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.     

The public health rationale for reducing saturated fat intakes: Is a maximum of 10% energy intake a good recommendation?

The role of saturated fat (SFA) in health is frequently debated. Guidelines from different countries are quite comparable, in that they generally advise people to avoid high intakes of SFA and to replace some saturated fats by cis unsaturated fats. A maximum level of intake of 10% energy of SFA (of total energy) is often advised as a guideline for the general population. This paper discusses issues around SFA and health including the pros and cons of randomised controlled trials with hard endpoints, prospective cohort studies and controlled dietary intervention studies with intermediate endpoints and risk markers, concluding that there is not a single kind of research study that will answer the question on whether intake of saturated fat influences health or not. However, taking all the evidence together suggests that replacing SFA by unsaturated fat, preferably polyunsaturated fat (PUFA), to an intake below 10% energy will favourably affect the risk of cardiovascular disease. It is important to take into account that the proposed changes should be implemented in an otherwise healthy and complete diet. To reach an intake of less than 10% energy from SFA without compromising on the quality of the total diet, the intake of fatty meat and baked goods such as cakes and pastries should be reduced and butter, lard and hard baking fats should be replaced by unsaturated oils and fat spreads made from them.     

Review of the evidence for the potential impact and feasibility of substituting saturated fat in the New Zealand diet

Objective: To estimate the potential impact on cardiovascular health of modifying dietary intake of saturated fat across the New Zealand population, and whether this would be appropriate and feasible. Methods: First, a literature review of meta‐analyses was conducted to estimate the magnitude of reduction in risk for cardiovascular events in response to a reduction in dietary saturated fat intake (with or without substitution with other macronutrients). Second, data from the New Zealand Adult Nutrition Survey 2008/09 were used to determine whether a change to the population's dietary fat intake would be warranted and feasible. Results: Five relevant meta‐analyses were identified. No significant association between saturated fat intake alone and cardiovascular disease was found. However, the incidence of cardiovascular disease events was less when dietary saturated fats were replaced with polyunsaturated fats, reducing the risk of cardiovascular events by about 10%. Compared with nutritional guidelines, New Zealanders’ current saturated fat intake is excessive while polyunsaturated fat intake is inadequate; both would be corrected by a substitution of 5% of daily energy intake. Conclusions: Replacing 5% of daily energy consumed as saturated fat with polyunsaturated fats would be expected to reduce cardiovascular events by about 10%. Implications: In order to achieve the population‐wide dietary fat modifications needed to improve cardiovascular health for New Zealanders, a public health strategy (e.g. fiscal, regulatory and/or educational interventions) must be implemented. Further work is needed to establish the cost‐effectiveness of the various strategies.     

Position of the Academy of Nutrition and Dietetics: Dietary Fatty Acids for Healthy Adults

It is the position of the Academy of Nutrition and Dietetics (the Academy) that dietary fat for the healthy adult population should provide 20% to 35% of energy, with an increased consumption of n-3 polyunsaturated fatty acids and limited intake of saturated and trans fats. The Academy recommends a food-based approach through a diet that includes regular consumption of fatty fish, nuts and seeds, lean meats and poultry, low-fat dairy products, vegetables, fruits, whole grains, and legumes. These recommendations are made within the context of rapidly evolving science delineating the influence of dietary fat and specific fatty acids on human health. In addition to fat as a valuable and calorically dense macronutrient with a central role in supplying essential nutrition and supporting healthy body weight, evidence on individual fatty acids and fatty acid groups is emerging as a key factor in nutrition and health. Small variations in the structure of fatty acids within broader categories of fatty acids, such as polyunsaturated and saturated, appear to elicit different physiological functions. The Academy recognizes that scientific knowledge about the effects of dietary fats on human health is young and takes a prudent approach in recommending an increase in fatty acids that benefit health and a reduction in fatty acids shown to increase risk of disease. Registered dietitian nutritionists are uniquely positioned to translate fat and fatty acid research into practical and effective dietary recommendations.     

