Study of the effect of trans fatty acids from ruminants on blood lipids and other risk factors for cardiovascular disease. Effects of trans- and n-3 unsaturated fatty acids on cardiovascular risk markers in healthy males. An 8 weeks dietary intervention study Rationale and design of the TRANSFACT project phase I: a study to assess the effect of the two different dietary sources of trans fatty acids on cardiovascular risk factors in humans. Differential impact of milk fatty acid profiles on cardiovascular risk biomarkers in healthy men and women Trans, and n-3 polyunsaturated fatty acids and vascular function-a yin yang situation? Do trans fatty acids from industrially produced sources and from natural sources have the same effect on cardiovascular disease risk factors in healthy subjects? Results of the trans Fatty Acids Collaboration (TRANSFACT) study. Consumption of trans fats and estimated effects on coronary heart disease in Iran (n-3) fatty acid supplementation in moderately hypertriglyceridemic adults changes postprandial lipid and apolipoprotein B responses to a standardized test meal. A high-trans fatty acid diet and insulin sensitivity in young healthy women. Effects of margarine and butter consumption on distribution of trans-18∶1 fatty acid isomers and conjugated linoleic acid in major serum lipid classes in lactating women Intake of a Diet High in Trans Monounsaturated Fatty Acids or Saturated Fatty Acids: Effects on postprandial insulinemia and glycemia in obese patients with NIDDM Dairy and industrial sources of trans fat do not impair peripheral insulin sensitivity in overweight women. Effect of trans-fatty acid intake on insulin sensitivity and intramuscular lipids--a randomized trial in overweight postmenopausal women. Replacement of saturated with unsaturated fats had no impact on vascular function but beneficial effects on lipid biomarkers, E-selectin, and blood pressure: results from the randomized, controlled Dietary Intervention and VAScular function (DIVAS) study. Dietary fatty acids affect plasma markers of inflammation in healthy men fed controlled diets: a randomized crossover study. Epidemiological Evidence of Relationships between Dietary Polyunsaturated Fatty Acids and Mortality in the Multiple Risk Factor Intervention Trial Effect of low doses of n-3 fatty acids on cardiovascular diseases in 4,837 post-myocardial infarction patients: design and baseline characteristics of the Alpha Omega Trial.
BACKGROUND The intake of trans fatty acids ( TFA ) from industrially hydrogenated vegetable oils ( iTFA ) is known to have a deleterious effect on cardiovascular health , the effects of TFA from ruminants ( rTFA ) are virtually unknown . OBJECTIVE The purpose of the present study was to compare the effects of rTFA and iTFA on plasma LDL concentrations and other cardiovascular disease risk factors in healthy subjects . DESIGN In a double-blind , r and omized crossover controlled study , 38 healthy men were fed each of 4 experimental isoenergetic diets lasting 4 wk each . The 4 diets were high in rTFA ( 10.2 g/2500 kcal ) , moderate in rTFA ( 4.2 g/2500 kcal ) , high in iTFA ( 10.2 g/2500 kcal ) , and low in TFA from any source ( 2.2 g/2500 kcal ) ( control diet ) . RESULTS Plasma LDL-cholesterol concentrations were significantly higher after the high- rTFA diet than after the control ( P = 0.03 ) or the moderate- rTFA ( P = 0.002 ) diet . Plasma LDL-cholesterol concentrations also were significantly ( P = 0.02 ) higher after the iTFA diet than after the moderate-rTFA diet . Plasma HDL-cholesterol concentrations were significantly ( P = 0.02 ) lower after the high-rTFA diet than after the moderate-rTFA diet . Finally , all risk factors were comparable between the control and the moderate-rTFA diets . CONCLUSIONS These results suggest that , whereas a high dietary intake of TFA from ruminants may adversely affect cholesterol homeostasis , moderate intakes of rTFA that are well above the upper limit of current human consumption have neutral effects on plasma lipids and other cardiovascular disease risk factors Background : Studies of long-term intake of industrially produced trans fatty acids ( TFA ) and n-3 polyunsaturated fatty acids ( PUFA ) suggest opposite effects on cardiovascular disease risk . Common mechanisms of action are probable . Objective : To examine the effects on cardiovascular risk markers of dietary enrichment with TFA or n-3 PUFA . Design : R and omized , double-blind , parallel intervention trial . Setting : Department of Human Nutrition , The Royal Veterinary and Agricultural University . Subjects : In all , 87 healthy males included , 79 completed . Intervention : Subjects were r and omly assigned to 8 weeks of a daily intake of 33 g of experimental fats from either partially hydrogenated soy oil containing 20 g of TFA , 12 g of fish oil with approximately 4 g of n-3 PUFA and 21 g of control fat , or 33 g of control fat . The experimental fats were incorporated into bakery products .  