Impact of heat stress on health-related symptoms and physiological changes among workers at a palm oil mill in Mukah, Sarawak, Malaysia.

INTRODUCTION: The palm oil (PO) industry is one of the most important sectors in the Malaysian economy. Workers at PO mills are, however, at risk for a number of health and safety issues, including heat stress, as the PO is one of the industries with high heat exposure. Heat stress occurs when a person's body cannot get rid of excess heat. Heat stress can result in heat cramps, heat exhaustion, heat rash, and heat stroke. It also results in physiological and psychological changes that can have an impact on a worker's performance. Therefore, this study aimed to evaluate the impact of heat stress on health-related symptoms and physiological changes among workers in a PO mill. MATERIALS AND METHODS: This cross-sectional study was conducted in a PO mill located in Mukah, Sarawak, Malaysia. Thirty-one workers from the four workstations (sterilizer, boiler, oil, and engine rooms) were selected as the respondents in this study. Wet Bulb Globe Thermometer was used in this study to measure the environmental temperature (WBGTin). Body core temperature (BCT), blood pressure (BP), and heart rate (HR) were recorded both before and after working in order to assess the physiological effects of heat stress on workers. A set of questionnaires were used to determine sociodemographic characteristics of the respondents and their symptoms related to heat stress. Data were then analyzed using SPSS Ver28. RESULTS: The WBGTin was found to be above the ACGIH threshold limit value of heat stress exposure in the engine room, sterilizer, and boiler workstations (>28.0°C). Additionally, there was a significant difference in the worker's BCT in these three workstations before and after work (p<0.05). Only the systolic BP and HR of those working at the boiler workstation showed significant difference between before and after work (p<0.05). The most typical symptoms that workers experience as a result of being exposed to heat at work include headache and fatigue. However, statistical analysis using Spearman Rho's test showed that there is no correlation between heat stress level with physiological changes and health-related symptoms among study respondents (p>0.05). CONCLUSION: Results of the present study confirmed that workers in PO mill were exposed to high temperatures while at work. Although the evidence indicates the physiological parameters in general are not significantly affected while working, it also demonstrated that worker's body adapts and acclimates to the level of heat. Even so, precautions should still be taken to reduce future heat exposure. It is recommended that a physiological study be carried out that focuses on cognitive function impairment to support the evidence regarding the effects of heat stress on PO mill workers.

Repeatedly heated palm olein disrupts male reproductive system of rat: A histological and biochemical study.

The aim of this study was to investigate the effect of heated and unheated palm olein in different doses on the male reproductive system of rats. Forty male rats were randomly classified into five groups (n = 8) including Control, Low palm, High palm, Heated low palm and Heated high palm. The palm olein was administrated orally for 6 months. Histological and biochemical parameters of the male reproductive system were measured. There was a significant reduction in sexual hormones, serum levels of superoxide dismutase, high-density lipoprotein, testis weight and sperm parameters in the high dose and heated palm olein groups compared to the other group (p < 0.05). The levels of malondialdehyde, apoptosis rate, proteins levels (TNF-α, IL-1ß, IL-6), low-density lipoprotein, cholesterol, triglyceride and the weight of the rats were significantly higher in the high dose and heated palm olein groups than the others (p < 0.05). High dose and heated palm olein treatment could damage the male rat's reproductive indices that were related to increased inflammatory markers, decreased sex hormone levels, and negative effects on testicular tissue and sperm parameters.

Biochemical properties, nutritional values, health benefits and sustainability of palm oil.

Palm oil (PO), although subject of controversies, is the most consumed oil and the first source of oil widely produced. In this review, we discussed its biochemical composition in fatty acids, carotenoids, vitamin E, its phenolic compounds, and its nutritional benefits. We addressed its biochemical properties in relation with the stereospecific distribution of its unsaturated fatty acids at the sn-2 position in triacylglycerols. PO is one of the most stable oils, which help it prolong food storability mostly due not only to its content of saturated fatty acids, but also to its antioxidant compounds. PO plays an important role in the prevention of many pathologies (diabetes, cardiovascular diseases, obesity and cancers). It is widely use in nutrition especially in the food industry and in biodiesel industry. Faced with attacks from environmentalists who blame PO for destorying biodiversity, there is an urgent need to develop a sustainable PO production plan. Compliance with sustainable PO goals would help ease those controversies. The use and consumption of PO in normal or moderate amounts in a varied, balanced and adequate diet does not present any known health risk. Education campaigns on the nutritional benefits of PO should be promoted.

