Americans' Awareness, Knowledge, and Behaviors Regarding Fats: 2006-2007

In recent years, epidemiologic and clinical studies, public and regulatory policy activity, and media coverage have focused on issues related to trans fats. To help increase awareness and understanding of trans fats and other fats, the American Heart Association (AHA) launched the “Face the Fats” national consumer education campaign in April 2007. The AHA commissioned a quantitative tracking survey between 2006 and 2007 to measure changes in consumer awareness, knowledge, and behaviors related fats and oils and their perceived impact on heart disease. The survey was conducted by Cogent Research. Data were collected during March 2006 and May 2007. At both time points, the survey included a representative sample of the American population age 18 to 65 years (n=1,000). The sampling plan for the survey was designed based on the 2000 and 2003 US Census. The margin of error was ±3.10 percentage points. Awareness of trans fats increased during the 1-year study period. In 2007, 92% of respondents were aware of trans fats, an increase from 84% in 2006 (P<0.05). The 2007 level was similar to the awareness of saturated fats (93%). Perceptions that certain fats and oils heighten the risk of heart disease increased for trans fats (73% in 2007 vs 63% in 2006; P<0.05), saturated fats (77% in 2007 vs 73% in 2006; P<0.05), and partially hydrogenated oils (56% in 2007 vs 49% in 2006; P<0.05). Knowledge about food sources of different fats remained low. On an unaided basis, 21% could name three food sources of trans fats in 2007, up from 17% in 2006 (P<0.05). Knowledge of food sources of saturated fat remained unchanged at 30% in 2007. Significantly more respondents in 2007 reported behavioral changes related to trans fat information, such as buying food products because they show “zero trans fat” on labels or packages (37% in 2007 vs. 32% in 2006; P<0.05). Between 2006 and 2007, consumer awareness about trans fats increased and attained awareness levels similar to saturated fats. The increased awareness is associated with improved self-reported behaviors in grocery shopping. Nonetheless, overall knowledge, especially regarding food sources of saturated and trans fats, remains relatively low, underscoring the need for heightened consumer education activities. The positive change in consumer awareness about trans fats is likely attributable to the wide range of messages available to them, including the AHA “Face the Fats” national consumer education campaign.     

Trans Fats in America: A Review of Their Use, Consumption, Health Implications, and Regulation

Trans fatty acids have long been used in food manufacturing due in part to their melting point at room temperature between saturated and unsaturated fats. However, increasing epidemiologic and biochemical evidence suggest that excessive trans fats in the diet are a significant risk factor for cardiovascular events. A 2% absolute increase in energy intake from trans fat has been associated with a 23% increase in cardiovascular risk. Although Denmark has shown it is possible to all but eliminate commercial sources of trans fats from the diet, total elimination is not possible in a balanced diet due to their natural presence in dairy and meat products. Thus, the American Heart Association recommends limiting trans fats to <1% energy, and the American Dietetic Association, the Institute of Medicine, US Dietary Guidelines, and the National Cholesterol Education Project all recommend limiting dietary trans-fat intake from industrial sources as much as possible. The presence of small amounts of trans fat in hydrogenated or partially hydrogenated oils/food products will likely cause many Americans to exceed their recommended maximum. This likelihood is exacerbated by the Food and Drug Administration labeling rules, which allow products containing <0.5 g trans fat per serving to claim 0 g trans fat. Many products with almost 0.5 g trans fat, if consumed over the course of a day, may approximate or exceed the 2 g maximum as recommended by American Heart Association, all while claiming to be trans-fat free. Accordingly, greater transparency in labeling and/or active consumer education is needed to reduce the cardiovascular risks associated with trans fats.     

Should trans fats be regulated?