Plasma lipids , blood pressure , heart rate variability ( HRV ) , arterial dilatory capacity , compliance , and distensibility were recorded before and after intervention and at follow-up 12 weeks after the intervention . Results : High-density lipoprotein cholesterol ( HDL-C ) decreased in the TFA group and triglycerides and mean arterial blood pressure decreased in the n-3 PUFA group compared to the control group . HRV , arterial dilatory capacity , compliance , and distensibility were unchanged . Conclusion : The results indicate that the association between coronary heart disease risk and intake of TFA and n-3 PUFA relates only modestly to changes in traditional risk markers . Sponsorship : Danish Medical Research Council ( Grant no. 22 - 01 - 0390 ) , Center of Advanced Food Research ( Copenhagen , Denmark ) ( Grant no. KVL-R-2001 - 107 ) , the Danish Heart Association ( Grant no. 99 - 2 - 3 - 45 - 22748 ) , Novozymes ( Bagsvaerd , Denmark ) , Aarhus Olie ( Aarhus , Denmark ) , and from private sources . The experimental fats were provided by Pronova Biocare ( Aalesund , Norway ) and Aarhus Olie ( Aarhus , Denmark ) BACKGROUND Detrimental effects of consumption of industrial trans fatty acids ( TFA ) from partially hydrogenated vegetable oils ( PHVO ) on cardiovascular disease ( CVD ) risk factors are well documented . However , very little information is available on the effect of natural sources of TFA coming from milk fat , dairy products and ruminant meat . In fact , due to the naturally low level of TFA in milk fat , it is almost impossible to conduct a clinical trial with a limited number of subjects ( < 200 ) . METHODOLOGY To compare the effects of industrial and natural dietary sources of TFA , two specific test fats have been design ed and produced . A substantial amount of milk fat ( 130 kg ) enriched in TFA has been produced by modification of the cow 's diet and selection of cows with the highest TFA content . The level obtained was approximately 4- to 7-fold higher than typically present in milk fat ( approximately 20 instead of 3 - 6 g/100 g of total fatty acids ) . The control fat is composed of PHVO balanced in saturated fatty acids ( lauric , myristic and palmitic ) . Both experimental fats contain about 20 - 22 % of monounsaturated TFA and the volunteers ' daily experimental fat intake ( 54 g ) , will represent about 12.0 g/day of TFA or 5.4 % of the daily energy ( based on 2000 kcal/day ) . These two test fats have been incorporated into food items and will be provided to 46 healthy subjects under a r and omised , double blind , controlled , cross-over design . The primary outcome is high-density lipoprotein cholesterol ( HDL-C ) , which is an independent risk factor for CVD . Other parameters such as low-density lipoprotein cholesterol ( LDL-C ) , very low-density lipoprotein cholesterol ( VLDL-C ) , and HDL-C level and subclasses will be also to be evaluated . CONCLUSION We have shown that it is technically feasible to perform a clinical trial on the comparative effects of natural and industrial sources of TFA isomers on CVD risk factors . Results are expected by mid-2006 Background / Objectives : The objective of this study was to evaluate the impact of three specific ruminant ( R ) milk fats result ing from modification of the cow 's diet on cardiovascular risk factors in healthy volunteers . R-milk fats were characterized by increased content in total trans fatty acids ( R-TFAs ) and parallel decrease in saturated fatty acids (SFAs).Subjects/ Methods : A total of 111 healthy , normolipemic men and women have been recruited for a monocentric , r and omized , double-blind and parallel intervention , 4-week controlled study . Volunteers consumed three experimental products ( butter , dessert cream and cookies ) made with one of the three specific milk fats ( 55 g fat per day ) . During the first week ( run-in period ) , the subjects consumed on a daily basis dairy products containing 72 % SFA/2.85 % R-TFA ( called ‘ L0 ’ ) . For the next 3 weeks of the study ( intervention period ) , the first group continued to