Effects of polar compounds in fried palm oil on liver lipid metabolism in C57 mice.

Polar components (PCs) are produced during the frying of oil, affecting the quality of edible oil and posing a hazard to human health. In this study, C57 mice were fed a high-fat (HF) diet containing purified PCs for nine weeks. Their effects on lipid metabolism and liver function in animals were analyzed. Our results indicated that the contents of total PCs and saturated fatty acid increased from 6.07 ± 0.6% and 58.27 ± 0.35% to 19.17 ± 1.8% and 69.91 ± 0.51%, respectively (P < 0.01). PC intake resulted an 18.56% higher liver index in mice than that in the HF group. The PC group had the highest malondialdehyde (MDA) content (1.94 ± 0.11 nmol/mg protein) and the liver nonalcoholic fatty liver disease (NAFLD) activity score (NAS) was 4, which already showed NAFLD characteristics. In addition, the expression levels of lipid metabolism-related genes, including sterol regulatory element binding protein-1c (SREBP-1c), fatty acid synthetase (FAS), peroxisome proliferator-activated receptor-alpha, and peroxisome acyl-CoA oxidase 1, indicated that PC increased hepatic lipid accumulation by upregulating the transcriptional level of fat synthesis genes and further leads to liver damage by affecting mitochondrial function. Our results provided important information about the effects of PCs produced in the frying process of PO on animal health, which is critical for assessing the biosafety of fried products. PRACTICAL APPLICATION: The research will help promote the industrial upgrading of fried foods and help consumers build healthy lifestyles.

Palmitic acid damages gut epithelium integrity and initiates inflammatory cytokine production.

The mechanisms leading to the low-grade inflammation observed during obesity are not fully understood. Seeking the initiating events, we tested the hypothesis that the intestine could be damaged by repeated lipid supply and therefore participate in inflammation. In mice, 1-5 palm oil gavages increased intestinal permeability via decreased expression and mislocalization of junctional proteins at the cell-cell contacts; altered the intestinal bacterial species by decreasing the abundance of Akkermansia muciniphila, segmented filamentous bacteria, and Clostridium leptum; and increased inflammatory cytokine expression. This was further studied in human intestinal epithelial Caco-2/TC7 cells using the two main components of palm oil, i.e., palmitic and oleic acid. Saturated palmitic acid impaired paracellular permeability and junctional protein localization, and induced inflammatory cytokine expression in the cells, but unsaturated oleic acid did not. Inhibiting de novo ceramide synthesis prevented part of these effects. Altogether, our data show that short exposure to palm oil or palmitic acid induces intestinal dysfunctions targeting barrier integrity and inflammation. Excessive palm oil consumption could be an early player in the gut alterations observed in metabolic diseases.

Occupational Health and Safety in the Palm Oil Industry: A Systematic Review.

BACKGROUND: The palm oil industry is the largest contributor to global production of oils and fats. Indonesia and Malaysia are the largest producers of palm oil. More than a million workers are employed in this industry, yet there is a lack of information on their occupational health and safety. OBJECTIVE: To identify and summarize occupational hazards among oil palm plantation workers. METHODS: A search was carried out in June 2018 in PubMed, Web of Science, Scopus, and Ovid. Relevant publications were identified by a systematic search of four databases and relevant journals. Publications were included if they examined occupational hazards in oil palm plantation workers. RESULTS: 941 publications were identified; of these, 25 studies were found eligible to be included in the final review. Of the 25 studies examined, 19 were conducted in Malaysia, 2 in Costa Rica, and one each in Ghana, Indonesia, Myanmar, Papua New Guinea, and Cameroon. Oil palm plantation workers were found to be at risk of musculoskeletal conditions, injuries, psychosocial disorders, and infectious diseases such as malaria and leptospirosis. In addition, they have potential exposure to paraquat and other pesticides. CONCLUSION: In light of the potential of palm oil for use as a biofuel, this is an industry with strong growth potential. The workers are exposed to various occupational hazards. Further research and interventions are necessary to improve the working conditions of this already vast and growing workforce.