Aim: The aim of this paper is to critically assess recent calls for increased regulation to lower the level of trans fats in the Australian diet. Methods: Key milestones in the elucidation of the effects on trans fats on health were identified and reviewed. Trends in intakes of trans fats in Australia and factors affecting those trends were described and compared with those in Denmark, which has regulated to lower population intake of trans fats. Results: The scientific evidence demonstrating adverse effects of trans fats on human health is consistent and strong. Australian health authorities were quick to identify the potential risk of trans fats and communicate it to health professionals and the food industry. The response from the margarine industry resulted in large falls in the trans fat content of the Australian diet in the mid‐1990s. A second wave of trans fat reduction across many foods categories has occurred subsequently. Total intake of trans fats in Australia is now low, half the upper limit recommended by the World Health Organization and lower than the intake in Denmark. Trans fats of industrial origin comprise just one‐eighth of 1% of dietary energy. These falls in trans fat intake mirror the large falls that occurred in Denmark prior to regulation. Conclusions: The case for increased regulation to lower intake of trans fats in Australia cannot be sustained. The trans fat issue stands as a good example of self‐regulation through collaboration between Australian health agencies, the food industry and the government.     

Fatty Acid Composition of Margarines and Cooking Fats Available on the Czech Market

In a series of 20 margarines, nine cooking fats, and butter, the fatty acid composition was determined after the American Oil Chemistry Society (AOCS) standard method using capillary gas chromatography. Margarines contained 15.2–54.1% and cooking fats 16.5–59.1% saturated fatty acids, respectively, which was less than in butter. The content of linoleic fatty acid varied between 3.7 and 52.4% in margarines, and small amounts of linolenic acid were present in most samples. Oleic acid prevailed in cooking fats. Monoenoic trans -fatty acids were present only in traces in 10 samples, trans -polyenoic acids were present only in small amounts. Most cooking fats had high contents oftrans -unsaturated fatty acids. The number of free- trans margarines has rapidly increased in a few years.     

Inflammatory properties of diet mediate the effect of depressive symptoms on Framingham risk score in men and women: Results from the National Health and Nutrition Examination Survey (2007-2014)

Depression is common in patients with cardiovascular disease (CVD) and associated with inflammation. Inflammation contributes to the development of CVD and can be modulated by diet. However, the role of inflammatory properties of diet in the relationship between depressive symptoms and CVD risk is not well understood. We hypothesized that the inflammatory properties of diet mediate the relationship between depressive symptoms and CVD risk in men and women. Cross-sectional data collected by the National Health and Nutrition Examination Survey (2007–2014) were used for the study. Depressive symptoms scores, inflammatory properties of diet, and CVD risk were measured by the Patient Health Questionnaire-9 (PHQ-9), the Dietary Inflammatory Index (DII), and the Framingham risk score (FRS), respectively. Generalized linear models were used for the mediation analysis. There were significant differences in the proportions of men and women in the depressed group (PHQ-9 ≥ 10; 5.24 ± 0.65% vs 9.36 ± 0.87%, P < .001) and high CVD risk group (FRS >20%; 16.47 ± 0.79% vs 6.03 ± 0.32%, P < .001). The DII partially mediated the relationship between depressive symptoms and CVD risk in men (indirect effect: 0.06, P = .010) but fully mediated the relationship between depressive symptoms and CVD risk in women (indirect effect: 0.10, P < .001). These findings confirmed our hypothesis that inflammatory properties of diet at least partially mediate the relationship between depressive symptoms and CVD risk in men and women. Our findings suggest that interventions designed to reduce depressive symptoms should contain strategies to reduce pro-inflammatory and increase anti-inflammatory properties of diet to decrease CVD risk.     

Potential cardiovascular mortality reductions with stricter food policies in the United Kingdom of Great Britain and Northern Ireland

Objective

To estimate how much more cardiovascular disease (CVD) mortality could be reduced in the United Kingdom through more progressive nutritional targets.

Methods

Potential reductions in CVD mortality in the United Kingdom between 2006 (baseline) and 2015 were estimated by synthesizing data on population, diet and mortality among adults aged 25 to 84 years. The effect of specific dietary changes on CVD mortality was obtained from recent meta-analyses. The potential reduction in CVD deaths was then estimated for two dietary policy scenarios: (i) modest improvements (simply assuming recent trends will continue until 2015) and (ii) more substantial but feasible reductions (already seen in several countries) in saturated fats, industrial trans fats and salt consumption, plus increased fruit and vegetable intake. A probabilistic sensitivity analysis was conducted. Results were stratified by age and sex.

