Cardiovasculaire Geneeskunde.nl

Trans fatty acids and cardiovascular disease

Slides (presentatie) - Mar. 12, 2009

Trans Fatty Acids and Cardiovascular Disease

Competing interests

www.notransfatnyc.org

Outline of presentation

Factory workers needed bread en butter

You cannot put cottonseed oil on bread..

1902: Wilhelm Norman patents the hardening of edible oils through hydrogenation

Partial hydrogenation gave food manufacturers control over the properties of a major food ingredient

A polyunsaturated fatty acid: linoleic acid

Hydrogenation converts essential polyunsaturated fatty acids into saturated and trans fatty acids

Saturated fats stack up like planks in a stack of wood, creating hard fats.

Why food manufacturers like the trans fat in partially hydrogenated oils

Partially hydrogenated cottonseed oil

Outline of presentation

In 1990 Mensink & Katan showed that trans fat lowers HDL and raises LDL

Effect of trans and saturated fat on the LDL:HDL ratio in 9 controlled trials

Trans fatty acids raise the bad cholesterol and lower the good cholesterol, so they ought to increase the risk of heart disease. Do they?

Risk of coronary heart disease as a function of industrial trans fat intake in prospective studies

Trans fat and cardiovascular disease: quality of the evidence

Trials of endothelial function as a surrogate for clinical trials

Measurement of arterial diameter

Flow-mediated dilation after cuff release is a measure of endothelial ‘health’

Trans fat impairs endothelial-dependent vasodilation in volunteers

Effects of trans fats on lipids and flow-mediated dilation are consistent with associations with CHD

“Pleiotropic” effects of trans fat

Why is the ‘effect’ in epidemiology larger than predicted from the effect on lipids?

Outline of presentation

The two sources of trans fat

Saturated and trans fatty acids in Dutch margarines, 1980-1996

Saturated and trans fatty acids in Dutch frying fats, 1980-2004

Trans fat intake in the 1960s and 2006

Sources of trans fat in the Dutch diet

Trans fat intake has plunged

Effect of conjugated linoleic acid on lipoproteins in healthy humans

Why study CLA?

“Animal” trans fatty acids: uncertainties

Conjugated Linoleic Acid: a ruminant trans fatty acid sold as a weight loss supplement

Objective

Design of CLA trial

Controlled dietary intervention

Effect of industrial and ‘natural’ trans fat on blood lipids relative to oleic acid

Dosis of trans fat and ΔLDL/HDL in published trials of industrial and animal trans fat

What would vaccenic acid do to the LDL/HDL ratio?

Conclusions

Thank you for your attention

Unsaturated fatty acids in native triglycerides have kinks and there is rotation around the kinks

So unsaturated triglycerides will not stack and therefore remain liquid

Hydrogenation changes the melting properties of triglycerides

Saturated and trans-unsaturated fatty acids are straight and allow triglycerides to crystallize

The Gap: Predicted effect on heart disease risk of reducing trans intake by 2 energy% (~ 5 gram/d)

Why is there a gap?

Cis- and trans isomers and nomenclature

Distribution of trans fatty acid isomers in milk and industrial fats

How different is natural trans from industrial trans?

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