Towards a standard diet-induced and biopsy-confirmed mouse model of non-alcoholic steatohepatitis: Impact of dietary fat source.

BACKGROUND: The trans-fat containing AMLN (amylin liver non-alcoholic steatohepatitis, NASH) diet has been extensively validated in C57BL/6J mice with or without the Lepob/Lepob (ob/ob) mutation in the leptin gene for reliably inducing metabolic and liver histopathological changes recapitulating hallmarks of NASH. Due to a recent ban on trans-fats as food additive, there is a marked need for developing a new diet capable of promoting a compatible level of disease in ob/ob and C57BL/6J mice. AIM: To develop a biopsy-confirmed mouse model of NASH based on an obesogenic diet with trans-fat substituted by saturated fat. METHODS: Male ob/ob mice were fed AMLN diet or a modified AMLN diet with trans-fat (Primex shortening) substituted by equivalent amounts of palm oil [Gubra amylin NASH, (GAN) diet] for 8, 12 and 16 wk. C57BL/6J mice were fed the same diets for 28 wk. AMLN and GAN diets had similar caloric content (40% fat kcal), fructose (22%) and cholesterol (2%) level. RESULTS: The GAN diet was more obesogenic compared to the AMLN diet and impaired glucose tolerance. Biopsy-confirmed steatosis, lobular inflammation, hepatocyte ballooning, fibrotic liver lesions and hepatic transcriptome changes were similar in ob/ob mice fed the GAN or AMLN diet. C57BL/6J mice developed a mild to moderate fibrotic NASH phenotype when fed the same diets. CONCLUSION: Substitution of Primex with palm oil promotes a similar phenotype of biopsy-confirmed NASH in ob/ob and C57BL/6J mice, making GAN diet-induced obese mouse models suitable for characterizing novel NASH treatments.

Palm Oil on the Edge.

Internationally recognized Spanish experts in the food industry, nutrition, toxicology, sustainability, and veterinary science met in Madrid on July 2018 to develop a consensus about palm oil (PO) as a food ingredient. Their aim was to provide a useful, evidence-based point of reference about PO. Scientific evidence about the role of PO in food safety, nutrition and sustainability was analyzed. Main conclusions were: (1) RSPO foundation responded to the environmental impact of palm crops. The Amsterdam Declaration pursues the use of 100% sustainable PO in Europe by 2020. Awareness about choosing sustainable products will help to maintain local economies and environments in the producing countries; (2) evidence shows that a moderate intake of PO within a healthy diet presents no risks for health. No evidence justifies any change fat intake recommendations; (3) food industry is interested in assuring safe, sustainable and high-quality products. The use of certified sustainable PO is increasing; and (4) there is no evidence associating PO consumption and higher cancer risk, incidence or mortality in humans. Tolerable daily intake (TDI) for toxic contaminants (2-and 3-monochloropropanediols (MCPDs), glycidyl esters (GEs)) have been established by JECFA and EFSA. Consequently, the European Commission has modified the Contaminants Regulation for GEs and it is still working on 3-MCPDs'.

Effect of palm oil consumption on plasma lipid concentrations related to cardiovascular disease: a systematic review and meta-analysis.

