Eliminating artificial trans fatty acids in Argentina: estimated effects on the burden of coronary heart disease and costs

Objective: To estimate the impact of Argentine policies to reduce trans fatty acids (TFA) on coronary heart disease (CHD), disability-adjusted life years (DALYs) and associated health-care costs. Methods: We estimated the baseline intake of TFA before 2004 to be 1.5% of total energy intake. We built a policy model including baseline intake of TFA, the oils and fats used to replace artificial TFAs, the clinical effect of reducing artificial TFAs and the costs and DALYs saved due to averted CHD events. To calculate the percentage of reduction of CHD, we calculated CHD risks on a population-based sample before and after implementation. The effect of the policies was modelled in three ways, based on projected changes: (i) in plasma lipid profiles; (ii) in lipid and inflammatory biomarkers; and (iii) the results of prospective cohort studies. We also estimated the present economic value of DALYs and associated health-care costs of coronary heart disease averted. Findings: We estimated that projected changes in lipid profile would avert 301 deaths, 1066 acute CHD events, 5237 DALYs and 17 million United States dollars (US$) in health-care costs annually. Based on the adverse effects of TFA intake reported in prospective cohort studies, 1517 deaths, 5373 acute CHD events, 26 394 DALYs and US$ 87 million would be averted annually. Conclusion: Even under the most conservative scenario, reduction of TFA intake had a substantial effect on public health. These findings will help inform decision-makers in Argentina and other countries on the potential public health and economic impact of this policy.Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Elorriaga, Natalia. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Garay, Ulises. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Poggio, Rosana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Caporale, Joaquin. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Matta, Maria Gabriela. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Pichón-Riviere, Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Mozaffarian, Dariush. Tufts University; Estados Unido

Acute effects of elevated NEFA on vascular function: a comparison of SFA and MUFA

There is emerging evidence to show that high levels of NEFA contribute to endothelial dysfunction and impaired insulin sensitivity. However, the impact of NEFA composition remains unclear. A total of ten healthy men consumed test drinks containing 50 g of palm stearin (rich in SFA) or high-oleic sunflower oil (rich in MUFA) on separate occasions; a third day included no fat as a control. The fats were emulsified into chocolate drinks and given as a bolus (approximately 10 g fat) at baseline followed by smaller amounts (approximately 3 g fat) every 30 min throughout the 6 h study day. An intravenous heparin infusion was initiated 2 h after the bolus, which resulted in a three- to fourfold increase in circulating NEFA level from baseline. Mean arterial stiffness as measured by digital volume pulse was higher during the consumption of SFA (P,0·001) but not MUFA (P¼0·089) compared with the control. Overall insulin and gastric inhibitory peptide response was greater during the consumption of both fats compared with the control (P,0·001); there was a second insulin peak in response to MUFA unlike SFA. Consumption of SFA resulted in higher levels of soluble intercellular adhesion molecule-1 (sI-CAM) at 330 min than that of MUFA or control (P#0·048). There was no effect of the test drinks on glucose, total nitrite, plasminogen activator inhibitor-1 or endothelin-1 concentrations. The present study indicates a potential negative impact of elevated NEFA derived from the consumption of SFA on arterial stiffness and sI-CAM levels. More studies are needed to fully investigate the impact of NEFA composition on risk factors for CVD

Effect of a whey protein and rapeseed oil gel feed supplement on milk fatty acid composition of Holstein cows