Dietetic guidelines on food and nutrition in the secondary prevention of cardiovascular disease – evidence from systematic reviews of randomized controlled trials (second update, January 2006)

AIM: To update dietetic guidelines based on systematic review evidence on dietary advice to prevent further events in people with existing cardiovascular disease (CVD) (secondary prevention). METHODS: The Cochrane Library, MEDLINE and EMBASE were comprehensively searched to January 2005 for systematic reviews on aspects of diet and heart health. Reviews were included if they searched systematically for randomized controlled trials relating to diet and secondary prevention of CVD. Each review was critically appraised by at least two members of the UK Heart Health and Thoracic Dietitians Group. The quality and results of each review were discussed and summarized at a group meeting. RESULTS: Evidence-based strategies that reduce cardiovascular events in those with CVD include reduction in saturated fat and substitution with unsaturated fats. Individuals who have suffered a myocardial infarction may also benefit from adopting a Mediterranean type diet and increasing intake of omega 3 fats, but it is not clear whether they are beneficial for all patients with CVD. There is no systematic review evidence to support the use of antioxidant vitamins supplements, low glycaemic index diets, or homocysteine lowering therapies in this group. CONCLUSION: There remains good evidence that reducing saturated fat reduces morbidity in patients with CVD. This advice is consistent for most manifestations of CVD, with the addition of Mediterranean dietary advice and increased omega 3 fats for those who have had a myocardial infarction.     

Fatty Acid Composition of Commercial Spanish Fast Food and Snack Food

Fatty acid composition, total fat contents and percentages of saturated (SFA), monounsaturated (MFA), polyunsaturated (PUFA) and trans isomers of fatty acids (t FA) were analysed in commercial Spanish fast food and snack food by capillary gas chromatography (CGC) using a capillary column. The results obtained show a great variability in the percentages of fatty acids (g/100 g total fatty acids) but generally there is a high proportion of saturated fatty acids (from 12.3 in popcorn to 65.8% in ice creams) and monounsaturated fatty acids (from 23.7 in snacks of cheese to 42.8% in hamburgers with a low proportion of trans isomers (from 0.1 in snacks of cheese to 46.0% in popcorn (microwave)) and polyunsaturated fatty acids (from 1.6 in popcorn (microwave) to 51.4% in popcorn).Our results show that commercial Spanish fast food and snack food have a high proportion of saturated fatty acids especially hamburgers, pizzas, ice creams, cakes with cover, biscuits, donuts, and snacks of cheese. The source of these saturated fatty acids in the fat fraction was basically animal fats, coconut oil, palm kernel oil and palm oil.     

Fat Quality Influences the Obesogenic Effect of High Fat Diets

High fat and/or carbohydrate intake are associated with an elevated risk for obesity and chronic diseases such as diabetes and cardiovascular diseases. The harmful effects of a high fat diet could be different, depending on dietary fat quality. In fact, high fat diets rich in unsaturated fatty acids are considered less deleterious for human health than those rich in saturated fat. In our previous studies, we have shown that rats fed a high fat diet developed obesity and exhibited a decrease in oxidative capacity and an increase in oxidative stress in liver mitochondria. To investigate whether polyunsaturated fats could attenuate the above deleterious effects of high fat diets, energy balance and body composition were assessed after two weeks in rats fed isocaloric amounts of a high-fat diet (58.2% by energy) rich either in lard or safflower/linseed oil. Hepatic functionality, plasma parameters, and oxidative status were also measured. The results show that feeding on safflower/linseed oil diet attenuates the obesogenic effect of high fat diets and ameliorates the blood lipid profile. Conversely, hepatic steatosis and mitochondrial oxidative stress appear to be negatively affected by a diet rich in unsaturated fatty acids.     

Nutritive value of fats in 3 basic meals of university students

The nutritional value of assessed of fat consumed by a selected group of university students. The assessment showed that although the intake of fat with the diet was adequate, its nutritional value might arouse objections. The predominant group constituted monounsaturated fats, saturated fats were present in about one-third lower amount, while polyunsaturated fats accounted for only one fourth of the amount of monounsaturated fats. The percent of energy derived from unsaturated fatty acids in the daily food ration differed from one ration to another, but its mean value was 4.34% while the percent of energy from hypercholesterolaemia-producing fatty acids was higher--10.6%. In the analysed meals the content of erucic acid was relatively low.     

