Implicações da ingestão de ácidos graxos trans sobre a saúde do consumidor / Implications of the intake of trans fatty acids on consumer health

O objetivo do presente trabalho consiste em uma revisão bibliográfica sobre os efeitos do consumo de ácidos graxos trans sobre a saúde do consumidor, servindo como veículo de alerta e informando sobre as quantidades diárias indicadas pelos órgãos competentes.

Trans fatty acid; a confounding risk factor in coronary heart disease

To find out the correlation between the consumption of trans fatty acid and fasting lipid profile and body mass index [BMI] in patients suffering from coronary heart disease. Prospective, comparative clinical study. This study was conducted at Shafakhana Sahib az Zaman Medical Hospital Quetta from April, 2007 to May, 2008. This comparative clinical trial was conducted on 50 patients [n=50] to find out the correlation between the consumption of trans fatty acid and fasting lipid profile and body mass index [BMI] in patients suffering from coronary heart disease. Detail history about the use of Trans fats containing products was recorded. Patient's height and weight was recorded by standard calibrated standiometer. The fasting glucose and lipid profile was performed by overnight fasting of 12 hours. The patients was divided into group I [n=18], who used Trans fats free oil/ghee and group II [n = 32], who used trans fats containing ghee. The results of the two groups were compared and correlation of different variables was determined. The study result shows that mean age 58.428 +/- 9.67721 years, mean height 5.476 +/- .5899 feet, mean weight 61.5 +/- 4.8793 Kg and mean BMI was 22.35 +/- 5.24195 Kg/m2. There was slightly higher value of BMI in group II. The comparison of serum lipid profile and glucose among the two groups shows that there is a correlation of Trans fatty acid with certain parameters like high density lipoprotein [HDL] and total lipid with p-value of 0.027 and 0.014 respectively. Similarly serum cholesterol and low density lipoprotein [LDL] correlated with Trans fats lipid having both p- value of 0.000. There is a correlation of Trans fatty acid with serum cholesterol, LDL, HDL and total lipid. The consumption of Trans fatty acid has shown positive correlation of certain parameters with each others like weight shows correlation with serum cholesterol, LDL and total lipid, LDL shows correlation with diastolic blood pressure, triglyceride shows correlation with systolic blood pressure while BMI shows negative correlation with HDL

Trans fatty acid intake is associated with insulin sensitivity but independently of inflammation

High saturated and trans fatty acid intake, the typical dietary pattern of Western populations, favors a proinflammatory status that contributes to generating insulin resistance (IR). We examined whether the consumption of these fatty acids was associated with IR and inflammatory markers. In this cross-sectional study, 127 non-diabetic individuals were allocated to a group without IR and 56 to another with IR, defined as homeostasis model assessment-IR (HOMA-IR) >2.71. Diet was assessed using 24-h food recalls. Multiple linear regression was employed to test independent associations with HOMA-IR. The IR group presented worse anthropometric, biochemical and inflammatory profiles. Energy intake was correlated with abdominal circumference and inversely with adiponectin concentrations (r = -0.227, P = 0.002), while saturated fat intake correlated with inflammatory markers and trans fat with HOMA-IR (r = 0.160, P = 0.030). Abdominal circumference was associated with HOMA-IR (r = 0.430, P < 0.001). In multiple analysis, HOMA-IR remained associated with trans fat intake (β = 1.416, P = 0.039) and body mass index (β = 0.390, P < 0.001), and was also inversely associated with adiponectin (β = -1.637, P = 0.004). Inclusion of other nutrients (saturated fat and added sugar) or other inflammatory markers (IL-6 and CRP) into the models did not modify these associations. Our study supports that trans fat intake impairs insulin sensitivity. The hypothesis that its effect could depend on transcription factors, resulting in expression of proinflammatory genes, was not corroborated. We speculate that trans fat interferes predominantly with insulin signaling via intracellular kinases, which alter insulin receptor substrates.