BACKGROUND AND OBJECTIVES: The precise association between palm oil consumption and lipid-related cardiovascular disease risk remains unclear. A systematic review was thus performed to assess whether palm oil consumption has a negative effect on plasma lipid-related cardiovascular disease marker levels. METHODS AND STUDY DESIGN: In June 2018, the electronic bibliographic databases PubMed, EMBASE (Ovid), the Cochrane Library (Ovid) and the Chinese National Knowledge Infrastructure were searched and a total of 11 eligible dietary intervention articles involving 961 volunteers were selected. Both random and fixed effect models were used to calculate pooled weighted mean differences (WMD). RESULTS: A total of 11 articles involving 547 participants met the inclusion criteria. The pooled analysis revealed that palm oil increased the concentration of high-density lipoprotein cholesterol (WMD: 0.15 mmol/L; p<0.00001). Palm oil consumption had no significant effects on blood total cholesterol (WMD: -0.01 mmol/L; p=0.82) and LDL-c (WMD: -0.05mmol/L; p=0.10) and triglyceride concentrations (WMD: 0.00 mmol/L; p=0.96), relative to the effects of unsaturated fatty acid consumption. Subgroup analyses revealed that palm oil has a beneficial effect on High-density lipoprotein cholesterol levels when more than 30% of total dietary energy was constituted by fat. CONCLUSIONS: This review revealed that palm oil does not induce increases in cardiovascular disease risk risk-related biomarkers relative to unsaturated fatty acids. Furthermore, larger-scale samples of human dietary intervention trials are required to increase the accuracy of meta-analyses.

The palm oil industry and noncommunicable diseases.

Large-scale industries do not operate in isolation, but have tangible impacts on human and planetary health. An often overlooked actor in the fight against noncommunicable diseases is the palm oil industry. The dominance of palm oil in the food processing industry makes it the world's most widely produced vegetable oil. We applied the commercial determinants of health framework to analyse the palm oil industry. We highlight the industry's mutually profitable relationship with the processed food industry and its impact on human and planetary health, including detrimental cultivation practices that are linked to respiratory illnesses, deforestation, loss of biodiversity and pollution. This analysis illustrates many parallels to the contested nature of practices adopted by the alcohol and tobacco industries. The article concludes with suggested actions for researchers, policy-makers and the global health community to address and mitigate the negative impacts of the palm oil industry on human and planetary health.

Les grandes industries ne fonctionnent pas en vase clos; elles ont des effets tangibles sur la santé des individus et de la planète. Un acteur souvent négligé dans la lutte contre les maladies non transmissibles est l'industrie de l'huile de palme. Étant donné sa prédominance dans l'industrie alimentaire, l'huile de palme est l'huile végétale la plus largement produite au monde. Nous avons appliqué les déterminants commerciaux de la santé pour analyser l'industrie de l'huile de palme. Nous mettons en évidence la relation mutuellement profitable entre cette industrie et l'industrie des aliments transformés ainsi que ses effets sur la santé des individus et de la planète, et notamment des pratiques culturales néfastes liées à des maladies respiratoires, la déforestation, la diminution de la diversité biologique et la pollution. Cette analyse établit de nombreux parallèles avec la nature contestée de pratiques adoptées par les industries de l'alcool et du tabac. L'article se conclut par des propositions d'action pour que les chercheurs, les responsables politiques et la communauté mondiale de la santé examinent et atténuent les effets négatifs de l'industrie de l'huile de palme sur la santé des individus et de la planète.

Las industrias a gran escala no operan de forma aislada, sino que tienen un impacto tangible en la salud humana y del planeta. Un agente que a menudo se ignora en la lucha contra las enfermedades no contagiosas es la industria del aceite de palma. El predominio del aceite de palma en la industria del procesamiento de alimentos lo convierte en el aceite vegetal más producido del mundo. Se han aplicado los determinantes comerciales del marco de la salud para analizar la industria del aceite de palma. Cabe destacar la relación mutuamente beneficiosa de la industria con la industria de los alimentos procesados y su impacto en la salud humana y del planeta, incluidas las prácticas de cultivo perjudiciales que están relacionadas con las enfermedades respiratorias, la deforestación, la pérdida de biodiversidad y la contaminación. Este análisis ilustra muchos paralelismos con la naturaleza controvertida de las prácticas adoptadas por las industrias del alcohol y el tabaco. El artículo concluye con varias sugerencias de posibles medidas para que los investigadores, los responsables de la formulación de políticas y la comunidad mundial de la salud aborden y mitiguen los impactos negativos de la industria del aceite de palma en la salud humana y del planeta.