Dietary fat and coronary heart disease: a comparison of approaches for adjusting for total energy intake and modeling repeated dietary measurements

Previous cohort studies of fat intake and risk of coronary heart disease (CHD) have been inconsistent, probably due in part to methodological differences and various limitations, including inadequate dietary assessment and incomplete adjustment for total energy intake. The authors analyzed repeated assessment of diet from the Nurses' Health Study to examine the associations between intakes of four major types of fat (saturated, monounsaturated, polyunsaturated, and trans fats) and risk of CHD during 14 years of follow-up (1980-1994) by using alternative methods for energy adjustment. In particular, the authors compared four risk models for energy adjustment: the standard multivariate model, the energy-partition model, the nutrient residual model, and the multivariate nutrient density model. Within each model, the authors compared four different approaches for analyzing repeated dietary measurements: baseline diet only, the most recent diet, and two different algorithms for calculating cumulative average diets. The substantive results were consistent across all models; that is, higher intakes of saturated and trans fats were associated with increased risk of CHD, while higher intakes of monounsaturated and polyunsaturated fats were associated with reduced risk. When nutrients were considered as continuous variables, the four energy-adjustment methods yielded similar associationS. However, the interpretation of the relative risks differed across models. In addition, within each model, the methods using the cumulative averages in general yielded stronger associations than did those using either only baseline diet or the most recent diet. When the nutrients were categorized according to quintiles, the residual and the nutrient density models, which gave similar results, yielded statistically more significant tests for linear trend than did the standard and the partition models.     

Total fat and fatty acid intakes and food sources in Mediterranean older adults requires education to improve health

The proportion of fat has increased at the expense of carbohydrates in the past years, and we aimed to assess total fat and fatty acids intake and their food sources among Mediterranean older adults and compare them to national and international recommendations. This study was conducted in 211 participants to determine lipid and fatty acid intake using a Spanish food database. The mean daily intake of lipids was 68.6 g/d (standard deviation [SD]: 24.6; 34.4%, SD: 7.0 of total energy consumed). Men, younger participants, and those with higher education ingested more lipids than their peers. Fatty acids were ingested as follows (expressed as percentage of total energy intake): monounsaturated fatty acids (MUFA) (16.7%, SD: 4.1), saturated fatty acids (SFA) (9.6%, SD: 2.6), and polyunsaturated fatty acids (PUFA) (5.0%, SD: 1.7). Oils and seeds were the highest contributors in the intake of lipids (38.8%, SD: 16.0), MUFA (53.9%, SD: 18.7), and PUFA (33.0%, SD: 16.4). The total fat intake (34.4%, SD: 7.0) was within the range of International and Spanish recommendations among Mediterranean older adults; however, the intake of fatty acids did not abide by the international (PUFA) and Spanish recommendations (SFA, MUFA). α-Linoleic acid, eicosapentaenoic acid, and docosahexaenoic acid intake were lower than recommendations, but cholesterol intake (243.9 mg, SD: 140.4) was within the range of recommendations. Therefore, public health campaigns are needed to encourage older adults to decrease SFA intake and increase adherence to the Mediterranean diet pattern for a better health.     

Dietary intakes vary with age among Eskimo adults of Northwest Alaska in the GOCADAN study, 2000-2003

Dietary factors influence the development of cardiovascular disease (CVD). The diet of Alaskan Eskimos differs from that of other populations. We surveyed Eskimo adults in Northwest Alaska to document their usual dietary intakes, differences based on gender and age, and sources of selected nutrients, and to generate appropriate dietary advice to reduce CVD. Interviewers surveyed 850 men and women 17-92 y old, using a quantitative food-frequency instrument. We observed many significant (chi(2) analysis P < 0.05) differences in nutrient intakes among 3 age-groups. Energy intake from carbohydrate was negatively related to participant age-group (P < or = 0.01). Energy intake from all fats (P < 0.001) and polyunsaturated fat (P < or = 0.01) was positively related to age-group among both men and women in contrast to other studies in which age differences were either not observed or decreased with age. Native foods were major sources of monounsaturated and polyunsaturated fats, including 56% of (n-3) fatty acids primarily from seal oil and salmon. However, Native foods contributed significantly less to the diets of young adults than to those of elders, especially among women. Store-bought foods were the main sources of energy, carbohydrate, fat, saturated fat, and fiber for all adults. Based on their nutrient density and potential to inhibit CVD, continued consumption of traditional foods is recommended. Variations in intake by age may portend changing eating patterns that will influence CVD as participants age. These data will contribute to understanding dietary risk factors for cardiovascular disease in this population.     