Findings

The first scenario would result in approximately 12 500 fewer CVD deaths per year (range: 5500–30 300). Approximately 4800 fewer deaths from coronary heart disease and 1800 fewer deaths from stroke would occur among men, and 3500 and 2400 fewer, respectively, would occur among women. More substantial dietary improvements (no industrial trans fats, reduction in saturated fats and salt and substantial increases in fruit and vegetable intake) could result in approximately 30 000 fewer (range: 13 300–74 900) CVD deaths.

Conclusion

Excess dietary trans fats, saturated fats and salt, along with insufficient fruits and vegetables, generate a substantial burden of CVD in the United Kingdom. Further improvements resembling those attained by other countries are achievable through stricter dietary policies.     

trans-11 18:1 Vaccenic Acid (TVA) Has a Direct Anti-Carcinogenic Effect on MCF-7 Human Mammary Adenocarcinoma Cells

Trans vaccenic acid (TVA; trans-11 18:1) is a positional and geometric isomer of oleic acid and it is the predominant trans isomer found in ruminant fats. TVA can be converted into cis-9, trans-11 conjugated linoleic acid (c9, t11-CLA), a CLA isomer that has many beneficial effects, by stearoyl CoA desaturase 1 (SCD1) in the mammary gland. The health benefits associated with CLA are well documented, but it is unclear whether trans fatty acids (TFAs) from ruminant products have healthy effects. Therefore, the effects of TVA on the proliferation of MCF-7 human breast adenocarcinoma cells and MCF-10A human breast epithelial cells were investigated in the present study. Results showed that TVA inhibited the proliferation of MCF-7 cells but not MCF-10A cells by down-regulating the expression of Bcl-2 as well as procaspase-9. In addition, the suppressive effect of TVA was confirmed in SCD1-depleted MCF-7 cells. Our results suggested that TVA exerts a direct anti-carcinogenic effect on MCF-7 cells. These findings provided a better understanding of the research on the anti-carcinogenic effects of TVA and this may facilitate the manufacture of TVA/c9, t11-CLA fortified ruminant products.     

Proposed Changes in U.S.A. Regulations for Food Labeling

On November 17, 1999, the United States (U.S.A.) Food and Drug Administration (FDA) published a proposed rule that would allow for the declaration of trans fatty acids in nutrition labeling and would limit trans fatty acids wherever saturated fat limits are placed on nutrient content or health claims. Specifically, FDA proposed that the amount oftrans fat be included with that of saturated fat. The combined amount would be followed by an asterisk referring to a footnote specifying the amount of trans fats included in the total value. In addition, the agency proposed that the percent Daily Value shown be based on the combined amount of saturated and trans fatty acids. Other options for declaringtrans fatty acids were discussed and comments requested.FDA also published a notice on June 26, 2000, requesting comment on a Citizen Petition that requested: (1) the declaration of added sugars in nutrition labeling, (2) the development of a Daily Value for added sugars so that consumers would be informed of the proportion of a reasonable day's intake of added sugars that was provided by a serving of food, and (3) the revision of criteria pertaining to nutrient content and health claims to take added sugars into account.     

A reappraisal of the impact of dairy foods and milk fat on cardiovascular disease risk

Background  This review provides a reappraisal of the potential effects of dairy foods, including dairy fats, on cardiovascular disease (CVD)/coronary heart disease (CHD) risk. Commodities and foods containing saturated fats are of particular focus as current public dietary recommendations are directed toward reducing the intake of saturated fats as a means to improve the overall health of the population. A conference of scientists from different perspectives of dietary fat and health was convened in order to consider the scientific basis for these recommendations. Aims  This review and summary of the conference focus on four key areas related to the biology of dairy foods and fats and their potential impact on human health: (a) the effect of dairy foods on CVD in prospective cohort studies; (b) the impact of dairy fat on plasma lipid risk factors for CVD; (c) the effects of dairy fat on non-lipid risk factors for CVD; and (d) the role of dairy products as essential contributors of micronutrients in reference food patterns for the elderly. Conclusions  Despite the contribution of dairy products to the saturated fatty acid composition of the diet, and given the diversity of dairy foods of widely differing composition, there is no clear evidence that dairy food consumption is consistently associated with a higher risk of CVD. Thus, recommendations to reduce dairy food consumption irrespective of the nature of the dairy product should be made with caution.     