[Palm oil and cardiovascular health: considerations to evaluate the literature critically]. / Aceite de palma y salud cardiovascular: consideraciones para valorar la literatura.

Palm oil is obtained from Elaeis guineensis, E. oleifera or the hybrid OxG palm fruits. When crude, it contains high carotenoid concentrations (responsible for the red color), tocopherols and tocotrienols, but most of them are eliminated during its refining. Palm oil main components are palmitic and oleic acids, both near 50%, but their proportion changes depending on the fraction used. Fatty acids absorption and the effect on blood lipid profile depend on the position in the triacylglycerol, especially in the sn-2 position. The location of the monounsaturated or saturated fatty acids varies depending on the type of palm oil or fraction used. We critically review the two main reviews published about palm oil, which analyze 67 publications, and several studies that are more recent. Most of the studies were performed in non-European countries where palm oil is the main culinary oil. The effect on cardiovascular risk factors depends on the fat used as counterpart. Palm oil improves lipid profile after a diet rich in trans and saturated fats, while it impairs lipid profile after a diet rich in monounsaturated and polyunsaturated fats. Relevant methodological errors have been identified, such as not differentiating between palm oil, palm kernel oil and their fractions, comparing single fatty acids with whole oils or fats, or not considering physical activity or other factors that can affect blood lipids. No studies considering palm oil as an ingredient in a Mediterranean diet context, where olive oil is the main culinary oil, were found, so extrapolation of data is currently very difficult.

El aceite de palma se obtiene de los frutos de Elaeis guineensis, E. oleifera y el cruce de ambas, OxG (híbrida). En crudo contiene gran proporción de carotenoides (responsables del color rojo), tocoferoles y tocotrienoles, pero se pierden durante su refinado. En su composición destacan los ácidos grasos palmítico y oleico, casi al 50%, aunque su proporción varía según la fracción en la que se utilizan. La absorción de los ácidos grasos y, por tanto, su efecto sobre el perfil lipídico plasmático dependen de su posición en el triglicérido, especialmente en sn-2. Según el aceite de palma o la fracción, variará dicha posición de los ácidos grasos monoinsaturados o saturados. Se revisan críticamente las dos principales revisiones publicadas en relación al aceite de palma, que incluyen un total de 67 artículos, además de otros estudios más recientes. La mayoría se realizan en países no europeos donde el aceite de palma es el principal aceite culinario. Su efecto sobre el perfil cardiovascular varía según con qué se compare, mejorándolo frente a las grasas trans y saturadas y empeorándolo frente a las grasas mono y poliinsaturadas. Hemosdetectado errores metodológicos importantes, como no diferenciar entre palma, palmiste o fracciones, comparar ácidos grasos con aceites o no considerar la actividad física y otros factores que influyen sobre el perfil lipídico. No hemos encontrado estudios realizados con aceite de palma como ingrediente de alimentos en un contexto de dieta mediterránea, donde el principal aceite culinario es el de oliva, que serían los extrapolables a nuestro entorno.

Aceite de palma y salud cardiovascular: consideraciones para valorar la literatura / Palm oil and cardiovascular health: considerations to evaluate the literature critically