Isoenergetic replacement of dietary saturated fatty acids (SFA) with cis-monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) can reduce cardiovascular disease (CVD) risk. Supplementing dairy cow diets with plant oils lowers milk fat SFA concentrations. However, this feeding strategy can also increase milk fat trans FA (TFA), and negatively impact rumen fermentation. Protection of oil supplements from the rumen environment is therefore needed. In the present study a whey protein gel (WPG) of rapeseed oil (RO) was produced for feeding to dairy cows, in two experiments. In Experiment 1 four multiparous Holstein-Friesian cows in mid-lactation were used in a change-over experiment, with 8-d treatment periods separated by a 5-day washout period. Total mixed ration diets containing 420 g RO or WPG providing 420 g of RO were fed and the effects on milk production, composition and FA concentration were measured. Experiment 2 involved four multiparous mid-lactation Holstein-Friesian cows in a 4 x 4 Latin square design experiment, with 28-d periods, to investigate the effect of incremental dietary inclusion (0, 271, 617 and 814 g/d supplemental oil) of WPG on milk production, composition and FA concentration in the last week of each period. There were minimal effects of WPG on milk FA profile in experiment 1, but trans-18:1 and total trans-MUFA were higher after 8 days of supplementation with RO than with WPG. Incremental diet inclusion of WPG in experiment 2 resulted in linear increases in milk yield, cis- and trans-MUFA and PUFA, and linear decreases in SFA (from 73 to 58 g/100 g FA), and milk fat concentration. The WPG supplement was effective at decreasing milk SFA concentration by replacement with MUFA and PUFA in experiment 2, but the increase in TFA suggested that protection was incomplete

Potentials to differentiate milk composition by different feeding strategies

To investigate the effect of the dietary intake of the cow on milk composition, bulk-tank milk was collected on 5 occasions from conventional (n = 15) and organic (n = 10) farms in Denmark and on 4 occasions from low-input nonorganic farms in the United Kingdom, along with management and production parameters. Production of milk based on feeding a high intake of cereals, pasture, and grass silage resulted in milk with a high concentration of α-linolenic acid (9.4 ± 0.2 mg/ kg of fatty acids), polyunsaturated fatty acids (3.66 ± 0.07 mg/kg of fatty acids), and natural stereoisomer of α-tocopherol (RRR-α-tocopherol, 18.6 ± 0.5 mg/kg of milk fat). A milk production system using a high proportion of maize silage, by-products, and commercial concentrate mix was associated with milk with high concentrations of linoleic acid (LA; 19.7 ± 0.4 g/kg of fatty acids), monounsaturated fatty acids (27.5 ± 0.3 mg/kg of fatty acids), and a high ratio between LA and α-linolenic acid (4.7 ± 0.2). Comparing these 2 production systems with a very extensive nonorganic milk production system relying on pasture as almost the sole feed (95 ± 4% dry matter intake), it was found that the concentrations of conjugated LA (cis-9,trans-11; 17.5 ± 0.7 g/kg of fatty acids), trans-11-vaccenic acid (37 ± 2 g/kg of fatty acids), and monounsaturated fatty acids (30.4 ± 0.6 g/kg of fatty acids) were higher in the extensively produced milk together with the concentration of antioxidants; total α-tocopherol (32.0 ± 0.8 mg/kg of milk fat), RRR-α-tocopherol (30.2 ± 0.8 mg/kg of milk fat), and β-carotene (9.3 ± 0.5 mg/kg of milk fat) compared with the organic and conventional milk. Moreover, the concentration of LA (9.2 ± 0.7 g/kg of fatty acids) in milk from the extensive milk production system was found to approach the recommended unity ratio between n-6 and n-3, although extensive milk production also resulted in a lower daily milk yield

Linoleic acid intake, plasma cholesterol and 10-year incidence of CHD in 20.000 middle-aged men and women in the Netherlands

We studied the associations of a difference in linoleic acid or carbohydrate intake with plasma cholesterol levels and risk of CHD in a prospective cohort study in the Netherlands. Data on diet (FFQ) and plasma total and HDL-cholesterol were available at baseline (1993–7) of 20 069 men and women, aged 20–65 years, who were initially free of CVD. Incidence of CHD was assessed through linkage with mortality and morbidity registers. During an average of 10 years of follow-up, 280 CHD events occurred. The intake of linoleic acid ranged from 3·6 to 8·0 % of energy (en%), whereas carbohydrate intake ranged from 47·6 to 42·5 en% across quintiles of linoleic acid intake. Linoleic acid intake was inversely associated with total cholesterol and HDL-cholesterol in women but not in men. Linoleic acid intake was not associated with the ratio of total to HDL-cholesterol. No association was observed between linoleic acid intake and CHD incidence, with hazard ratios varying between 0·83 and 1·00 (all P>0·05) compared to the bottom quintile. We conclude that a 4–5 en% difference in linoleic acid or carbohydrate intake did not translate into either a different ratio of total to HDL-cholesterol or a different CHD incidenc