consume L0 products . The second group received dairy products containing 63.3 % SFA/4.06 % R-TFA ( called ‘ L4 ’ ) , and the third group received dairy products containing 56.6 % SFA/12.16 % R-TFA ( called ‘ L9 ’ ) . Results : Plasma concentrations of high-density lipoprotein (HDL)-cholesterol were not significantly altered by either diet ( P=0.38 ) . Compared to L0 diet , L4 diet contributed to reduce low-density lipoprotein (LDL)-cholesterol ( −0.14±0.38 mmol/l , P=0.04 ) , total cholesterol ( −0.13±0.50 mmol/l , P=0.04 ) , LDL-cholesterol/HDL-cholesterol ( −0.14±0.36 , P=0.03 ) and total cholesterol/HDL-cholesterol ( −0.18±0.44 , P=0.02 ) . Conclusions : Different milk fat profiles can change cardiovascular plasma parameters in human healthy volunteers . A limited increase of the R-TFA/SFA ratio in dairy products is associated with an improvement in some cardiovascular risk factors . However , a further increase in R-TFA/SFA ratio has no additional benefit Trans fatty acids ( TFA ) and n-3 polyunsaturated fatty acids ( n-3 PUFA ) have opposite effects on several biological functions . We report a study on the effects on risk markers for cardiovascular disease .  Eighty-seven healthy males were r and omly assigned to 8 weeks of daily intake of either 20 g of industrially produced TFA ( IP-TFA ) , 4 g n-3 PUFA , or control fat , incorporated in bakery products as part of the daily food . High-density lipoprotein cholesterol decreased in the TFA-group , triglycerides and mean arterial blood pressure decreased in the n-3 group . Heart rate variability ( HRV ) , arterial dilatory capacity , flow mediated vasodilation , compliance , and distensibility were unchanged . Post hoc , we did a subgroup analysis of the results from the subjects with normal initial HRV . In these , 24-h heart rate ( HR ) was significantly increased by approximately three beats/min in the TFA group , with a decrease of the same magnitude in the n-3 group . A high HR is associated to an increased mortality and vice versa . Our results thus support the notion that IP-TFA and n-3 PUFA affect risk for cardiovascular mortality via mechanisms not only related to changes in plasma concentrations of lipids and lipoproteins BACKGROUND The consumption of monounsaturated trans fatty acids ( TFAs ) increases the risk of cardiovascular disease ( CVD ) . Putative differences between the effects of TFAs from industrially produced and natural sources on CVD risk markers were not previously investigated in healthy subjects . OBJECTIVE We aim ed to compare the effects of TFAs from industrially produced and natural sources on HDL and LDL cholesterol , lipoprotein particle size and distribution , apolipoproteins , and other lipids in healthy subjects . DESIGN In a r and omized , double-blind , controlled , crossover design , 46 healthy subjects ( 22 men and 24 women ) consumed food items containing TFAs ( 11 - 12 g/d , representing approximately 5 % of daily energy ) from the 2 sources . RESULTS Forty subjects ( 19 men and 21 women ) completed the study . Compared with TFAs from industrially produced sources , TFAs from natural sources significantly ( P = 0.012 ) increased HDL cholesterol in women but not in men . Significant ( P = 0.001 ) increases in LDL-cholesterol concentrations were observed in women , but not in men , after the consumption of TFAs from natural sources . Apolipoprotein (apo)B and apoA1 concentrations confirmed the changes observed in LDL and HDL cholesterol . Analysis of lipoprotein subclass showed that only large HDL and LDL concentrations were modified by TFAs from natural sources but not by those from industrially produced sources . CONCLUSIONS This study shows that TFAs from industrially produced and from natural sources have different effects on CVD risk factors in women . The HDL cholesterol-lowering property of TFAs seems to be specific to industrial sources . However , it is difficult in the present study to draw a conclusion about the effect of TFAs from either source on absolute CVD risk in these normolipidemic subjects . The mechanism underlying the observed sex- and isomer-specific effects warrants further investigation Objective : To investigate the consumption of industrial trans-fatty acids ( TFAs )  in Iranian homes and the proportion of coronary heart disease ( CHD ) events in Iran attributable to such intake . Design , setting and participants : The consumption of industrial TFAs was determined using ( 1 ) detailed in-home assessment s of dietary intake among 7158 urban and rural households containing 35 924 individuals and ( 2 ) gas chromatography to determine TFA contents of the most commonly consumed partially hydrogenated oils . The population -attributable risk for CHD owing to TFA consumption was calculated on the basis of ( 1 ) documented effects of TFAs on total : high-density lipoprotein ( HDL ) cholesterol in r and omized controlled dietary trials and ( 2 ) relationships of TFA intake with incidence of CHD in prospect i ve observational studies . Results : Partially hydrogenated oils were used extensively for cooking in Iranian homes with average per-person intake of 14 g/1000 kcal .  