Dietary fat, insulin sensitivity and the metabolic syndrome

Insulin resistance is the pathogenetic link underlying the different metabolic abnormalities clustering in the metabolic syndrome. It can be induced by different environmental factors, including dietary habits. Consumption of energy-dense/high fat diets is strongly and positively associated with overweight that, in turn, deteriorates insulin sensitivity, particularly when the excess of body fat is located in abdominal region. Nevertheless the link between fat intake and overweight is not limited to the high-energy content of fatty foods; the ability to oxidize dietary fat is impaired in some individuals genetically predisposed to obesity. Insulin sensitivity is also affected by the quality of dietary fat, independently of its effects on body weight. Epidemiological evidence and intervention studies clearly show that in humans saturated fat significantly worsen insulin-resistance, while monounsaturated and polyunsaturated fatty acids improve it through modifications in the composition of cell membranes which reflect at least in part dietary fat composition. A recent multicenter study (KANWU) has shown that shifting from a diet rich in saturated fatty acids to one rich in monounsaturated fat improves insulin sensitivity in healthy people while a moderate alpha-3 fatty acids supplementation does not affect insulin sensitivity. There are also other features of the metabolic syndrome that are influenced by different types of fat, particularly blood pressure and plasma lipid levels. Most studies show that alpha-3 fatty acids reduce blood pressure in hypertensive but not in normotensive subjects while shifting from saturated to monounsaturated fat intake reduces diastolic blood pressure. In relation to lipid abnormalities alpha-3 fatty acids reduce plasma triglyceride levels but in parallel, increase LDL cholesterol. Substitution of unsaturated fat for saturated fat not only reduces LDL cholesterol but contributes also to reduce plasma triglycerides in insulin resistant individuals. In conclusion, there is evidence available in humans indicating that dietary fat quality influences insulin sensitivity and associated metabolic abnormalities. Therefore, prevention of the metabolic syndrome has to be targeted: (1) to correct overweight by reducing the energy density of the habitual diet (i.e., fat intake) and (2) to improve insulin sensitivity and associated metabolic abnormalities through a reduction of dietary saturated fat, partially replaced, when appropriate, by monounsaturated and polyunsaturated fats.     

Substitution of saturated with monounsaturated fat in a 4-week diet affects body weight and composition of overweight and obese men

A randomised crossover study of eight overweight or obese men (aged 24-49 years, BMI 25.5-31.3 kg/m(2)), who followed two diets for 4 weeks each, was performed to determine whether substitution of saturated fat with monounsaturated fat affects body weight and composition. Subjects were provided with all food and beverages as modules (selected ad libitum) of constant macronutrient composition, but differing energy content. The % total energy from saturated fat, monounsaturated fat and polyunsaturated fat was 24, 13 and 3 % respectively on the saturated fatty acid (SFA)-rich diet and 11, 22 and 7 % respectively on the monounsaturated fatty acid (MUFA)-rich diet. MUFA accounted for about 80 % of the unsaturated fats consumed on both diets. Body composition, blood pressure, energy expenditure (resting and postprandial metabolic rates, substrate oxidation rate, physical activity), serum lipids, the fatty acid profile of serum cholesteryl esters and plasma glucose and insulin concentrations were measured before and after each diet period. Significant (P< or =0.05) differences in total cholesterol and the fatty acid composition of serum cholesteryl esters provided evidence of dietary adherence. The men had a lower weight (-2.1 (SE 0.4) kg, P=0.0015) and fat mass (-2.6 (SE 0.6) kg, P=0.0034) at the end of the MUFA-rich diet as compared with values at the end of the SFA-rich diet. No significant differences were detected in energy or fat intake, energy expenditure, substrate oxidation rates or self-reported physical activity. Substituting dietary saturated with unsaturated fat, predominantly MUFA, can induce a small but significant loss of body weight and fat mass without a significant change in total energy or fat intake.     

The effect of replacing dietary saturated fat with polyunsaturated or monounsaturated fat on plasma lipids in free-living young adults