Occupational class differences in ankle-brachial index and pulse wave velocity measurements to detect subclinical vascular disease

Background: High pulse wave velocity (PWV) and low ankle brachial index (ABI) have been proposed as surrogate end-points for cardiovascular disease (CVD). Objectives: In a cross-sectional setting, we aimed at assessing the distributions of PWV and ABI among occupational classes (OC) in a population-based ever-employed salaried sample. Methods: We enrolled 1388 salaried CVD-free workers attending a CVD population-based survey, the RoCAV study, and classified them into four OC, based on current or last job title: manager/director (MD), non-manual (NMW), skilled-manual (SMW) and (UMW) unskilled-manual workers. We derived brachial-ankle PWV and ABI from four-limb blood pressures measurements, then carotid-femoral PWV (cfPWV) was estimated. We estimated the OC gradients in cfPWV and ABI using linear and logistic regression models. Results: Compared to MD (reference category), UMW had higher age- and BMI-adjusted cfPWV mean values both in men (0.63 m/s; 95%CI:0.11-1.16) and women (1.60 m/s; 0.43-2.77), only marginally reduced when adjusting for CVD risk factors. Decreased ABI mean values were also detected in lower OC. The overall detection rate of abnormal cfPWV (≥12 m/s) or ABI (≤0.9) values was 28%. Compared to MD, the prevalence of abnormal cfPWV or ABI was higher in NMW (OR=1.77; 95%CI:1.12-2.79), SMW (1.71; 1.05-2.78) and UMW (2.72; 1.65-4.50). Adjustment for CVD risk factors used in risk score equations did not change the results. Discussion: We found a higher prevalence of abnormal values of arterial stiffness measures in lower OC, and these differences were not explained by traditional CVD risk factors. These may be presumably determined by additional work- and environmental-related risk factors.     

Interesterified fats: What are they and why are they used? A briefing report from the Roundtable on Interesterified Fats in Foods

Interesterification rearranges the position of fatty acids within triacylglycerols, the main component of dietary fat, altering physical properties such as the melting point and providing suitable functionality for use in a range of food applications. Interesterified (IE) fats are one of a number of alternatives which have been adopted to reformulate products to remove fats containing trans fatty acids generated during partial hydrogenation, which are known to be detrimental to cardiovascular health. The use of IE fats can also reduce the saturated fatty acid (SFA) content of the final product (e.g. up to 20% in spreads), while maintaining suitable physical properties (e.g. melt profile). A novel analysis was presented during the roundtable which combined data from the UK National Diet and Nutrition Survey (2012/2013–2013/2014) with expert industry knowledge of the IE fats typically used in food products, to provide the first known estimate of population intakes of IE fats among UK children and adults. IE fats were found to contribute approximately 1% of daily energy across all ages. The major contributors to overall IE fat intakes were fat spreads (~54%) and bakery products (~22%), as well as biscuits (~8%), dairy cream alternatives (~6%) and confectionery (~6%). Increasing use of IE fats could contribute towards reducing total SFA intakes in the population, but would depend on which food products were reformulated and their frequency of consumption among sub‐groups of the population. Studies comparing the effect of IE and non‐IE fats on markers of lipid metabolism have not shown any consistent differences, either in the fasted or in the postprandial state, suggesting a neutral effect of IE fats on cardiovascular disease risk. However, these studies did not use the type of IE fats present in the food supply. This issue has been addressed in two studies by King's College London, which measured the postprandial response to a commercially relevant palm stearin/palm kernel (80:20) IE ‘hard stock’, although again no consistent effects of the IE fat on markers of lipid metabolism were found. Another study is currently investigating the same IE hard stock, consumed as a fat spread (blended with vegetable oil), and will measure a broader range of postprandial cardiometabolic risk factors. However, further long‐term trials using commercially relevant IE fats are needed. Subsequent to the roundtable, a consumer survey of UK adults (n = 2062; aged 18+ years) suggested that there is confusion about the health effects of dietary fats/fatty acids, including trans fats and partially hydrogenated fats. This may indicate that providing evidence‐based information to the public on dietary fats and health could be helpful, including the reformulation efforts of food producers and retailers to improve the fatty acid profile of some commonly consumed foods.     

