The Influence of Trans-fatty acids on human health.
The prevalent perception of lipids is that they not only lead to obesity, but also contribute to an increased risk of dyslipidemia (cholesterol), atherosclerosis, myocardial infarction, stroke, diabetes and cancer. However, lipids are an essential dietary component vital to human health. (1) Some lipids are healthier than others, for example saturated fats are more associated with an increase in cholesterol and disease whereas mono-saturated and poly-saturated fats actually improve cholesterol levels in the blood. Omega-6 and omega-3 fats play a crucial role in growth and development as well as brain function in the human body, whereas trans fatty acids can be harmful but can also be beneficial if unsaturated. (1)
For decades, healthy living was based upon the notion of eating low-fat diets due to the publicity it received. The general population has adhered to this perception as a means to lose excess weight and to prevent or manage cardiovascular disease. (2)
Reformulation and modification of food items by major food companies took place in order to increase their marketing of products that are “fat free”, often increasing the sugar as well as salt content to compensate for compromise of flavour. (2) The type of lipid and the total calories in the diet are more important to consider in order to control weight and disease state.
Trans-fatty acids are molecules that encompass a minimum of one trans-double bond that exists between two carbon (C) atoms. (3) A trans-double bond differs from a cis double bond (commonly found in nature) in its geometrical position. The hydrogen (H2) atoms linked to the double bond are positioned on either side of the C-atom in the trans molecule, compared to the cis molecule where both H2 atoms are positioned on the same side of the C-atom. (3) Trans-fatty acids exhibit an unsaturated chemical nature, however the chemical configuration is comparable to that of the saturated fats with a slight difference in geometrical positioning. (3) This variance in chemical structure results in a difference in their effect on biological processes in the human body.
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Human consumption of trans-fatty acids comes from food products that encompass partially hydrogenated fats, animal fats and dairy fats. (3) Trans-fatty acids are produced by the partial hydrogenation of vegetable oils. This is a procedure that solidifies vegetable oil to margarine and other commercial cooking products. Trans-fatty acids are preferred amongst the major food companies due to their increased shelf life and stability. (4)Trans-fatty acids from dietary consumption, like other types of fatty acids are stored in adipose tissue. The trans-fatty acid composition stored in the adipose tissue can be examined by analysing the fatty acid content in a biopsy. (3)
The major effects of trans-fatty acids on serum fat levels in the body have been assessed in scientific trials. The intake of trans-fatty acids increases the levels of low density lipoproteins (LDL’s), decreases the levels of high-density lipoproteins (HDL’s) and increases the percentage of overall cholesterol to the HDL; this in turn increases the risk of coronary heart disease. (3, 4)
Trans-fatty acids also elevate triglyceride (TG) levels in the plasma. When contrasted with the consumption of other lipids an elevated level of lipoprotein (a) was observed as well as a reduction in the molecular size of LDL; both of which can elevate the risk of coronary heart disease; thus trans fatty acids exhibit unhealthy effects on plasma levels in the human body. (4)
One study investigated whether the increase in low-density lipoprotein to high-density lipoprotein ratio, negatively influenced the risk of coronary heart disease by studying dietary data from the partakers of a Nurses Health Study. (5) The study consisted of calculating the consumption of fatty acids from questionnaires based on their dietary intake that were completed by 85 095 women who were not suffering from coronary heart disease, stroke, dyslipidemia or diabetes during 1980. (5) Throughout the following eight years, there were 431 cases of new coronary heart disease patients, which included both myocardial infarction events as well as death as a consequence of coronary heart disease. (5) After examining the cases, scaling and modification of data (which included age and the patients overall energy consumption) took place in order to uncover whether the consumption of fatty acids was directly related to an increased risk of coronary heart disease. (5) Patients who developed coronary heart disease or exhibited associated risk factors, utilised additional control such as the use of multivitamins, a decreased intake of saturated and monosaturated fat, linoleic acid, exogenous cholesterol, increased intake of vitamins E as well as C, carotene and fiber; however these controls did not alter the relative risk significantly. (5)