Calidad de grasa, arterioesclerosis y enfermedad coronaria: efectos de los ácidos grasos saturados y ácidos grasos trans / Quality of fat intake, atherosclerosis and coronary disease: effects of saturated and trans fatty acids

Epidemiological, clinical and metabolic research has shown a strong association between dietary fatty acids intake and cardiovascular disease (CVD) risk factors and clinical events. Saturated fatty acids (SFA) and trans fatty acids (TFA) derived from industrial hydrogenation of oils have been associated with an increased prevalence of CVD. However experimental results on the relationship between physiological pathologic effects and specific functions of individual SFA are often contradictory. Therefore a more detailed exploration of the potential benefit and risks of specific saturated and trans fatty acids is needed in order to update dietary recommendations. In the case of TFAs, the deleterious effect on CVD has been well demonstrated and a maximum accepted level of 1 percent of total energy has been agreed internationally. What is currently under discussion is what would be the best alternative to replace them in the diet.

Voluntary reduction of trans-fatty acids in Latin America and the Caribbean: current situation / Disminución voluntaria del contenido de ácidos grasos trans en América Latina y el Caribe: situación actual

As part of the Pan American Health Organization/World Health Organization Trans-Fat-Free Americas initiative, 12 representatives from food industries in Latin America and the Caribbean signed a declaration stating their intention to voluntarily eliminate industrially produced trans-fatty acids (TFA) from the Americas. A year later, in order to document the extent of the voluntary reduction, each declarant was asked to describe all reformulations and reductions in the TFA content of their products. After up to six requests for data, only three declarants provided such information in detail, and three others offered an overall summary of their reformulations. Additionally, three declarants reported the barriers that limit this process: availability of oil substitutes, cost, and consumers' sensory acceptance. The content of TFA and saturated fat in the food supply in the Americas should be regulated and strictly monitored in order to adequately evaluate a reduction of TFA in the region.

Como parte de la iniciativa "Las Américas sin grasas trans" de la Organización Panamericana de la Salud/Organización Mundial de la Salud, 12 representantes de empresas alimentarias de América Latina y el Caribe firmaron una declaración en la que se comprometieron a eliminar voluntariamente los ácidos grasos trans (AGT) de los alimentos producidos industrialmente. Un año después, a fin de verificar el progreso en este sentido, se solicitó a cada firmante que describiera todas las reformulaciones y la disminución del contenido de AGT de sus productos. Después de solicitar los datos hasta seis veces en algunos casos, solo tres de las empresas firmantes suministraron información detallada y otras tres ofrecieron un resumen general de las distintas reformulaciones incorporadas. Además, tres proporcionaron información acerca de los obstáculos que dificultan este proceso: la disponibilidad de sucedáneos del aceite, el costo y la aceptación de los consumidores. Es preciso reglamentar y vigilar con rigurosidad el contenido de AGT y grasas saturadas de los alimentos comercializados en la Región de las Américas con el fin de efectuar un seguimiento adecuado de la disminución de los AGT.

Ácidos grasos con isomería trans II: situación de consumo en latinoamérica y alternativas para su sustitución / Isomeric trans fatty acids II: consumption in Latin America and alternatives for substitution

TFA consumption is well established in developed countries, all of which have begun to adopt policies and regulations to drastically reduce the TFA content of processed foods. Not so in Latin America. We lack up-to-date studies on TFA, and in most cases, have only estimates of TFA consumption based on information from incomplete tables, sometimes from other countries or regions with different consumption habits. Fot intake varies widely within each country or group of countries. Some countries have no regulations governing the fot composition of foods, especially their TFA content. The methodology developed for the industry to reduce the TFA content of hydrogenated products involves the use of oils with high degree of saturation in their natural state, or previously hydrogenated vegetable oils until reaching a high degree of saturation. In light of the nutritional recommendations to reduce TFA intake, it is expected that consumption of these isomers, primarily those of industrial origin, will decrease in the coming years. This paper discusses the sources of the TFA in our diet, the current alternatives for reducing TFA content in foods, and includes information regarding the production and estimated intake of fats and TFA for some Latin American countries for which this information is available.

El consumo de AGT está bien establecido en los países desarrollados, en los que se han elaborado políticas y regulaciones para reducir drásticamente su contenido en los alimentos procesados. No ocurre lo mismo en Latinoamérica. Son escasos los estudios sobre consumo de AGT y en la mayoría de los casos son solo estimaciones basadas en información incompleta, a veces procedente de otras regiones o países con hábitos de consumo diferentes. El consumo de grasas varía mucho de un país a otro, e incluso dentro de un mismo país. Algunos países no tienen regulaciones sobre el consumo de grasas y el contenido de AGT de los alimentos. La metodología desarrollada por la industria para reducir el contenido de AGT de los productos hidrogenados, involucra el uso de aceites con alto grado de saturación en su condición natural, o el uso de aceites vegetales con un alto grado de hidrogenación previa. Se espera, en vista de las recomendaciones nutricionales, que el consumo de AGT, principalmente aquellos de origen industrial, se reduzca considerablemente en los próximos a±os. Este trabajo discute las fuentes de AGT en nuestra dieta, las alternativas para reducir el consumo de AGT en los alimentos, e incluye información sobre la producción y el consumo estimado de AGT de algunos países de Latinoamérica de los cuales se dispone de información.