Trans fat intake lowers total cholesterol and high-density lipoprotein cholesterol levels without changing insulin sensitivity index in Wistar rats

Epidemiologic studies have demonstrated that trans fat intake increases the risk of some chronic diseases. We hypothesize that trans fat intake would increase the risk of cardiovascular disease and type 2 diabetes mellitus by changing the lipid profile in plasma, the secretion of adipokines in adipose tissue, and the insulin sensitivity. Accordingly, the major objective of present study was to investigate the effect of dietary intake of trans fat on lipid profile, insulin sensitivity, and adipokine levels in plasma. Two groups of Wistar rats were fed a diet containing 4.5% trans fat or a control diet containing no trans fat for 16 weeks. Fasting glucose level was monitored every 2 weeks. At the end of feeding experiment, blood, heart, kidney, liver, omental adipose tissue, and semitendinosus muscle were collected. The trans fat content in organs, lipid profile, adipokine, insulin, and glucose levels in plasma were analyzed. The trans fat content in adipose tissue, heart, kidney, liver, and muscle of rats fed trans fat were 169.9, 0.6, 1.2, 1.7, and 2.5 mg/g samples, respectively. The trans fat content in these organs contributed to 15.9%, 1.2%, 2.3%, 4.3%, and 6.1% of the total fat, respectively. The plasma glucose level, insulin level, and insulin sensitivity index were not significantly different between the trans fat and control groups. The results indicated that trans fat intake might not be related to insulin resistance. However, lipid profile and plasma adipokine levels were significantly changed after trans fat feeding. The trans fat fed group showed significantly lower total cholesterol and high-density lipoprotein cholesterol levels than the control group. The decreased high-density lipoprotein cholesterol level may indicate the detrimental effect of trans fat intake on lipid profile. Adiponectin and resistin levels were significantly higher in the trans fat group than the control group. Leptin levels were significantly lower in the trans fat group than the control group. The results indicated that dietary intake of trans fat can significantly change the adipokine levels, but the possible links between adipokine level change caused by trans fat intake and metabolic effects of this change need further investigations.     

Understanding the role of depression and anxiety on cardiovascular disease risk, using structural equation modeling; the mediating effect of the Mediterranean diet and physical activity: the ATTICA study

PurposeTo evaluate the mediating role of behavioral patterns, such as adherence to the Mediterranean diet and physical activity status, in the relationship between depression, anxiety, and the cardiovascular disease (CVD) risk score HellenicSCORE.MethodsIn the context of the ATTICA study, a cross-sectional survey, 453 men (45 ± 13 years) and 400 women (44 ± 18 years), with complete psychological evaluation were studied. Participants were without any evidence of cardiovascular or other chronic disease. Depression was assessed with the Zung Self-Rating Depression Scale and anxious state by the Spielberger State Anxiety Inventory Scale. Physical activity was assessed using the International Physical Activity Questionnaire and adherence to the Mediterranean diet was assessed by the MedDietScore. Structural equation modeling methodology was implemented in the statistical analysis.ResultsFive latent depression and anxiety factors were revealed and associated with CVD risk score through mediation of physical activity status and adherence to the Mediterranean diet with very good fit to the data (χ²/df ratio = 2.34; root mean square error of approximation = 0.021; 90% confidence interval, 0.020–0.022; comparative fit index = 0.951). Significant total effect on CVD risk was found for the “anxiety–worry” latent factor, and this effect was through the inverse relationship of “anxiety–worry” with MedDietScore (P = .002). Moreover, “positive feelings” latent construct was associated with lower CVD risk, and this seems to be through the higher adherence to the Mediterranean diet (P = .01).ConclusionsAdherence to the Mediterranean diet seems to mediate the unfavorable effect of depression and anxiety on CVD risk.     

