Australia and New Zealand for a food to be considered a source of omega-3 fatty acids. The proportions of trans 18:1 and n-6 FA were higher (P<0.001) for both grain-fed beef groups than grass-fed beef. Data from the present study show that grain feeding decreases functional lipid components (long chain n-3 FA and CLA) in Australian beef regardless of meat cuts, while increasing total trans 18:1 and saturated FA levels.

Animal Feed↗

FT-midIR determination of fatty acid profiles, including trans fatty acids, in bakery products after focused microwave-assisted Soxhlet extraction.

A study of the feasibility of Fourier transform medium infrared spectroscopy (FT-midIR) for analytical determination of fatty acid profiles, including trans fatty acids, is presented. The training and validation sets-75% (102 samples) and 25% (36 samples) of the samples once the spectral outliers have been removed-to develop FT-midIR general equations, were built with samples from 140 commercial and home-made bakery products. The concentration of the analytes in the samples used for this study is within the typical range found in these kinds of products. Both sets were independent; thus, the validation set was only used for testing the equations. The criterion used for the selection of the validation set was samples with the highest number of neighbours and the most separation between them (H<0.6). Partial least squares regression and cross validation were used for multivariate calibration. The FT-midIR method does not require post-extraction manipulation and gives information about the fatty acid profile in two min. The 14:0, 16:0, 18:0, 18:1 and 18:2 fatty acids can be determined with excellent precision and other fatty acids with good precision according to the Shenk criteria, R (2)>/=0.90, SEP=1-1.5 SEL and R (2)=0.70-0.89, SEP=2-3 SEL, respectively. The results obtained with the proposed method were compared with those provided by the conventional method based on GC-MS. At 95% significance level, the differences between the values obtained for the different fatty acids were within the experimental error.

Bread↗

The linoleic acid and trans fatty acids of margarines.

Fifty brands of margarine were analysed for cis-polyunsaturated acids by lipoxidase, for trans fatty acid by infared spectroscopy, and for fatty acid composition by gas-liquid chromatography. High concentrations of trans fatty acids tended to be associated with low concentrations of linoleic acid. Later analyses on eight of the brands, respresenting various proportions of linoleic to trans fatty acids, indicated that two of them contained still higher levels of trans fatty acids (greater than 60%) and negligible amounts of linoleic acid. It is proposed that margarine could be a vehicle for the distribution of some dietary linoleic acid and that the level of linoleic acid and the summation of the saturated plus trans fatty acids be known to ascertain nutritional characteristics.

Chromatography, Gas↗

Metabolic interactions between essential and trans-fatty acids.

Trans-fatty acids exacerbate essential fatty acid deficiency in experimental animals by interfering with the metabolism of linoleic (18:2n-6) and alpha-linolenic (18:3n-3) acids and, hence, the eicosanoid production. The interfering effect depends on the type of trans-fatty acid. The detrimental effect of trans-fatty acid, however, apparently disappears when dietary linoleic acid is sufficiently supplemented. Trans-fatty acids appear to disturb fetal growth and birth weight, possibly by the same mechanism.

Animals↗

Position paper on trans fatty acids. ASCN/AIN Task Force on Trans Fatty Acids. American Society for Clinical Nutrition and American Institute of Nutrition.

This report addresses the current controversy about possible health hazards of dietary trans fatty acid isomers, which are created during hydrogenation of unsaturated fats to change their textural properties and melting points. Estimates of intakes are approximations based on limited data and problematic analytic techniques. Major contributors in the diet are fried and baked foods and margarine, in which partially hydrogenated vegetable oils may replace fat sources richer in saturated fatty acids and cholesterol. Consumption of trans fatty acids in the United States has been relatively constant, and new food technologies are yielding decreases in the trans fatty acid content of commercially prepared foods. When intake of trans fatty acids (as hydrogenated fat) is compared with that of saturated fat, total and low-density-lipoprotein (LDL)-cholesterol concentrations in blood are lower, but both trans fats and saturated fats increase total and LDL concentrations when compared with cis fatty acids or native unhydrogenated fat. Epidemiologic data are conflicting with respect to cardiovascular disease outcomes. We cannot conclude that the intake of trans fatty acids is a risk factor for coronary heart disease nor can we expect that substituting trans- for cis-containing fats will reduce the risk of coronary heart disease. Few rigorous studies have dealt with biomedical effects of trans fatty acids and possible mechanisms relevant to human health and diseases. The nutrition labeling issue is unresolved. The options, recommendations, and research suggestions in this report should outline for nutrition scientists the database needed before any new dietary recommendations or changes in nutrition policy concerning trans fatty acids can be made. The debate about trans fatty acids should not detract from dietary recommendations to limit the intake of saturated fat and total fat.

Cardiovascular Diseases↗

Influence of dietary linoleic acid and trans fatty acids on the fatty acid profile of cardiolipins in rats.

Cardiolipins (CL) have unique fatty acid profiles with generally high levels of polyunsaturated fatty acids, primarily 18:2n-6, and low levels of saturated fatty acids. In order to study the effect of dietary fatty acid isomers on the fatty acid composition of cardiolipins, rats were fed partially hydrogenated marine oils (HMO), rich in 16:1, 18:1, 20:1, and 22:1 isomeric fatty acids, supplemented with linoleic acid at levels ranging from 1.9% to 14.5% of total fat. Although the dietary fats contained 33% trans fatty acids, the levels of trans fatty acids in CL were below 2.5% in all organs. The fatty acid profiles of cardiolipins of liver, heart, kidney and testes showed different responses to dietary linoleic acid level. In liver, the contents of 18:2 reflected the dietary levels. In heart and kidney, the levels of 18:2 also paralleled increasing dietary levels, but in all groups fed HMO, levels of 18:2 were considerably higher than in the reference group fed palm oil. In testes, the 18:2 levels were unaffected by the dietary level of 18:2 and HMO.

Animals↗

World-wide consumption of trans fatty acids.

Dietary trans fatty acids (TFA) originate from commercially hydrogenated oils and from dairy and meat fats. Estimates of dietary TFA consumption vary with dietary habits and food supply as well as methods used to estimate consumption. Methods include: (1) market share data, (2) laboratory analysis of duplicate portions or composite diets, (3) analysis of consumption data of a representative population, and (4) biomarkers, such as human milk. In North America, daily intakes have been estimated by food frequency questionnaire to be 3-4 g/person and by extrapolation of human milk data to be greater than 10 g/person. Diets in northern Europe traditionally have contained more TFA than in Mediterranean countries where olive oil is used. Intakes in Europe range from minimal values in Italy, Portugal, Greece and Spain (1.4-2.1 g/day) to greater values for Germany, Finland, Denmark, Sweden, France, United Kingdom, Belgium, Norway, The Netherlands, and Iceland (2.1-5.4 g/day) Recent decreases in dietary TFA have been observed due to modifications of commercial fats and changes in consumer choices. The impact of legislation restricting use of hydrogenated fats and requiring TFA content on food labels awaits future studies.

Cardiovascular Diseases↗