El aceite de palma se obtiene de los frutos de Elaeis guineensis, E. oleifera y el cruce de ambas, OxG (híbrida). En crudo contiene gran proporción de carotenoides (responsables del color rojo), tocoferoles y tocotrienoles, pero se pierden durante su refinado. En su composición destacan los ácidos grasos palmítico y oleico, casi al 50%, aunque su proporción varía según la fracción en la que se utilizan. La absorción de los ácidos grasos y, por tanto, su efecto sobre el perfil lipídico plasmático dependen de su posición en el triglicérido, especialmente en sn-2. Según el aceite de palma o la fracción, variará dicha posición de los ácidos grasos monoinsaturados o saturados. Se revisan críticamente las dos principales revisiones publicadas en relación al aceite de palma, que incluyen un total de 67 artículos, además de otros estudios más recientes. La mayoría se realizan en países no europeos donde el aceite de palma es el principal aceite culinario. Su efecto sobre el perfil cardiovascular varía según con qué se compare, mejorándolo frente a las grasas trans y saturadas y empeorándolo frente a las grasas mono y poliinsaturadas. Hemosdetectado errores metodológicos importantes, como no diferenciar entre palma, palmiste o fracciones, comparar ácidos grasos con aceites o no considerar la actividad física y otros factores que influyen sobre el perfil lipídico. No hemos encontrado estudios realizados con aceite de palma como ingrediente de alimentos en un contexto de dieta mediterránea, donde el principal aceite culinario es el de oliva, que serían los extrapolables a nuestro entorno

Palm oil is obtained from Elaeis guineensis, E. oleifera or the hybrid OxG palm fruits. When crude, it contains high carotenoid concentrations (responsible for the red color), tocopherols and tocotrienols, but most of them are eliminated during its refining. Palm oil main components are palmitic and oleic acids, both near 50%, but their proportion changes depending on the fraction used. Fatty acids absorption and the effect on blood lipid profile depend on the position in the triacylglycerol, especially in the sn-2 position. The location of the monounsaturated or saturated fatty acids varies depending on the type of palm oil or fraction used. We critically review the two main reviews published about palm oil, which analyze 67 publications, and several studies that are more recent. Most of the studies were performed in non-European countries where palm oil is the main culinary oil. The effect on cardiovascular risk factors depends on the fat used as counterpart. Palm oil improves lipid profile after a diet rich in trans and saturated fats, while it impairs lipid profile after a diet rich in monounsaturated and polyunsaturated fats. Relevant methodological errors have been identified, such as not differentiating between palm oil, palm kernel oil and their fractions, comparing single fatty acids with whole oils or fats, or not considering physical activity or other factors that can affect blood lipids. No studies considering palm oil as an ingredient in a Mediterranean diet context, where olive oil is the main culinary oil, were found, so extrapolation of data is currently very difficult

Clinical side effects after oral administration of palm oil and Alchornea cordifolia decoction in a child.

Alchornea cordifolia is known to be a plant with a variety of medicinal properties and is quoted by many traditional healers to treat a variety of medicinal problems in the Democratic Republic of Congo. However, very little is known about its potential toxicity. We report the case of a 9-year-old boy referred for assessment of suspected bronchial troubles without a history of atopic disease or drug allergy who developed dyspnea, dysphagia, asthenia and lingual ulcers within 30 minutes after nasal and oral administration of decoction of palm oil associated with A. cordifolia leaves in water. In the present report, adverse effects of A. cordifolia therapy may be related to the mixtures of active compounds that they contain and can cause the symptoms observed in our patient. These findings call for caution in the use of A. cordifolia especially in children.

The development and implementation of a new import duty on palm oil to reduce non-communicable disease in Fiji.

BACKGROUND: Non communicable diseases (NCD) place a significant health burden on Pacific Island countries including Fiji. Policy interventions to curb NCDs have been implemented in Fiji including a 32% increase in the import duty on palm oil. This study aims to analyse the development and implementation of the increase in palm oil import duty in Fiji. Also, to document the policy process, identify barriers and facilitators during implementation and to examine the impact of the new import duty on import volumes. METHODS: Data were collected through key informant interviews with private stakeholders, government officials and supermarket managers. Transcripts were analysed thematically. Import volumes were analysed for the 2010-2015 period. RESULTS: Facilitators of policy development and implementation included stakeholder awareness of the health implications of palm oil, preparation of a comprehensive policy briefing paper, and inter-sectoral support and leadership. This decrease in the availability of palm oil was encouraging however, it may have been counteracted to some extent by industry relabelling the product as vegetable oil. CONCLUSIONS: Barriers to policy changes need to be anticipated during the policy development process. Whilst the decline in imports probably reduced population consumption, further research is needed to determine if this translated to a population wide reduction in saturated fat.