TFAs  accounted for 33 % of fatty acids in these products , or 4.2 % of all calories consumed ( 12.3 g/day ) . On the basis of total : HDL cholesterol effects alone , 9 % of CHD events would be prevented by replacement of TFA in Iranian homes with cis-unsaturated fats ( 8 % by replacement with saturated fats ) . On the basis of relationships of TFA intake with CHD incidence in prospect i ve studies , 39 % of CHD events would be prevented by replacement of TFA with cis-unsaturated fats ( 31 % by replacement with saturated fats ) . These population -attributable risks may be overestimates owing to competing risks and because not all the fat used for cooking might actually be consumed . If actual TFA consumption were only half as large , the estimated proportion of CHD events prevented by TFA elimination would be 5 % on the basis of total : HDL cholesterol effects and replacement with cis-unsaturated ( 4 % for replacement with saturated fats ) , and 22 % on the basis of prospect i ve studies and replacement with cis-unsaturated fats ( 17 % for replacement with saturated fats ) . These estimates do not include possible additional benefits derived from replacing TFAs with vegetable oils containing n-3 fatty acids . Conclusions : Intake of TFAs is high in Iranian homes and contributes to a sizeable proportion of CHD events . Replacement of partially hydrogenated oils with unhydrogenated oils would likely produce substantial reductions in CHD incidence . Sponsorship : National Heart , Lung and Blood Institute , National Institutes of Health , USA . National Nutrition & Food Technology Research Institute , Tehran , Iran The effects of ( n-3 ) fatty acids on the postpr and ial state were investigated by monitoring the alimentary responses to identical test meals fed to adults [ n = 11 ; fasting triacylglycerol ( TG ) 2.55 + /- 0.24 mmol/L ; mean + /- SEM ] after a self-selected diet baseline period ( BLP ) and then after a 6-wk ( n-3 ) fatty acid period ( FOP ) [ approximately 5.2 g ( n-3 ) fatty acids ] and a 6-wk control oil period ( COP ) administered in r and om order . Sample s were drawn immediately prior to the test meal ( time 0 ) and then hourly from 2 to 6 h postmeal . Postpr and ial plasma triacylglycerol ( TG ) and TG-rich lipoprotein ( TRL ) TG apo B48 , and B100 absolute concentrations were significantly lower after FOP than after COP or BLP , while plasma cholesterol was unchanged . Normalizing the results as increments over time 0 eliminated the diet effect on all but plasma TG . Time remained a significant effect for plasma TG , TRL TG , and TRL TC . Finally , only absolute TRL B48 and absolute and incremental plasma TG concentrations displayed significant time-diet interactions . These results suggest that postpr and ial TRL apo B reductions are likely caused by ( n-3 ) fatty acid suppression of both hepatic and intestinal apoB secretion/ synthesis . Altered TRL metabolism , i.e. changes in postpr and ial TG , cholesterol , apo B48 , and increase in LDL particle size , may represent an additional mechanism for the reduced heart disease risk associated with fish [ ( n-3 ) fatty acid ] consumption Epidemiological and experimental studies suggest that a diet rich in saturated fat affects insulin sensitivity . Monoenes and dienes that have an usaturated bond with the trans configuration ( trans fatty acids ) resemble saturated fatty acids with respect to structure , but no published data are available on the effect of trans fatty acids on insulin sensitivity . Therefore , the effects of diets high in trans fatty acids ( TFA diet ) and oleic acid ( monounsaturated fat [ MUFA ] diet ) on glucose and lipid metabolism were studied in 14 healthy women . Subjects consumed both experimental diets for 4 weeks according to a r and omized crossover study design . Both experimental diet periods were preceded by consumption of a st and ardized baseline diet for 2 weeks . The diets provided 