Efecto de los ácidos grasos trans sobre las lipoproteínas del plasma / Effect of trans fatty acids on plasma lipoproteins

Estudios clínicos y epidemiológicos indican que un consumo elevado de ácidos grasos trans (AGtrans) aumenta el riesgo de enfermedad cardio-vascular (ECV). Los ácidos grasos trans provenientes de los aceites parcialmente hidrogenados han sido asociados a muertes por ECV, pero estos efectos negativos sobre la salud humana no son atribuibles a los isómeros trans-11 C18:1 ó al cis-9, trans-11 del ácido linoleico conjugado (CLA) presentes en la carne o leche de ganado vacuno u ovino. El objetivo de esta revisión es presentar las evidencias disponibles a la fecha, sobre los diferentes aspectos químicos de los ácidos grasos con isomería trans, sobre el proceso de hidrogenación usado por la industria de alimentos y de biohidrogenación, así como de los posibles efectos del consumo de los AG trans sobre los factores de riesgo de ECV asociados con las lipoproteínas del plasma.

Trans fatty acid-forming processes in foods: a review

There is a mounting concern about the intake of foods containing trans fatty acids (TFA) due to their deleterious effects on human health, mainly on the cardiovascular system. In this way, it is important to consider the processes that form TFA in foods, and the alternatives to minimize them. Among the processes that result in the formation of TFA, the hydrogenation of vegetable oils stands out for its impact on the diet of people living in industrialized countries. Other processes such as edible oil refining, meat irradiation, food frying, and biohydrogenation also contribute to increase the daily intake of TFA.

Existe uma crescente preocupação em relação a ingestão elevada de ácidos graxos trans (AGT), devido aos seus efeitos desfavoráveis à saúde, principalmente sobre o sistema cardiovascular. Assim, é importante considerar os processos queoriginam os AGT nos alimentos, e as alternativas para minimizar a sua formação. Entre os processos que resultam na produção de AGT, a hidrogenação de óleos vegetais tem recebido o maior destaque por seu impacto na dieta de pessoas que vivem em países industrializados. Outros processos, como o refino de óleos vegetais, a irradiação de carnes, o preparo de alimentos fritos e a bio-hidrogenação, também contribuem para aumentar a ingestão diária de AGT.

Ácidos grasos trans y riesgo cardiovascular / Acids fatty trans and cardiovascular risk

Los ácidos grasos trans (TUFAS) son una variante isomérica producida durante los procesos industriales de hidrogenación y calentamiento de aceites vegetales ricos en ácidos grasos poliinsaturados cis (PUFAS). Se ha demostrado epidemiológicamente la relación de su consumo con el desarrollo de cardiopatía isquémica, sin embargo los mecanismos fisiopatológicos implicados no han sido establecidos por completo. Los TUFAS participan en el desarrollo de un perfil lipídico aterogénico, expresado por elevación de las lipoproteínas de baja densidad, y disminución de las lipoproteínas de alta densidad e hiperlipoproteinemia (a), aumentando la probabilidad de desarrollo de procesos aterogénicos y en consecuencia el infarto del miocardio. Adicionalmente los TUFAS antagonizan el metabolismo de los eicosanoides contribuyendo a un estado protrombótico. En virtud de lo anteriormente expuesto, esta revisión pretende describir los mecanismos moleculares implicados en el desarrollo de un estado aterogénico como la consecuencia de la ingesta de ácidos grasos trans.

