Health care providers should advise consumers
about how to minimize the intake of trans fatty
acids, consumers should be able to recognize and
avoid products containingtransfatty acids and restau-
rants and food manufacturers should use alternative
fats in food production and preparation. These meas-
ures should ensure a reduction intransfatty acid con-
sumption and result in substantial health benefits
particularly a reduction in the incidence of CHD.ComplicationsTrans fatty acid intake and risk of disease
TRANSFATTY ACID INTAKE AND CHD.On a per
calorie basis,trans fatty acids increase the risk of
CHD more than any other macronutrient, conferring
a substantially increased risk even at low levels of
consumption (between 1 to 3% of total energy intake).
Even a small rise in energy intake fromtransfatty
acids can cause a large increase risk. A meta-analysis
of four prospective cohort studies that included data
from 140,000 subjects showed a 23% increase in CHD
incidence when energy intake fromtransfatty acids
increased by just 2%. So dramatic is the impact of
transfatty acids on CHD risk, another study showed
that the positive association between levels oftrans
fatty acids in adipose tissue (a biomarker for dietary
intake) and CHD risk was diminished after 1996,
whentransfatty acids where eliminated from margar-
ines sold in Australia and the population’s consump-
tion levels decreased.
The potential benefits of reducing of reducing con-
sumption oftransfatty acids from industrial sources on
the incidence of CHD in the United States has been
calculated. On the basis of predicted changes in total
and HDL cholesterol, CHD events could be reduced by
between 3 and 6 percent. If the influence oftransfatty
acids on other risk factors such as inflammatory effects
is considered, CHD events could be reduced by 10–19%
(equivalent to between 72,000 and 228,000 CHD events
each year). This reduction could be even greater, if
healthiercisunsaturated fatty acids, includingomega-
3 fatty acids, are used to replacetransfatty acids.
TRANS FATTY ACID INTAKE AND DIABETES.The
association between risk of diabetes andtransfatty
acid intake is less clear. Three prospective studies
have investigated this relationship and in two of the
studies, consumption oftransfatty acids was not sig-
nificantly associated with increased risk of diabetes.
However, in a study of nearly 85,000 female nurses a
strong positive association was found. The nurses
were followed for 16 years, information of dietary
intake was periodically updated and self-reported dia-betes was validated. The conclusions of no association
in the first two studies may be explained by the rela-
tively low intake in one cohort of male health profes-
sionals (average intake of 1.3% energy).Parental concerns
Parents should eliminate all sources oftransfatty
acids from industrial sources from theirchildren’s
dietsas these have no intrinsic health value above
their energy value. Therefore their consumption is
linked with considerable potential harm and no appa-
rent benefit. As adverse effects are seen at even low
levels of intake, between 1 and 3% of total energy (2–
7g per day for a person consuming 2,000 calories), it
seems complete or near complete avoidance oftrans
fatty acids should be advised in order to minimize
health risks.Resources
BOOKS
British Nutrition Foundation.trans Fatty Acids. London:
British Nutrition Foundation, 1995. A report of the
British Nutrition Task Force.
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