OBJECTIVE: To examine, in free-living adults eating self-selected diets, the effects on plasma cholesterol of substituting saturated fat rich foods with either n-6 polyunsaturated or monounsaturated fat rich foods while at the same time adhering to a total fat intake of 30-33% of dietary energy. DESIGN: Two randomised crossover trials. SETTING: General community. SUBJECTS: Volunteer sample of healthy free-living nutrition students at the University of Otago. Trial I, n=29; and trial II, n=42. INTERVENTIONS: In trials I and II participants were asked to follow for 2(1/2) weeks a diet high in saturated fat yet with a total fat content that conformed to nutrition recommendations (30-33% energy). During the 2(1/2) week comparison diet, saturated fat rich foods were replaced with foods rich in n-6 polyunsaturated fats (trial I) whereas in trial II the replacement foods were rich in monounsaturated fats. Participants were asked to maintain a total fat intake of 30-33% of energy on all diets. MAIN OUTCOME MEASURES: Energy and nutrient intakes, plasma triglyceride fatty acids, and plasma cholesterol. RESULTS: When replacing saturated fat with either n-6 polyunsaturated fat or monounsaturated fat, total fat intakes decreased by 2.9% energy and 5.1% energy, respectively. Replacing saturated fat with n-6 polyunsaturated fat (trial I) lowered plasma total cholesterol by 19% [from 4.87 (0.88) to 3.94 (0.92) mmol/l, mean (s.d.)], low density lipoprotein cholesterol by 22% [from 2.87 (0.75) to 2.24 (0.67) mmol/l], and high density lipoprotein cholesterol by 14% [from 1.39 (0.36) to 1.19 (0.34) mmol/l], whereas replacing saturated fat with monounsaturated fat (trial II) decreased total cholesterol by 12%, low density lipoprotein cholesterol by 15%, and high density lipoprotein cholesterol by 4%, respectively. The change in the ratio of total to high density lipoprotein cholesterol was similar during trial I and trial II. CONCLUSIONS: Young adults are very responsive to dietary-induced changes in plasma cholesterol even when an isocaloric replacement of saturated fat with n-6 polyunsaturated or monounsaturated fat is not achieved. Replacing saturated fat with either n-6 polyunsaturated or monounsaturated fat is equally efficacious at reducing the total to high density lipoprotein cholesterol ratio. SPONSORSHIP: University of Otago, Meadow Lea Ltd.     

Estimating the cardiovascular mortality burden attributable to the European Common Agricultural Policy on dietary saturated fats

OBJECTIVE: To estimate the burden of cardiovascular disease within 15 European Union countries (before the 2004 enlargement) as a result of excess dietary saturated fats attributable to the Common Agricultural Policy (CAP). METHODS: A spreadsheet model was developed to synthesize data on population, diet, cholesterol levels and mortality rates. A conservative estimate of a reduction in saturated fat consumption of just 2.2 g was chosen, representing 1% of daily energy intake. The fall in serum cholesterol concentration was then calculated, assuming that this 1% reduction in saturated fat consumption was replaced with 0.5% monounsaturated and 0.5% polyunsaturated fats. The resulting reduction in cardiovascular and stroke deaths was then estimated, and a sensitivity analysis conducted. FINDINGS: Reducing saturated fat consumption by 1% and increasing monounsaturated and polyunsaturated fat by 0.5% each would lower blood cholesterol levels by approximately 0.06 mmol/l, resulting in approximately 9800 fewer coronary heart disease deaths and 3000 fewer stroke deaths each year. CONCLUSION: The cardiovascular disease burden attributable to CAP appears substantial. Furthermore, these calculations were conservative estimates, and the true mortality burden may be higher. The analysis contributes to the current wider debate concerning the relationship between CAP, health and chronic disease across Europe, together with recent international developments and commitments to reduce chronic diseases. The reported mortality estimates should be considered in relation to the current CAP and any future reforms.     

Effect of moderate changes in dietary fatty acid profile on postprandial lipaemia, haemostatic and related CVD risk factors in healthy men

OBJECTIVE: To investigate the effect of moderate changes in dietary fatty acid profile on postprandial risk factors for cardiovascular disease (CVD). DESIGN: Double-blind, randomised, crossover, intervention trial. SETTING:: University of Auckland Human Nutrition Unit, New Zealand. SUBJECTS: A total of 18 lean healthy men. INTERVENTION: A dairy butter fat modified to reduce the saturated:unsaturated fatty acid ratio and a conventional high saturated butter fat were given on two separate occasions as a high-fat test meal (59+/-4 g fat; 71 en% fat) at breakfast. A fat exclusion lunch, dinner and snacks were also given. Blood samples were collected at 0 (baseline), 1, 3, 6, 10 and 24 h. RESULTS: Maximum peak in total triacylglycerol (TAG) occurred 3 h postprandially and was highest on modified treatment (diet, P<0.05) due predominantly to increased TAG within the chylomicron-rich fraction. Transient peaks in total-, LDL- and HDL-cholesterol occurred postprandially, but did not differ between dietary treatments (P>0.05). There were no differential effects of diet on postprandial free fatty acids, apo A, apo B, glucose, insulin, amylin or haemostatic clotting factors (P>0.05). CONCLUSIONS: In a group of healthy young men, replacement of 16% of total saturated fatty acids by mono- and polyunsaturated fats within a dairy lipid did not induce postprandial changes in CVD risk that may be considered beneficial for health. SPONSORSHIP: Fonterra, Wellington; New Zealand.     