Ácidos Graxos Trans: alimentos e efeitos na saúde / Trans fatty acids: foods and effects on health

Os ácidos graxos trans podem ser encontrados em alimentos obtidos a partir de animais ruminantes e em alimentos que contêm gordura vegetal parcialmente hidrogenada, como os "fast food". O consumo dos ácidos graxos trans é maior nos Estados Unidos, no Canadá e em países da Europa e menor no Japão e em países do Mediterrâneo. De forma semelhante, a incidência de doenças cardiovasculares são maiores naqueles países que apresentam um maior consumo. Os estudos demonstram que esses ácidos graxos podem contribuir para o aumento de LDL e de lipoproteína [a], além de reduzir os níveis de HDL. Ainda, os isômeros trans parecem inibir a ação de enzimas de dessaturação dos ácidos graxos essenciais (Δ5- e Δ6-dessaturase), inibindo a biossíntese de importantes ácidos graxos, como o ácido araquidônico e o ácido docosahexaenóico (DHA). Sobre a saúde materno-infantil, as concentrações de ácidos graxos trans ingeridos pela nutriz estão associadas às concentrações encontradas no leite materno. Além do leite, tais isômeros podem ser transferidos ao recém-nascido pela via placentária. Os estudos sugerem que os ácidos graxos trans afetariam o crescimento intra-uterino devido à inibição do metabolismo dos ácidos graxos essenciais, pelas enzimas dessaturases. A inibição dessas enzimas pode ser também um fator desencadeante de uma precoce lesão aterosclerótica. Porém, os efeitos dos ácidos graxos trans sobre a saúde ainda não são conclusivos e não existem recomendações para seu consumo. Além disso, no Brasil, os estudos para determinar o teor desses isômeros nos alimentos ainda são incipientes, o que demonstra uma grande necessidade de pesquisas nesta área.

Trans fatty acids can be found in foods derived from ruminant animals and foods that contain partially hydrogenated fat such as fast foods. The consumption of trans fatty acids is larger in the United States, Canada, and some European countries than in Japan and Mediterranean countries. The incidence of coronary heart diseases is higher in countries where the consumption of trans fatty is high. Studies show that trans fatty acids can contribute to increase LDL and lipoprotein [a], and to reduce the levels of HDL. In addition, trans isomeric seems to inhibit the action of desaturase enzymes of essential fatty acids (Δ5- and Δ6-desaturase) by holding back the biosynthesis of important fatty acids such as arachidonic acid and docosahexaenoic acid (DHA). With respect to pregnant women’s and infant’s health, concentrations of trans fatty acids ingested by the mother are associated to concentrations found in the maternal milk. Besides the milk, the trans fatty acids can be transferred to the newly born through the placenta. Studies suggest that trans fatty acids can affect intra-uterine growth due to the inhibition of the conversion of essential fatty acids by desaturase enzymes. The inhibition of DHA can also cause early atherosclerosis lesion. However, studies on the effects of trans fatty acids on health are still inconclusive and there are no current recommendations on their consumption. Additionally, in Brazil, studies to determine the composition of trans isomeric in foods are still incipient, which indicates a great need of research in this area.

Ácidos grasos trans en alimentos consumidos habitualmente por los jóvenes en Argentina / Trans-fatty acids usually ingested by youths in Argentina

Introducción. En nuestros jóvenes, la alimentacióninadecuada, uno de los factores de riesgo para lasenfermedades cardiovasculares, se observa desdela infancia y tiende a persistir en la etapa adulta. Elproceso de aterosclerosis se inicia en la infancia,con la formación de las estrías grasas en la paredvascular. Entre los alimentos que repercuten negativamentese encuentran los ácidos grasos saturadosy los insaturados con configuración trans. Elobjetivo fue investigar la presencia de ácidos grasostrans en alimentos de consumo frecuente en jóvenesen Argentina, para proponer estrategias tendientesa disminuir su disponibilidad y consumo.Material y métodos. Se estudiaron margarinas, mantecas,mayonesas, galletitas, alfajores y productosde copetín. Se determinó el contenido lipídico porel método de Folch. La composición en ácidos grasosse determinó por cromatografía gaseosa.Resultados. Se encontró una importante presenciade ácidos grasos trans en los alimentos, aun enaquellos promocionados como con bajo contenidode colesterol. En algunos casos, el contenido deácidos grasos saturados y trans es superior al deinsaturados cis. El contenido de ácidos grasospoliinsaturados omega-6 es importante en algunosalimentos y, en general, el contenido de ácidosgrasos poliinsaturados omega-3 es bajo.Conclusiones. Debido al alto contenido de ácidosgrasos trans encontrado en los alimentos analizados,además de una relación omega-6/omega-3 no deseada, se hace necesaria la implementación de estrategias que mejoren la calidad nutricional de los alimentos que consumen nuestros jóvenes.