Dietary meat fats and burden of cardiovascular disease risk factors,in the elderly: a report from the MEDIS study

Dietary fats have long been associated with human health, and especially cardiovascular disease (CVD). Some observational studies have shown that reduction in dietary fats, and particularly cholesterol is associated with lower cardiovascular risk; however, other prospective studies or randomized controlled trials of dietary fat reduction or modification have shown varying results on CVD morbidity and mortality. In this work we evaluated the relationships between dietary fats and a cluster of CVD risk factors (i.e., diabetes, obesity, hypercholesterolemia, hypertension), among elderly individuals without known CVD. In particular, dietary and clinical data from 1486 elderly (aged 65 to 100 years) men and women living in Cyprus, Mitilini, Samothraki, Cephalonia, Crete, Lemnos, Syros, Naxos, Corfu and Zakynthos islands, and participated in the MEDIS study, were analysed. Data analysis revealed that 18.5% of males and 33.3% of females had three or four cardiovascular disease risk factors; the major source of fat was olive oil (mean intake for men and women 50.0 ± 19.3 g/day and 46.0 ± 16.8 g/day, p < 0.001). In addition it was observed that a 5% increase in energy adjusted fat intake from meat was associated with a 21% increase in the likelihood of having one additional CVD risk factor (95%CI 6%-39%); no significant associations were observed regarding the other types of fat consumed by the elderly participants. These findings may state a hypothesis that the consumption of fat only from meat or its products seems to increase the burden of CVD risk factors among CVD-free, elderly people.     

Modulation of postprandial lipaemia by a single meal containing a commonly consumed interesterified palmitic acid-rich fat blend compared to a non-interesterified equivalent

Purpose

Interesterification of palm stearin and palm kernal (PSt/PK) is widely used by the food industry to create fats with desirable functional characteristics for applications in spreads and bakery products, negating the need for trans fatty acids. Previous studies have reported reduced postprandial lipaemia, an independent risk factor for CVD, following interesterified (IE) palmitic and stearic acid-rich fats that are not currently widely used by the food industry. The current study investigates the effect of the most commonly consumed PSt/PK IE blend on postprandial lipaemia.

Methods

A randomised, controlled, crossover (1 week washout) double-blind design study (n = 12 healthy males, 18–45 years), compared the postprandial (0–4 h) effects of meals containing 50 g fat [PSt/PK (80:20); IE vs. non-IE] on changes in plasma triacylglycerol (TAG), glucose, glucose-dependent insulinotropic polypeptide (GIP), peptide YY (PYY), insulin, gastric emptying (paracetamol concentrations) and satiety (visual analogue scales).

Results

The postprandial increase in plasma TAG was higher following the IE PSt/PK versus the non-IE PSt/PK, with a 51 % greater incremental area under the curve [mean difference with 95 % CI 41 (23, 58) mmol/L min P = 0.001]. The pattern of lipaemia was different between meals; at 4-h plasma TAG concentrations declined following the IE fat but continued to rise following the non-IE fat. Insulin, glucose, paracetamol, PYY and GIP concentrations increased significantly after the test meals (time effect; P < 0.001 for all), but did not differ between test meals. Feelings of fullness were higher following the non-IE PSt/PK meal (diet effect; P = 0.034). No other significant differences were noted.

Conclusions

Interesterification of PSt/PK increases early phase postprandial lipaemia (0–4 h); however, further investigation during the late postprandial phase (4–8 h) is warranted to determine the rate of return to baseline values.

Trial registration number

Clinicaltrials.gov as NCT02365987.