Proceedings: Nutrition forum: Progress in developing the prudent diet. Summary of symposium and recommendations for food industry action

Diet and nutrition are important factors in the prevention and treatment of the commonest types of cardiovascular disease—coronary heart disease and stroke—both in the primary and secondary prevention.The most important aspect of diet and cardiovascular disease is that one can manipulate the diet with some ease. Many of the principles of nutrition that have preventive values relative to heart disease can actually be built into manufactured foods, and most of our foods today, and more in the future, will be manufactured foods. This, I think, is not only a challenge to the food industry but a responsibility. It is a challenge in which they should be helped by our regulatory agencies rather than hindered. No doubt those in the food industry who continue to make advances in this area will continue to be attacked by far out consumer activists who get such ego satisfaction by creating confusion and distrust in a gullible public that all is not well with the nation's food supply.Here are a few specifics for the food industry: design of foods with fewer calories, generally that means foods with less fat and more water; design of foods with less saturated fat, replacing part of the saturated fat with either mono- or polyunsaturated fat; the production of meat low in saturated fats and meat products (e.g., sausages, hot dogs, and cold cuts) low in saturated fats yet with an acceptable total fat, by the addition of polyunsaturated fats; the development of strains of animals that convert higher proportions of feed to protein rather than fat; a shift to range feeding with earlier slaughter of cattle to yield leaner animals; modernization of laws and regulations relating to the definition of meat products; further development and use of high-quality vegetable protein products; development of an intensive education program concerning the cooking of lean meats to assure their optimal palatability and acceptability without the use of added saturated fats; reduction in saturated fat and cholesterol content of dairy products; reduction of saturated fat, cholesterol, and calorie content of baked goods; reduction of use of egg yolk in foods. Lastly, it should be emphasized that diet is only one of the risk factors in our commonest type of ill health and death—cardiovascular disease—but it is a risk factor readily modified.     

Dietary Habits,Nutrients and Bone Mass in Spanish Premenopausal Women: The Contribution of Fish to Better Bone Health

The moderate consumption of fish is recommended for a healthy diet and is also a feature of the Mediterranean diet. Fish is a major food group in diets throughout the world, and studies show that fish consumption is associated with a lower risk of a number of conditions. Spain has one of the highest annual per capita consumptions of fish worldwide. As fish is a source of high quality protein; n-3 polyunsaturated fatty acids; vitamins, such as A and D; and minerals, such as selenium, calcium, iodine, magnesium, copper and zinc, nutrients that have positive effects on bone characteristics, it has been proposed that its consumption could improve bone health. In this cross-sectional study, we have investigated the relationship between dietary habits and nutrient intake of 151 Spanish premenopausal women and analyzed the association of fish consumption on bone mass measured by quantitative ultrasound of the phalanges. A higher (P < 0.05) bone mass and vitamin D intake (P < 0.05) was observed in the group with a fish intake of 5–7 servings/week. We conclude that increased fish consumption is helpful in maintaining an adequate bone mass in Spanish premenopausal women.     

Dietary Saturated Fats and Health: Are the U.S. Guidelines Evidence-Based?

The last decade has seen nearly 20 papers reviewing the totality of the data on saturated fats and cardiovascular outcomes, which, altogether, have demonstrated a lack of rigorous evidence to support continued recommendations either to limit the consumption of saturated fatty acids or to replace them with polyunsaturated fatty acids. These papers were unfortunately not considered by the process leading to the most recent U.S. Dietary Guidelines for Americans, the country’s national nutrition policy, which recently reconfirmed its recommendation to limit saturated fats to 10% or less of total energy intake, based on insufficient and inconsistent evidence. Continuation of a cap on saturated fat intake also fails to consider the important effects of the food matrix and the overall dietary pattern in which saturated fatty acids are consumed.     

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.