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The correlation between an increased fatty acid intake leading to a greater risk of developing coronary heart disease was greater for the 69 181 women whose hydrogenated fatty acid consumption over the previous decade had been relatively stable. (5) Food consumption high in trans fatty acids such as margarine, cakes and cookies, were each considerably associated with elevated risks of coronary heart disease. Therefore, this study has linked that the consumption of trans fatty acids in the form of hydrogenated vegetable oils may increase the manifestation of coronary heart disease. (5)
One study examined the relationship between reported consumption of dietary fatty acids and the incidence of type-2 diabetes. The study was conducted on 35 988 older women who were not suffering from diabetes at the beginning of the study. (6)
Nutrition regime was evaluated with an initial food frequency survey that was completed by the participants, with 1890 cases of diabetes transpiring throughout an 11-year evaluation. (6) Data was adjusted for various variables such as smoking, alcohol consumption, the age of the participant, body mass index (BMI), exercise, Mg2+ and fiber intake; where results identified that the incidence of diabetes was adversely related to the consumption of polyunsaturated fatty acids, vegetable oil and trans-fatty acids; however, a positive relation between omega 3 fatty acids and cholesterol was found in regards to the decrease in development of diabetes. (6)
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After further statistical modification and adjustment between the data for the intake of other dietary fats, it was clear that vegetable fats were mostly linked to an increased risk of developing diabetes. (6) The study undertaken supports an inverse relationship between the incidence of type-2 diabetes and the dietary consumption of vegetable fats and trans fatty acids. A diet that is low in trans fatty acids is suggested for patients not only suffering from diabetes but also for the general population, however epidemiological studies illustrate the total dietary fatty acid link to an increase in development of type-2 diabetes to be inconsistent. (6) Although studies between the link of an increased trans-fatty acid intake and the development of diabetes still remain largely unknown, metabolic as well as epidemiological studies have suggested that the dietary fat component may be a crucial component to further our understanding about the pathogenesis of diabetes mellitus. (6) Trans-fatty acids for example may affect the progress of diabetes mellitus by altering the phospholipid bilayer structure of cell membranes in the human body, which may lead to a irreversible modification in the function and/ or a conformational alteration of the insulin receptor. (6)
The relationship between trans-fatty acids in the plasma; which reflect the dietary consumption of the patient, and the incidence of stroke was studied in a controlled analysis of 96 male subjects who suffered from a stroke incident and a further 96 male subjects utilised as a control group that were matched according to age, the same medical centre, treatment unit as well as the date of randomisation. (7) Gas liquid chromatography was utilised to measure the serum (plasma) levels of cholesterol as well as phospholipid fatty acid levels after identifying and stabilising the serum samples. (7) The cholesterol and phospholipid levels were expressed as a percentage of the total amount of fatty acids present in the body and their association with the incidence of stroke was also examined. (7)
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Utilising regression statistical techniques (conditional logistic) for the risk factors associated with an elevated risk of stroke, it was found that specific fatty acids were independently related to the elevated risk of stroke, whereas some were actually associated with a decline in risk of developing a stroke. (7)
Results demonstrated that phospholipid stearic acid was linked to a 37% elevation in the risk of developing a stroke whereas phospholipid – linolenic acid illustrated a 28% reduction in the risk of developing stroke. (7) A rise in the serum levels of linolenic acid exemplified a 37% decrease in the risk of developing stroke, with hypertension and smoking also contributing to the incidence of stroke development. (7) Therefore the results exemplify that an increased serum level of the fatty acid linolenic acid will independently decrease the risk of stroke in the middle-aged men population who are at greater risk of stroke and coronary heart disease whereas the increased serum level of trans-fatty acids will be more likely to significantly elevate the risk of developing stroke. (7)
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