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Trans Fatty Acids and Cardiovascular Disease
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Competing interests
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www.notransfatnyc.org
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Outline of presentation
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Factory workers needed bread en butter
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You cannot put cottonseed oil on bread..
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1902: Wilhelm Norman patents the hardening of edible oils through hydrogenation
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Partial hydrogenation gave food manufacturers control over the properties of a major food ingredient
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A polyunsaturated fatty acid: linoleic acid
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Hydrogenation converts essential polyunsaturated fatty acids into saturated and trans fatty acids
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Saturated fats stack up like planks in a stack of wood, creating hard fats.
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Why food manufacturers like the trans fat in partially hydrogenated oils
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Partially hydrogenated cottonseed oil
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Outline of presentation
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In 1990 Mensink & Katan showed that trans fat lowers HDL and raises LDL
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Effect of trans and saturated fat on the LDL:HDL ratio in 9 controlled trials
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Trans fatty acids raise the bad cholesterol and lower the good cholesterol, so they ought to increase the risk of heart disease. Do they?
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Risk of coronary heart disease as a function of industrial trans fat intake in prospective studies
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Trans fat and cardiovascular disease: quality of the evidence
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Trials of endothelial function as a surrogate for clinical trials
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Measurement of arterial diameter
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Flow-mediated dilation after cuff release is a measure of endothelial ‘health’
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Trans fat impairs endothelial-dependent vasodilation in volunteers
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Effects of trans fats on lipids and flow-mediated dilation are consistent with associations with CHD
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“Pleiotropic” effects of trans fat
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Why is the ‘effect’ in epidemiology larger than predicted from the effect on lipids?
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Outline of presentation
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The two sources of trans fat
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Saturated and trans fatty acids in Dutch margarines, 1980-1996
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Saturated and trans fatty acids in Dutch frying fats, 1980-2004
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Trans fat intake in the 1960s and 2006
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Sources of trans fat in the Dutch diet
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Trans fat intake has plunged
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Effect of conjugated linoleic acid on lipoproteins in healthy humans
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Why study CLA?
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“Animal” trans fatty acids: uncertainties
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Conjugated Linoleic Acid: a ruminant trans fatty acid sold as a weight loss supplement
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Objective
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Design of CLA trial
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Controlled dietary intervention
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Effect of industrial and ‘natural’ trans fat on blood lipids relative to oleic acid
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Dosis of trans fat and ΔLDL/HDL in published trials of industrial and animal trans fat
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What would vaccenic acid do to the LDL/HDL ratio?
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Conclusions
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Thank you for your attention
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Unsaturated fatty acids in native triglycerides have kinks and there is rotation around the kinks
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So unsaturated triglycerides will not stack and therefore remain liquid
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Hydrogenation changes the melting properties of triglycerides
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Saturated and trans-unsaturated fatty acids are straight and allow triglycerides to crystallize
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The Gap: Predicted effect on heart disease risk of reducing trans intake by 2 energy% (~ 5 gram/d)
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Why is there a gap?
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Cis- and trans isomers and nomenclature
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Distribution of trans fatty acid isomers in milk and industrial fats
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How different is natural trans from industrial trans?
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