     

Nutrition,sensory evaluation,and performance analysis of hydrogenated frying oils

The Food and Drug Administration now requires labeling of trans fats on nutrition labels, a decision that has created a push to reformulate deep-fat frying oils. Prior to the passage of this law, frying oils contained trans fats because trans fats made the oils more stable and thus allowing for longer frying usage. In the present study, oil performance, sensory evaluation and nutritional analysis was conducted on trans fat-free oils through a 10-day degradation process using French fries to break down the oil. The goal of the study was to test oil stability and nutrition analysis and to learn consumer preference between trans fat and trans fat-free oils. Sensory evaluation indicated a preference for fries composed from trans fat-free oil mixtures. The most stable oils were also combination oils. Based on these findings, industry representatives considering using the trans fat-free frying oils should consider using blended oils instead, which met customers’ taste preference and minimized oil rancidity and usage.     

Effect of Dietary Fatty Acids on Human Lipoprotein Metabolism: A Comprehensive Update

Dyslipidemia is a major risk factor for cardiovascular disease (CVD). Dietary fatty-acid composition regulates lipids and lipoprotein metabolism and may confer CVD benefit. This review updates understanding of the effect of dietary fatty-acids on human lipoprotein metabolism. In elderly participants with hyperlipidemia, high n-3 polyunsaturated fatty-acids (PUFA) consumption diminished hepatic triglyceride-rich lipoprotein (TRL) secretion and enhanced TRL to low-density lipoprotein (LDL) conversion. n-3 PUFA also decreased TRL-apoB-48 concentration by decreasing TRL-apoB-48 secretion. High n-6 PUFA intake decreased very low-density lipoprotein (VLDL) cholesterol and triglyceride concentrations by up-regulating VLDL lipolysis and uptake. In a study of healthy subjects, the intake of saturated fatty-acids with increased palmitic acid at the sn-2 position was associated with decreased postprandial lipemia. Low medium-chain triglyceride may not appreciably alter TRL metabolism. Replacing carbohydrate with monounsaturated fatty-acids increased TRL catabolism. Trans-fatty-acid decreased LDL and enhanced high-density lipoprotein catabolism. Interactions between APOE genotype and n-3 PUFA in regulating lipid responses were also described. The major advances in understanding the effect of dietary fatty-acids on lipoprotein metabolism has centered on n-3 PUFA. This knowledge emphasizes the importance of regulating lipoprotein metabolism as a mode to improve plasma lipids and potentially CVD risk. Additional studies are required to better characterize the cardiometabolic effects of other dietary fatty-acids.     

Differential effect of corn oil-based low <Emphasis Type="Italic">trans</Emphasis> structured fat on the plasma and hepatic lipid profile in an atherogenic mouse model: comparison to hydrogenated <Emphasis Type="Italic">trans</Emphasis> fat

Background  

Trans fat are not desirable in many aspects on health maintenance. Low trans structured fats have been reported to be relatively more safe than trans fats.     

Low Social Support Level is Associated with Non-Adherence to Diet at 1 Year in the Family Intervention Trial for Heart Health (FIT Heart)

ObjectiveEvaluate the relationship between low social support (SS) and adherence to diet in a cardiovascular disease (CVD) lifestyle intervention trial.DesignProspective substudy.Setting and ParticipantsBlood relatives/cohabitants of hospitalized cardiac patients in a randomized controlled trial (n = 458; 66% female, 35% nonwhite, mean age 50 years).Main Outcome MeasuresNon-adherence to diet using MEDFICTS (Meats, Eggs, Dairy, Fried foods, fat In baked goods, Convenience foods, fats added at the Table, and Snacks) tool; SS using the Enhancing Recovery in Coronary Heart Disease Patients Social Support Instrument.AnalysisLogistic regression models adjusted for confounders.ResultsSignificant predictors (P < .05) of non-adherence to diet recommendations at 1 year included low SS, increased body mass index and waist size, lower physical activity, depression, pre-action stages of change, control group assignment, and being male. Those with low SS at baseline 2.7 greater odds of being non-adherent to diet at 1 year vs those with higher SS (95% confidence interval = 1.1 - 6.4); there was no interaction by group assignment.Conclusion and ImplicationsLow SS at baseline was independently associated with non-adherence to diet at 1 year, suggesting that family members with low SS may be at heightened CVD risk as a result of poor dietary adherence.