36.6 % to 37.9 % of energy ( E% ) as fat . In the TFA diet , there was 5.1 E% trans fatty acids , and in the MUFA diet , 5.2 E% oleic acid , substituted for saturated fatty acids in the baseline diet . A frequently sample d intravenous glucose tolerance test ( FSIGT ) was performed at the end of the experimental diet periods . Glucose effectiveness ( S(G ) ) and the insulin sensitivity index ( S(I ) ) did not differ after the two experimental diet periods . There was also no difference in the acute insulin response between the diets . The total cholesterol to high-density lipoprotein ( HDL ) cholesterol ratio and serum total triglyceride , HDL , and low-density lipoprotein ( LDL ) triglyceride and apolipoprotein B ( apoB ) concentrations were higher ( P < .05 ) after the TFA diet . In conclusion , in young healthy women , the TFA diet result ed in a higher total/HDL cholesterol ratio and an elevation in triglyceride and apo B concentrations but had no effect on glucose and insulin metabolism compared with the MUFA diet Trans FA ( TFA ) have at least one trans double bond and comprise several isomers and types , including many of the CLA ( e.g. , c9 , t11–18∶2 CLA ) . Some TFA may have adverse effects ( e.g. , cardiovascular disease ) , whereas some are though to have beneficial effects ( e.g. , anticarcinogenicity ) . The presence of TFA in human tissues and fluids is related to dietary intake , although this relationship is not completely understood — especially in regard to serum lipid fractions . This study was conducted as part of an investigation design ed to test the influence of butter ( B ) , “ low TFA ” margarine ( LT ) , and regular margarine ( RM ) on milk fat content . Here we tested the secondary hypothesis that consumption of B , LT , and RM by lactating women would result in differential distribution of TFA and CLA in major serum lipid classes . Breastfeeding women ( n=11 ) participated in this r and omized Latinsquare study consisting of five periods : intervention I ( 5 d ) , washout I ( 7 d ) , intervention II ( 5 d ) , washout II ( 7 d ) , and intervention III ( 5 d ) . Extracted serum lipid was separated into cholesterol ester ( CE ) , TAG , and phospholipid ( PL ) fractions and analyzed for total and isomeric TFA and CLA concentrations . Data indicate that TAG consistently contained the highest concentration of total t-18∶1 . No interaction between treatment and fraction was found for any of the t-18∶1 isomers identified . Absolute concentration of each t-18∶1 isomer was greatest during the RM period , regardless of fraction . On a relative basis , concentrations of t10–18∶1 and t12–18∶1 were most responsive to treatment in the CE fraction . The concentration of c9 , t11–18∶2 CLA was highest in the TAG fraction and lowest in the PL fraction , regardless of treatment . In summary , these results indicate ( i ) that there is a differential distribution of some isomeric TFA and CLA among human serum lipid fractions and ( ii ) that dietary TFA intake influences absolute and relative concentrations of some of the isomers in selected fractions OBJECTIVE High intake of trans fatty acids and saturated fatty acids ( SFAs ) is known to increase the risk of coronary heart disease . We studied the effects of diets enriched in various fatty acids on postpr and ial insulinemia and fasting serum levels of lipids and lipoproteins in obese patients with NIDDM . RESEARCH DESIGN AND METHODS Sixteen obese NIDDM patients were studied in a free-living outpatient regimen . After a run-in period , the patients received three different isocaloric diets for 6 weeks using a r and omized crossover design . The patients were instructed to keep the energy intake from carbohydrate and protein constant at 50 and 20 E% ( percent of energy intake ) , respectively , on all three diets . The fat composition of the diets differed : saturated fat ( SAT ) diet ( 20 E% SFAs , 5 E% polyunsaturated fatty acids [ PUFAs ] , and 5 E% monounsaturated fatty acids [ MUFAs ] ) versus cis monounsaturated fatty acid ( CMUFA ) diet ( 20 E% cis-MUFAs , 5 E% PUFAs , and 5 E% SFAs ) versus trans monounsaturated fatty acid ( TMUFA ) diet ( 20 E% trans-MUFAs , 5 E% PUFAs , and 5 E% SFAs ) . Fasting serum levels of lipids and lipoproteins were measured at baseline and in the fasting state before meal tolerance tests at the end of each study period . Insulin secretion was assessed from incremental serum insulin and C-peptide responses during the meal tests . RESULTS BMI , waist-to-hip ratio , and glycemic control