The gut microbiota drives the impact of bile acids and fat source in diet on mouse metabolism.

BACKGROUND: As the gut microbiota contributes to metabolic health, it is important to determine specific diet-microbiota interactions that influence host metabolism. Bile acids and dietary fat source can alter phenotypes of diet-induced obesity, but the interplay with intestinal microorganisms is unclear. Here, we investigated metabolic consequences of diets enriched in primary bile acids with or without addition of lard or palm oil, and studied gut microbiota structure and functions in mice. RESULTS: In combination with bile acids, dietary lard fed to male C57BL/6N mice for a period of 8 weeks enhanced fat mass accumulation in colonized, but not in germ-free mice when compared to palm oil. This was associated with impaired glucose tolerance, lower fasting insulin levels, lower counts of enteroendocrine cells, fatty liver, and elevated amounts of hepatic triglycerides, cholesteryl esters, and monounsaturated fatty acids. Lard- and bile acid-fed mice were characterized by shifts in dominant gut bacterial communities, including decreased relative abundances of Lachnospiraceae and increased occurrence of Desulfovibrionaceae and the species Clostridium lactatifermentans and Flintibacter butyricus. Metatranscriptomic analysis revealed shifts in microbial functions, including lipid and amino acid metabolism. CONCLUSIONS: Caution is required when interpreting data from diet-induced obesity models due to varying effects of dietary fat source. Detrimental metabolic consequences of a diet enriched with lard and primary bile acids were dependent on microbial colonization of the host and were linked to hepatic lipid rearrangements and to alterations of dominant bacterial communities in the cecum.

sn-2 Hypothesis: a Review of the Effects of Palm Oil on Blood Lipid Levels.

Saturated fats are commonly claimed to raise human blood cholesterols and contribute to cardiovascular disease. Previous literature data were highlighted that although palm oil is 50% saturated, it does not behave like a saturated fat. Human trials were conducted to compare the effects on serum cholesterol levels given by palm olein and monounsaturated oils. It was postulated that saturation/unsaturation of the fatty acids situated at sn-2 positions of triglycerides in the fat molecules determine the induced blood lipid levels but not the overall saturation of oils. The results showed that the lipid parameters (LDL and HDL) effects induced by these oils are similar with no significant differences. This study provides concrete evidence that the unsaturation levels of these oils at sn-2 position of TG are similar (90-100%) which are claimed to be responsible for the lipid parameters. In conclusion, the public negative perception on believing that the overall saturation of oils is detrimental to health should be corrected because in fact the unsaturation at sn-2 positions of the saturated vegetable fat such as palm olein and cocoa butter make them behave like mono-unsaturated oils, unlike saturated animal fats that possess a high content of saturated fatty acids at sn-2 position.

A phase I single-blind clinical trial to evaluate the safety of oil palm phenolics (OPP) supplementation in healthy volunteers.

Plant phenolics are being increasingly consumed globally with limited scientific and clinical evidence pertaining to safety and efficacy. The oil palm fruit contains a cocktail of phenolics, and palm oil production results in high volumes of aqueous by-products enriched in phenolics and bioactives. Several lines of evidence from in vitro and in vivo animal studies confirmed that the aqueous extract enriched in phenolics and other bioactives collectively known as oil palm phenolics (OPP) is safe and has potent bioactivity. A phase one clinical trial was conducted to evaluate the safety and effects of OPP in healthy volunteers. In this single-blind trial, 25 healthy human volunteers were supplemented with 450 mg gallic acid equivalent (GAE)/day of OPP or control treatments for a 60-day period. Fasting blood and urine samples were collected at days 1, 30 and 60. Medical examination was performed during these trial interventions. All clinical biochemistry profiles observed throughout the control and OPP treatment period were in the normal range with no major adverse effect (AE) or serious adverse effect (SAE) observed. Additionally, OPP supplementation resulted in improvement of total cholesterol and LDL-C levels, compared to the control treatment. The outcomes support our previous observations that OPP is safe and may have a protective role in reducing cholesterol levels.

