ContextCoronary heart disease (CHD) remains the leading cause of mortality
in industrialized countries and is rapidly becoming a primary cause of death
worldwide. Thus, identification of the dietary changes that most effectively
prevent CHD is critical.ObjectiveTo review metabolic, epidemiologic, and clinical trial evidence regarding
diet and CHD prevention.Data Sources and Study SelectionWe searched MEDLINE through May 2002 for epidemiologic and clinical
investigations of major dietary factors (fat, cholesterol, omega-3 fatty acids, trans-fatty acids, carbohydrates, glycemic index, fiber,
folate, specific foods, and dietary patterns) and CHD. We selected 147 original
investigations and reviews of metabolic studies, epidemiologic studies, and
dietary intervention trials of diet and CHD.Data ExtractionData were examined for relevance and quality and extracted by 1 of the
authors.Data SynthesisCompelling evidence from metabolic studies, prospective cohort studies,
and clinical trials in the past several decades indicates that at least 3
dietary strategies are effective in preventing CHD: substitute nonhydrogenated
unsaturated fats for saturated and trans-fats; increase
consumption of omega-3 fatty acids from fish, fish oil supplements, or plant
sources; and consume a diet high in fruits, vegetables, nuts, and whole grains
and low in refined grain products. However, simply lowering the percentage
of energy from total fat in the diet is unlikely to improve lipid profile
or reduce CHD incidence. Many issues remain unsettled, including the optimal
amounts of monounsaturated and polyunsaturated fats, the optimal balance between
omega-3 and omega-6 polyunsaturated fats, the amount and sources of protein,
and the effects of individual phytochemicals, antioxidant vitamins, and minerals.ConclusionsSubstantial evidence indicates that diets using nonhydrogenated unsaturated
fats as the predominant form of dietary fat, whole grains as the main form
of carbohydrates, an abundance of fruits and vegetables, and adequate omega-3
fatty acids can offer significant protection against CHD. Such diets, together
with regular physical activity, avoidance of smoking, and maintenance of a
healthy body weight, may prevent the majority of cardiovascular disease in
Western populations.

https://jamanetwork.com/journals/jama/articlepdf/195543/jcc20005.pdf

Optimal diets for prevention of coronary heart disease.

During the past several decades, reduction in fat intake has been the main focus of national dietary recommendations to decrease risk of coronary heart disease (CHD). Several lines of evidence, however, have indicated that types of fat have a more important role in determining risk of CHD than total amount of fat in the diet. Metabolic studies have long established that the type of fat, but not total amount of fat, predicts serum cholesterol levels. In addition, results from epidemiologic studies and controlled clinical trials have indicated that replacing saturated fat with unsaturated fat is more effective in lowering risk of CHD than simply reducing total fat consumption. Moreover, prospective cohort studies and secondary prevention trials have provided strong evidence that an increasing intake of n-3 fatty acids from fish or plant sources substantially lowers risk of cardiovascular mortality. In this article, we review evidence from epidemiologic studies and dietary intervention trials addressing the relationship between dietary fat intake and risk of CHD, with a particular emphasis on different major types of fat, n-3 fatty acids and the optimal balance between n-3 and n-6 fatty acids. We also discuss the implications of the available evidence in the context of current dietary recommendations.

/pdf/types-of-dietary-fat-and-risk-of-coronary-heart-disease-a-2woy5ulpxz.pdf

Types of dietary fat and risk of coronary heart disease: a critical review.

Nutrient reference values for Australia and New Zealand: Including recommended dietary intakes

Characterizations of fatty acids composition in % of total methylester of fatty acids (FAMEs) of fourteen vegetable oils—safflower, grape, silybum marianum, hemp, sunflower, wheat germ, pumpkin seed, sesame, rice bran, almond, rapeseed, peanut, olive, and coconut oil—were obtained by using gas chromatography (GC). Saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA), palmitic acid (C16:0; 4.6%–20.0%), oleic acid (C18:1; 6.2%–71.1%) and linoleic acid (C18:2; 1.6%–79%), respectively, were found predominant. The nutritional aspect of analyzed oils was evaluated by determination of the energy contribution of SFAs (19.4%–695.7% ERDI), PUFAs (10.6%–786.8% ERDI), n-3 FAs (4.4%–117.1% ERDI) and n-6 FAs (1.8%–959.2% ERDI), expressed in % ERDI of 1 g oil to energy recommended dietary intakes (ERDI) for total fat (ERDI—37.7 kJ/g). The significant relationship between the reported data of total fat, SFAs, MUFAs and PUFAs intakes (% ERDI) for adults and mortality caused by coronary heart diseases (CHD) and cardiovascular diseases (CVD) in twelve countries has not been confirmed by Spearman’s correlations.

Fatty Acids Composition of Vegetable Oils and Its Contribution to Dietary Energy Intake and Dependence of Cardiovascular Mortality on Dietary Intake of Fatty Acids

https://www.dur-a-avaler.com/wp-content/uploads/2013/02/Red%20meat%20consumption%20An%20overview%20of%20the%20risks%20and%20benefits.pdf

Red meat consumption: an overview of the risks and benefits.

Although dietary trans fatty acids can affect plasma lipoproteins negatively in humans, no direct comparison with specific saturated fatty acids has been reported, even though trans fatty acids were designed to replace saturates in foods and food processing. In this study, dietary trans 18:1 [elaidic acid at 5.5% energy (en)] was specifically exchanged for cis 18:1, 16:0 or 12:0 + 14:0 in 27 male and female subjects consuming moderate fat (31% en), low cholesterol (<225 mg/d) whole food diets during 4-wk diet periods in a crossover design. The trans-rich fat significantly elevated total cholesterol and LDL cholesterol relative to the 16:0-rich and 18:1-rich fats and uniquely depressed HDL cholesterol relative to all of the fats tested. Trans fatty acids also elevated lipoprotein (a) [Lp(a)] values relative to all dietary treatments. Furthermore, identical effects on lipoproteins were elicited by 16:0 and cis 18:1 in these subjects. The current results suggest that elaidic acid, one of the principal trans isomers produced during industrial hydrogenation of edible oils, adversely affects plasma lipoproteins. Thus, the negative effect of elaidic acid on the lipoprotein profile of humans appears to be unmatched by any other natural fatty acid(s).

Anisah Ismail

Papers

Trans (Elaidic) Fatty Acids Adversely Affect the Lipoprotein Profile Relative to Specific Saturated Fatty Acids in Humans