remained stable throughout the study . After meal stimulation , postpr and ial glycemic responses were similar on all diets ; however , serum insulin and C-peptide responses were greater following the TMUFA and SAT diets than following the baseline or CMUFA diets ( P < 0.05 ) . No statistical difference was found in fasting levels of serum lipids ( total cholesterol , triglyceride , phospholipid , and nonesterified fatty acids ) or lipoproteins of HDL cholesterol , VLDL cholesterol , LDL cholesterol , and apolipoprotein B between diets . CONCLUSIONS In the presence of unchanged glycemia , both dietary trans fatty acids and SFAs induce an increase in postpr and ial insulinemia in obese patients with NIDDM BACKGROUND The 2 major dietary sources of trans fatty acids ( TFAs ) are partially hydrogenated oils and ruminant-derived products . Epidemiologic data suggest that chronic consumption of industrial sources of TFAs could be damaging to insulin sensitivity , but intervention studies on this issue have remained inconclusive . OBJECTIVE The trial was design ed to compare the effects of dairy compared with industrial sources of TFAs on insulin sensitivity in overweight women . DESIGN Sixty-three healthy women with abdominal obesity [ waist circumference > 88 cm and a body mass index ( in kg/m(2 ) ) > 28 ] were recruited . After a run-in period , the volunteers were r and omly assigned to consume 1 of 3 four-week diets : 60 g low-TFA lipids/d ( 0.54 g/d ; n = 21 ) , ruminant TFA-rich lipids ( 4.86 g/d ; n = 21 ) , or industrial TFA-rich lipids ( 5.58 g/d ; n = 21 ) . Changes in peripheral insulin sensitivity were assessed by using hyperinsulinemic-euglycemic clamps . RESULTS After the intervention period , fasting glycemia and insulinemia and insulin sensitivity were not significantly modified in either group ( P > 0.05 ) . CONCLUSIONS These data indicate that consumption of dairy- and industrial- source TFAs for 4 wk at nutritional levels do not impair peripheral insulin sensitivity in insulin-resistant women . Our study may not preassess the effects of TFAs in normal insulin-sensitive individuals . This trial was registered at Clinical Trials.gov as NCT00617435 Intake of industrially produced trans-fatty acids ( TFA ) has been linked to increased risk of type 2 diabetes mellitus in observational studies . We investigated the causality of this association by examining if a high intake of TFA impairs measures of glucose homeostasis and induces intramuscular lipid deposition in abdominally obese women . In a double-blind , parallel dietary intervention study , 52 healthy but overweight postmenopausal women were r and omized to receive either partially hydrogenated soybean oil ( 15 g/d TFA ) or a control oil ( mainly oleic and palmitic acid ) for 16 weeks . Three markers of glucose homeostasis and 4 markers of lipolysis were derived from glucose , insulin , C-peptide , nonesterified fatty acid , and glycerol concentrations during a 3-hour frequent sampling oral glucose tolerance test . Intramuscular lipids were assessed by magnetic resonance spectroscopy . Forty-nine women completed the  study .  Insulin sensitivity ( assessed by ISI(composite ) ) , β-cell function ( the disposition index ) , and the metabolic clearance rate of insulin were not significantly affected by the dietary intervention . Neither was the ability of insulin to suppress plasma nonesterified fatty acid and glycerol during oral glucose ingestion nor the intramuscular lipid deposition . In conclusion , high TFA intake did not affect glucose metabolism over 16 weeks in postmenopausal overweight women . A study population with a stronger predisposition to insulin resistance and /or a longer duration of exposure may be required for insulin sensitivity to be affected by intake of industrial TFA BACKGROUND Public health strategies to lower cardiovascular disease ( CVD ) risk involve reducing dietary saturated fatty acid ( SFA ) intake to ≤10 % of total energy ( % TE ) . However , the optimal type of replacement fat is unclear . OBJECTIVE We investigated the substitution of 9.5 - 9.6%TE dietary SFAs with either monounsaturated fatty acids ( MUFAs ) or n-6 ( ω-6 ) polyunsaturated fatty acids ( PUFAs ) on vascular function and other CVD risk factors . DESIGN In a r and omized , controlled , single-blind , parallel-group dietary intervention , 195 men and women aged 21 - 60 y from the United Kingdom with moderate CVD risk ( ≥50 % above the population mean ) followed one of three 16-wk isoenergetic diets ( % TE target compositions , total fat : SFA : MUFA : n-6 PUFA ) that were rich in SFAs ( 36:17:11:4 , n = 65 ) , MUFAs ( 36:9:19:4 , n = 64 ) , or n-6 PUFAs ( 36:9:13:10 , n = 66 ) . The primary outcome measure was flow-mediated dilatation ; secondary outcome measures included fasting serum lipids , microvascular reactivity , arterial stiffness , ambulatory blood pressure , and markers of insulin resistance , inflammation , and endothelial activation . RESULTS Replacing SFAs with MUFAs or n-6 PUFAs did not affect the percentage of flow-mediated dilatation ( primary endpoint ) or other measures of vascular reactivity . Of the secondary outcome measures , substitution of SFAs with MUFAs attenuated the increase in night systolic blood pressure ( -4.9 mm Hg , P = 0.019 ) and reduced E-selectin ( -7.8 % , P = 0.012 ) . Replacement with MUFAs or n-6 PUFAs lowered fasting serum total cholesterol ( -8.4 % and -9.2 % , respectively ) , low-density lipoprotein cholesterol ( -11.3 % and -13.6 % ) , and total cholesterol to high-density lipoprotein cholesterol ratio ( -5.6 % and -8.5 % ) ( P ≤ 0.001 ) . These changes in low-density lipoprotein cholesterol equate to an estimated 17 - 20 % reduction in CVD mortality . CONCLUSIONS Substitution of 9.5 - 9.6%TE dietary SFAs with either MUFAs or n-6 PUFAs did not significantly affect the percentage of flow-mediated dilatation or other measures of vascular function . However , the beneficial effects on serum lipid biomarkers , blood pressure , and E-selectin offer a potential public health strategy for CVD risk reduction . This trial was registered at www . clinical trials.gov as NCT01478958 BACKGROUND The effect of individual dietary fatty acids on emerging risk factors for cardiovascular disease that are associated with sub clinical inflammation is unknown . OBJECTIVE The goal was to evaluate the role of dietary fat and specific fatty acids , especially trans fatty acids , in altering concentrations of markers of inflammation in humans fed controlled diets . DESIGN In a r and omized crossover design , 50 men consumed controlled diets for 5 wk that provided 15 % of energy from protein , 39 % of energy from fat , and 46 % of energy from carbohydrate . Eight percent of fat or fatty acids was replaced across diets with the following : cholesterol , oleic acid , trans fatty acids ( TFAs ) , stearic acid ( STE ) , TFA+STE ( 4 % of energy each ) , and 12:0 - 16:0 saturated fatty acids ( LMP ) . RESULTS Fibrinogen concentrations were higher after consumption of the diet enriched in stearic acid than after consumption of the carbohydrate diet . C-reactive protein concentrations were higher after consumption of the TFA diet than after consumption of the carbohydrate diet , but were not significantly different after consumption of the TFA and TFA+STE diets than after consumption of the LMP diet .  Interleukin 6 concentrations were lower after consumption of the oleic acid diet than after consumption of the LMP , TFA , and STE diets .  E-selectin concentrations were higher after consumption of the TFA diet than after consumption of the carbohydrate diet . Consumption of the TFA but not the TFA+STE diet result ed in higher E-selectin concentrations than did the LMP diet . CONCLUSIONS These data provide evidence that dietary fatty acids can modulate markers of inflammation . Although stearic acid minimally affects LDL cholesterol , it does appear to increase fibrinogen concentrations Abstract This evaluation of the Multiple Risk Factor Intervention Trial data base investigated the effects of dietary PUFA on disease outcomes that may relate to polyunsaturated fatty acid ( PUFA ) biochemistry . The Multiple Risk Factor Intervention Trial was a r and omized clinical trial in coronary heart disease ( CHD ) primary prevention involving 12,866 middle-aged men determined to be at high risk of CHD . They were assigned to either a special intervention group or a usual care group and returned to clinics on an annual basis for assessment of risk factor status . Only data on the usual care men ( n = 6,250 ) are presented , since the multi-intervention effects on the special intervention group introduce considerable analytic complexities . Mean PUFA intake estimates were calculated from four dietary recall interviews at baseline and follow-up Years 1 , 2 , and 3 and estimates for PUFA were established using absolute grams , percentage of total kilocalories , and ratios . Proportional hazards regression analysis controlling for age , race and baseline diastolic blood pressure , smoking , high and low