Pediatric Age Palm Oil Consumption.

Palm oil is widely used in the food industry for its chemical/physical properties, low cost and wide availability. Its widespread use has provoked an intense debate about whether it is a potential danger to human health. In a careful review of the scientific literature, we focused on nutritional characteristics and health effects of the use of palm oil with regards to children, seeking to determine whether there is evidence that justifies fears about the health effects of palm oil. Our review showed that palm oil represents a significant source of saturated fatty acids, to which scientific evidence attributes negative health effects when used in excess, especially with regards to cardiovascular diseases. However, to date, there is no evidence about the harmful effects of palm oil on the health of children. Nevertheless, palm oil has possible ill health effects linked to its composition of fatty acids: its consumption is not correlated to risk factors for cardiovascular diseases in young people with a normal weight and cholesterol level; the elderly and patients with dyslipidaemia or previous cardiovascular events or hypertension are at a greater risk. Therefore, the matter is not palm oil itself but the fatty-acid-rich food group to which it belongs. The most important thing is to consume no more than 10% of saturated fatty acids, regardless of their origin and regardless of one's age. Correct information based on a careful analysis of the scientific evidence, rather than a focus on a singular presumed culprit substance, should encourage better lifestyles.

Systematic review of palm oil consumption and the risk of cardiovascular disease.

BACKGROUND: The high amount of saturated fatty acids (SFA) coupled with the rising availability and consumption of palm oil have lead to the assumption that palm oil contributes to the increased prevalence of cardiovascular diseases worldwide. We aimed at systematically synthesising the association of palm oil consumption with cardiovascular disease risk and cardiovascular disease-specific mortality. METHODS: We systematically searched Central, Medline and Embase databases up to June 2017 without restriction on setting or language. We performed separate searches based on the outcomes: coronary heart disease and stroke, using keywords related to these outcomes and palm oil. We searched for published interventional and observational studies in adults (Age: >18 years old). Two investigators extracted data and a consensus was reached with involvement of a third. Only narrative synthesis was performed for all of the studies, as the data could not be pooled. RESULTS: Our search retrieved 2,738 citations for stroke with one included study and 1,777 citations for coronary heart disease (CHD) with four included studies. Palmitic acid was reported to be associated with risk of myocardial infarction (MI) (OR 2.76; 95%CI = 1.39-5.47). Total SFA intake was reported to be not significant for risk of MI. Varying intake of fried foods, highest contributor to total SFA with 36% of households using palm oil for frying, showed no significant associations to risk of MI. Odds of developing first non-fatal acute MI was higher in palm oil compared to soybean oil with 5% trans-fat (OR = 1.33; 95%CI = 1.09-1.62) than palm oil compared to soybean oil with 22% trans-fat (OR = 1.16; 95%CI = 0.86-1.56). Nevertheless, these risk estimates were non-significant and imprecise. The trend amongst those taking staple pattern diet (characterised by higher palm oil, red meat and added sugar consumption) was inconsistent across the factor score quintiles. During the years of 1980 and 1997, for every additional kilogram of palm oil consumed per-capita annually, CHD mortality risk was 68 deaths per 100,000 (95% CI = 21-115) in developing countries and 17 deaths per 100,000 (95%CI = 5.3-29) in high-income countries, whereas stroke was associated with 19 deaths per 100,000 (95%CI = -12-49) and 5.1 deaths per 100,000 (95% CI: -1.2-11) respectively. The evidence for the outcomes of this review were all graded as very low. The findings of this review should be interpreted with some caution, owing to the lack of a pooled effect estimate of the association, significant bias in selection criteria and confounding factors, inclusion of other food items together with palm oil, and the possible out-dated trend in the ecological study. CONCLUSION: In view of the abundance of palm oil in the market, quantifying its true association with CVD outcomes is challenging. The present review could not establish strong evidence for or against palm oil consumption relating to cardiovascular disease risk and cardiovascular disease-specific mortality. Further studies are needed to establish the association of palm oil with CVD. A healthy overall diet should still be prioritised for good cardiometabolic health.