Effects of a High Oleic Acid Beef Diet on Cardiovascular Disease Risk Factors of Human Subjects

The consumption of high-fat hamburger enriched with saturated fatty acids (SFA) and trans-fatty acids (TFA) may increase risk factors for cardiovascular disease, whereas hamburger enriched with monounsaturated fatty acids (MUFA) may have the opposite effect. Ten mildly hypercholesterolemic men consumed five, 114-g hamburger patties per week for two consecutive phases. Participants consumed low-MUFA (high SFA) hamburger (MUFA:SFA = 0.95; produced from pasture-fed cattle) for 5 wk, consumed their habitual diets for 3 wk, and then consumed high-MUFA hamburger (MUFA:SFA = 1.31; produced from grain-fed cattle) for 5 wk. These MUFA:SFA were typical of ranges observed for retail ground beef. Relative to habitual levels and levels during the high-MUFA phase, the low-MUFA hamburger: increased plasma palmitic acid, palmitoleic acid, and triacylglycerols (P 0.10). Plasma palmitoleic acid was positively correlated with triacylglycerols (r = 0.90), VLDL-C (r = 0.73), and the LDL:HDL (r = 0.45), and was negatively correlated with plasma HDL-C (r = -0.58), whereas plasma palmitic, stearic, and oleic acid were negatively correlated with LDL particle diameter (all P <= 0.05). Because plasma palmitoleic acid was derived from [delta]9 desaturation of palmitic acid in the liver, we conclude that alterations in hepatic stearoyl-CoA desaturase activity may have been responsible for the variation in HDL-C and triacylglycerols caused by the low-MUFA and high-MUFA hamburgers. Cattle with a genetic predisposition to deposit MUFA in their lean and fat tissues, such as Wagyu cattle can be used to produce beef products that are especially enriched with oleic acid and lower in SFA and TFA, and feeding practices can further enhance the composition of beef fat. This indicates that ground beef or hamburger products can be produced that are naturally enriched with oleic acid, and conversely that certain production practices can impair the nutritional quality of beef fat. Finally, we cannot discern from this study design whether the high-MUFA hamburger reversed the effects of the low-MUFA hamburger, or whether the subjects gradually adapted to the elevated intake of total fat. It is clear, however, that the high-MUFA hamburger did not exacerbate any of the effects of the low-MUFA hamburger and can be viewed as at least neutral in its effects on HDL-C and triacylglycerols

Changes in body composition and fatty acid profile during embryogenesis of quillback rockfish (Sebastes maliger)

We investigated developmental changes in the body compositions and fatty acid (FA) profiles of embryos and preparturition larvae of the quillback rockfish (Sebastes maliger). Comparisons of proximate composition data from early-stage embryos with data from hatched preparturition larvae taken from wild-caught gravid females indicated that embryos gain over one-third their weight in moisture while consuming 20% of their dry tissue mass for energy as they develop into larvae. Lipid contributed 60% of the energy consumed and was depleted more rapidly than protein, indicating a protein-sparing effect. Oil globule volume was strongly correlated with lipid levels, affirming its utility as an indicator of energetic status. FA profiles of early embryos differed significantly from those of hatched larvae. Differences in the relative abundances of FAs between early embryos and hatched larvae indicated different FA depletion rates during embryonic development. We conclude that some metabolically important FAs may prove useful in assessing the condition of embryos and preparturition larvae, particularly 20:4n-6, which cannot be synthesized by many marine fish and which is conserved during embryogenesis. Variability in body composition and energy use among rockfish species should be considered when interpreting any measures of condition