density lipoprotein cholesterol levels , and alcohol was used to analyze dietary PUFA intakes on 10.5-year mortality rates . Results were more significant when PUFA were expressed as percentage of total kilocalories . No significant associations with mortality were detected for linoleic acid ( 18:2n-6 ) , the predominant dietary PUFA . Significant inverse associations were observed for linolenic acid ( 18:3n-3 ) on mortality from CHD ( P < 0.04 ) , all cardiovascular diseases ( CVD ) ( P < 0.03 ) , and all cause mortality ( P < 0.02 ) ; the sum of fatty acids primarily derived from fish oils ( 20:5n-3 + 22:5n-3 + 22:6n-3 ) on CHD ( P < 0.02 ) , CVD ( P < 0.006 ) , and all cause ( P < 0.02 ) mortality ; and , the ratio of 18:3n-3 to 18:2n-6 on cancer mortality ( P < 0.05 ) . Analysis using the total n-3 ( 18:3 + 20:5 + 22:5 + 22:6 ) to total n-6 ( 18:2 + 18:4 + 20:4 ) ratio was also significant on cancer mortality ( P < 0.04 ) . These findings support reports that n-3 fatty acids are protective against CVD and suggest that composition of dietary PUFA may influence CVD and cancer rates BACKGROUND Weekly fish consumption has been related to a lower risk of fatal coronary heart disease ( CHD ) and incident stroke in population s with a low fish intake . This relation has mainly been attributed to n-3 fatty acids in fish , that is , eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) . It is at present unclear whether alpha-linolenic acid ( ALA ) , a n-3 fatty acid from vegetable origin , could also be protective against cardiovascular diseases ( CVDs ) . There is a need for food-based trials to establish the efficacy of low doses of n-3 fatty acids in CVD prevention . OBJECTIVES The aim of the study was to evaluate the effect of an additional daily intake of 400 mg of EPA + DHA and 2 g of ALA on CVD morbidity and mortality in free-living subjects with a history of myocardial infa rct ion . DESIGN The multicenter Alpha Omega Trial is a r and omized , double-blind , placebo-controlled trial with a 2 x 2 factorial design . Between May 2002 and December 2006 , we enrolled a total of 4,837 men and women aged 60 through 80 who experienced a myocardial infa rct ion within 10 years before entering the study . Subjects were r and omized to 1 of 4 margarine spreads that were enriched with EPA + DHA and /or ALA , or placebo . Compliance was monitored via tub counts and assessment of n-3 fatty acids in plasma . Subjects were observed for 40 months for the occurrence of fatal and nonfatal CVD . RESULTS The cohort was on average 69 years old at the start of the study and comprised 22 % women . Subjects had their ( last ) myocardial infa rct ion approximately 4 years before enrollment . Mean body mass index was 27.7 kg/m(2 ) , and 17 % smoked . Average serum total and high-density lipoprotein cholesterol were 4.7 and 1.3 mmol/L , respectively , and 85 % used statins . Mean blood pressure was 142/80 mm Hg , and most subjects were on antihypertensive medication ( 88 % ) . Diabetes mellitus was reported by 17 % of the subjects , and 7 % reported a history of stroke . The overall mortality rate during the trial period was 23 per 1,000 person-years , with approximately 40 % due to CVD . CURRENT STATUS Follow-up of the patients was completed in November 2009 , and findings will be reported in the second part of 2010
We found no relationship between  R-TFA intake levels of up to 4.19 % of daily energy intake ( EI ) and changes in cardiovascular risk factors such as TC : HDL-C and LDL-cholesterol (LDL-C):HDL-C ratios .
In addition , a multivariate regression analysis that included other dietary variables , as well as subject baseline characteristics , confirmed that doses of R-TFA did not significantly influence the changes in the lipid ratio .
Our findings showed that doses of R-TFA did not influence the changes in the ratios of plasma TC : HDL-C and LDL-C : HDL-C. These data suggest that TFA from natural sources , at least at the current levels of intake and up to 4.19 % EI , have no adverse effects on these key CVD risk markers in healthy people
The effects of ruminant ( R ) trans-fatty acids ( TFA ) on the risk of CVD are still under debate .
It could be argued that the lack of the effect of R-TFA may be the result of the small amount of their intake .
Taking into consideration the growing available data from intervention studies , we carried out a systematic review and meta-regression to assess the impact of R-TFA intake levels on changes in the total cholesterol : HDL-cholesterol ( TC : HDL-C ) ratio .